biography work dementia

What is Life Story Work?

Black and white photos laid on table. The back of a person's head, with their hands holding a photo.

What is life story work?

Everybody has a unique life story, which helps to shape our identity from our life experience. People living with dementia may need help to communication parts of their identity, such as their interests, who and what is important to them.

Life Story work is an activity in which the person with dementia is supported by family members and/or carers and care staff to gather and review their past life events. The person’s personal biography is then recorded in a scrapbook, album, journal, or video.

It is used to help the person understand their past experiences and events in their life.

Benefits of Life Story Work

As a tool to help reminisce, trigger positive feelings and an increased sense of wellbeing.

To help the person develop closer relationships with family, friends, carers and care staff through sharing stories.

Life story work can help people with dementia to better communicate their needs and wishes. For example, if they have close relationships with certain friends or have certain preference of clothing. This can be useful when the person living with dementia may have difficulty sharing this information themselves.

A person's life story work can inform their care and ensure that it is provided in a positive way that suits their needs and preferences.

Interested in learning more about life story work? Why not join BRACE ambassador and Dementia Consultant and Campaigner, Beth Britton online, Wednesday 9th June at 11am. Beth will be offering a talk on: Beth Britton: Life story, Wellbeing and Dementia

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Life Story Work

Learning about someone’s life can give a real insight in to how somebody might be feeling. This knowledge then helps us to support someone in a more personalised way. It’s also a great way to develop a relationship and learn some fascinating things!

This page has top tips and resources to help you learn more about a person with dementia’s life story.

Knowing about the person and their past is the first step. Life story work is recognised as vital to person-centred dementia care. It’s a tool to get to know someone, and the better you know someone, the better relationships with staff, family and carers can be. A record of experiences, likes and dislikes is very useful when someone is moving between care settings or when different professionals are involved in a person’s care.

What are the benefits of Life Story work?

It can help people with dementia share their stories and enhance their sense of identity. This is especially useful when they are having difficulty in sharing this information themselves.
Life Story work can help encourage better communication and an understanding of the person’s needs and wishes. This can inform their care and ensure that it is provided in a positive and person-centred way.
It can help the person develop closer relationships with family carers and staff through sharing stories.
It helps family members develop a closer bond with the person with dementia, through sharing their stories.
It gives professional carers an understanding of the person’s life, and a better understanding of the person’s needs, allowing them to communicate with the person and care for them in the best way possible.
It enables professionals to better understand and engage with the person they care for.

What does Life Story work look like?

There are several ways that Life Story work can be practiced, and you can choose the format – or a combination of formats – that works best for the person with dementia. These include:

Books: this format is portable and can be easily accessible to carers and visitors. Keep it simple with photos and clear, easy-to-read text. Multi-colour and patterns can be confusing for people with dementia, so clear and simple with two contrasting colours is the best approach. It may be a good idea to laminate the final copy to protect it from damage. Many care settings have their own life story book formats so you may need to transfer the information into their template.
Collages: these are less adaptable as things change. But images work well to encourage reminiscing and can be useful for people in later stages of dementia.
Video recordings: are a good way to record visual information, such as family films and messages from the person with dementia to their family, friends and carers. They can also be added to, or amended as life changes.
Reminiscence or memory box: these can be particularly useful for people with sensory impairments, such as sight loss or perceptual problems; or for those people in the later stages of dementia, when touch or smell are relied on more to communicate.
Apps: there are a number of Apps (downloadable computer programmes for your phone or tablet), to help save and share photos and memories of special places; by marking them on a map, or playing video and audio. They’re simple to use and suitable for people in earlier stages of dementia.
Personal profile documents/one-page profiles: these are short versions of a Life Story often used in hospitals designed to help staff understand the person’s needs.

How to create a Life Story

When creating a Life Story, involve the person with dementia in the process as fully as possible. This makes the Life Story more likely to reflect the person’s wishes and preferences and encourages a sense of ownership. Talk together, help them where needed, and write or type the information together so they can see the story forming with you.

Go with the flow and let the person talk about an aspect of their life they’re most comfortable with. You don’t have to start at the beginning. Try taking one topic at a time so it doesn’t become overwhelming. Take breaks and complete the story at your own pace; it might take days, weeks, or months. Remember you can always add to it later.

If someone finds it difficult to communicate their life story, other family members and friends may be able to provide key information. You can also try to prompt them by using familiar photos of people or places.

Reflecting on our lives can be emotional so sensitivity is needed. Don’t be afraid of this but think carefully about what information the person would want to be shared.

Content of a Life Story

Good topics to focus on are:

Basic current information: name, age, where they live etc.
Significant relationships with family and friends
Their childhood
Working life
Significant places and life events
Preferences with their appearance
Food likes and dislikes
Their routines
Music/TV preferences
Activities they enjoy/don’t enjoy
General likes and dislikes

Try not to bombard the person with too many specific questions. General questions or opening up the conversation about a topic may be easier. For example: “Can you tell me about where you grew up?”

You can design a life story box/book/film/song in any way meaningful to the person with dementia however, if you are looking for a more structured template, The Alzheimer’s Society & Dementia UK have resources to print which can be found below:

Dementia UK: https://www.dementiauk.org/life-story-work/

This is Me – Alzheimer’s Society: https://www.alzheimers.org.uk/sites/default/files/2020-03/this_is_me_1553.pdf

Supporting those with dementia: Reminiscence therapy and life story work

This Insight looks at reminiscence therapy and life story work for those with dementia.

Reminiscence therapy and life story work are valuable psychotherapeutic approaches
Reminiscence therapy and life story work can improve the mood, cognitive ability and well-being of those with mild to moderate dementia
Research suggests that the effects of biographical interventions are weaker for people with severe dementia
There is evidence to support the view that life story work can improve the relationship, whether family or professional, between the person with dementia and their carer(s)
Reminiscence therapy and in particular life story work provide a context for the provision of person-centred care, whether in the home, nursing home or hospital context
Life story work can be especially valuable when the person with dementia is transferred from a home to an institutional setting, or between institutions

Current situation and policy context

Dementia is a priority for the Scottish Government and this is reflected in the publication of Scotland's National Dementia Strategy (June 2010). In Scotland there are an estimated 71,000 people with dementia. This number is expected to double over the next 25 years. Some 64% of dementia sufferers live in their own homes, with the others living in care homes. Approximately 70% of care home residents may have dementia. There is some evidence to support the view that a healthy lifestyle comprised of good nutrition, adequate exercise and social relations may reduce the risk of developing dementia in later life. However, there is no single prophylactic (drug or lifestyle choice) that prevents the onset of the condition.

Part of the government's focus on dementia involves ensuring that people with the disease get access to the care and support they need, and this includes reducing the use of psychoactive medication where possible. Research highlights the various alternatives to drugs that are available to those with dementia. The therapies most commonly referenced are reminiscence therapy, including life story work, cognitive orientation and cognitive stimulation therapy. Reminiscence therapy has attracted considerable attention in recent years and there is a growing body of literature that supports using this technique with people with mild to moderate dementia.

Studies undertaken with those with severe dementia have yielded mixed, but occasionally encouraging, results (Hoerster et al, 2001; McPherson et al, 2001).

Reminiscence therapy is a biographical intervention that involves either group reminiscence work, where the past is discussed generally, or the use of stimuli such as music or pictures. Although closely related to reminiscence therapy, life story work tends to focus on putting together a life story album for an individual (Moos and Bjorn, 2006). Evidence suggests that reminiscence therapy can lead to overall improvements in depression and loneliness and promote psychological well-being (Chiang et al, 2010). Research also supports the view that reminiscence therapy, including life story work, can improve relationships between people with dementia and their carers and thereby 'benefits both' (Woods et al, 2009:1; Clarke et al, 2003; McKeown et al, 2006). Other reported benefits include enhancing the opportunity to provide personal and individualised care and assisting the individual move between different care environments such as home to care home, or between care homes (Murphy, 2000).

In Scotland, policies dealing with dementia and the provision of social and other types of support have focused on care and respect (Charter of Rights for People with Dementia and their Carers in Scotland, 2009), and at improving staff skills and knowledge. Ensuring that care staff have information about the person with dementia, including their likes and dislikes and not just their diagnosis, has been seen as critical to providing effective support (Scotland's National Dementia Strategy, 2010). The 2009 report from the Care Commission and the Mental Welfare Commission, Remember, I'm Still Me , cautioned that the use of psychoactive drugs should be the course of last, rather than first resort, when responding to challenging behaviour.

Working with Older People in Scotland (NES, 2007) stipulates that nurses should demonstrate sensitivity to the older person, by understanding their cultural, spiritual and social background and should seek to engage with them through their values and aspirations. Additionally, nursing practitioners should, 'draw on a range of different psychological and psychosocial approaches appropriate to the older person' (p19). Of key importance and heavily emphasised in this document is the ability of the nursing practitioner, at all levels, to 'promote collaboration with the older person, recognising their individual life story and values' and that this should 'inform all care decisions' (p21). Within this context reminiscence therapy, and more specifically life story work, have been recognised as offering ways for those with dementia to articulate their needs, and for allowing care and nursing staff to deliver person- centred care.

Barriers to using reminiscence therapy and life story work

Clarke and colleagues (2003) reveal the expressed concern of care staff that psychological types of therapy involving discussion and personal interaction are often not viewed as 'real work'. Another view explored by Kerr et al (2005) suggests that depression in older people is viewed as somehow natural, even when evidence indicates that a range of interventions, many of them psychotherapeutic, can be effective. If reminiscence therapy and life story work are to be used as effective treatments for those with mild to medium cognitive impairment, it is important that the potential value of these psychotherapeutic approaches is understood by care staff and endorsed by those in managerial positions.

Research evidence

The research evidence on reminiscence therapy has examined its impact on older people with dementia and those without the disease. Research by Chiang and colleagues (2010) among older people without dementia in institutions in Taiwan, found that there was a positive effect amongst research subjects involved in reminiscence therapy that was not found in the control group. The study found that those participants involved in reminiscence therapy were more sociable, less depressed and showed stronger signs of well-being than control group members. The relatively small sample size, its composition (all male) and short-term nature of the study (three months) mean that the results, although favourable, cannot be generalised to the whole population.

Other studies conducted amongst individuals with dementia have delivered very encouraging findings on the effect of reminiscence therapy. Although the Cochrane review (Woods et al, 2009) found that evidence in support of reminiscence therapy for those with dementia was inconclusive, they indicated that at a meta-analytical level, the combined results of the studies showed that reminiscence therapy has the following positive effects:

Improvements in cognition and mood of those with dementia
Reductions in the strain experienced by care-givers and relatives
Improvements in functional ability of dementia participants
Reductions in the symptoms of depression

Of considerable significance is the finding that, 'no harmful effects were identified on the outcomes measures reported' (p2). A study by McKee and colleagues (2003) identified several positive effects of reminiscence therapy and emphasised the enjoyment of those involved. The Alzheimer's Society is strongly in favour of the reminiscence therapy approach and outline it in their publication Memories are Made of This (Heathcote, 2009). The main benefits to the individual are cited as follows:

Empowerment
Raised self-esteem
Improved communication
Stimulation and fun
Enhanced mood.

While current research findings are encouraging and supportive of the use of reminiscence therapy, there is still a need for thorough, rigorous research on the therapy to further substantiate the effectiveness of the approach.

Aims and models of delivery

Reminiscence therapy and life story work can be utilised in a number of ways; indeed, the variation in the methods of possible delivery further confound many of the research results considered in the Cochrane review and in this document. The short synopsis of approaches outlined below is intended to be indicative, rather than exhaustive, of the various approaches to delivering reminiscence therapy and life story work.

The aims of reminiscence therapy and life story work are varied
Uncover or preserve the identify of older people (Murphy, 2000; Clarke et al, 2003)
Improve the quality of life through the impact of 'being listened to' (McKee et al, 2003)
Allow staff to see beyond the diagnosis (Murphy 2000; Clarke et al, 2003)
Facilitate communication between the person with dementia and their families (Batson et al, 2002)
Provide enjoyment for the recipient of therapy (Murphy, 2000)

Reminiscence therapy and life story work therapy can range from one-to-one delivery to group work. It may involve the development of a life story album for a person (care home staff and relatives can assist with its formation), or it may involve group reminiscence work where memory prompts such as photographs are shown. The life story approach allows the individual to map where they have been, their jobs, the food they enjoy and other information specific to their life. It provides a context and focus for engagement with care home staff and family members. The Alzheimer's Society publication Memories are Made of This presents a valuable starting point for those wishing to understand and apply the technique as part of a care strategy.

Implications for practice

The Dementia Strategy for Scotland highlights the case of an older man with dementia entering a care home. He was found to be disruptive, restless and angry, and was prescribed neuroleptics. However, he had previously been employed as a postman and had enjoyed a very active lifestyle yet had been denied access to outside space and exercise whilst resident in a care home. Adequate information about an individual with dementia is considered a fundamental requirement to developing and delivering person-centred care. Understanding the individual within the context of their 'life story' assists care staff develop appropriate care strategies and delivery methods. According to the foregoing research, life story work can also enhance the relationship between the dementia sufferer and their carer and/or family. It is the Alzheimer's Society's view that life story work, by pinpointing the likes, dislikes, spiritual and contextual aspects of a person's life, greatly enhances the ability for care staff to understand and respond to the individual with dementia, and to create a framework for delivering tailored personal care. Reminiscence therapy and particularly life story work are valuable tools for care staff in developing engagement with those with dementia. The Alzheimer's Society summarise the benefits of the approach for care staff as follows:

Supporting people with dementia
Improving understanding and engagement
Appreciating the person first and dementia second
Improving communication skills in terms of both listening and responding
Facilitating work with people and their families

A valuable repository of information for those wishing to learn about or use life story work can be found at http://www.lifestorynetwork.org.uk .

Biographical approaches provide older people with opportunities, if they so desire, to talk about their life experiences family, friends, work history, hobbies often using photographs and personal belongings as triggers to discussion. Exploring older people s past and present lives with them, particularly the circumstances which have shaped their experiences, potentially provides greater insights into their needs and aspirations and may help to challenge ageist stereotypes about later life. Listening to a person s life story is a powerful way of showing that they are valued as an individual and may also have a cathartic value. -Clarke, Hanson and Ross (2003)

Batson P, Thorne K and Peak J (2002) Life story work sees the person beyond the dementia, Journal of Dementia Care 10, 3,15-17
Chiang K J, Chu H, Chang H J et al (2010) The effects of reminiscence therapy on psychological well-being, depression, and loneliness among the institutionalised aged, International Journal of Geriatric Psychiatry, 25, 380-388
Clarke A, Hanson E J and Ross H (2003) Seeing the person behind the patient: enhancing the care of older people using a biographical approach, Journal of Clinical Nursing, 12, 697-706
Heathcote J (2009) Memories are made of this: Reminiscence activities for person-centred care, London: Alzheimer's Society
Hoerster L, Hickey E and Bourgeois M (2001) Effects of memory aids on conversations between nursing home residents with dementia and nursing assistants, Neuropsychological Rehabilitation, 11, 399-427
Kerr B, MacDonald C, Gordon J and Stalker K (2005) Effective Social Work with Older People, Edinburgh: Scottish Executive Social Research
McKee K, Wilson F, Elford H et al (2003) Reminiscence: is living in the past good for wellbeing? Nursing and Residential Care, 5, 489-491
McKeown J, Clarke A and Repper J (2006) Life story work in health and social care: systematic literature review, Journal of Advanced Nursing, 55, 237-247
McPherson A, Furniss F, Sdogati C et al (2001) Effects of individualised memory aids on the conversation of persons with severe dementia: a pilot study, Aging and Mental Health 5, 289-294
Moos I and Bjorn A (2006) Use of life story in the institutional care of people with dementia: a review of intervention studies, Ageing and Society, 26, 431- 454
Murphy C (2000) Crackin' lives: an evaluation of a life story book project to assist patients from a long stay psychiatric hospital in their move to community care situations, Stirling: Dementia Services Development Centre
NHS Education for Scotland (2007) Working with Older People in Scotland - A Framework for Mental Health Nurses
Woods B, Spector A, Jones C et al (2009) Reminiscence therapy for dementia (Review), www.thecochranelibrary.com

Iriss would like to thank the Dementia Services Development Centre at the University of Stirling for their help sourcing articles for this Insight

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Benefits of Life Story Work For People With Dementia

Getting a loved one to answer life story questions before a dementia diagnosis can have a significant impact on their wellbeing and the quality of care as their condition progresses.

Storii Team

April 13, 2023

Getting a loved one to answer life story questions can have a significant impact on their wellbeing and the quality of care they receive as they age. The World Health Organization estimates that 10 million people are diagnosed with dementia each year. Unfortunately, it is rather common for seniors to develop a form of dementia or mild cognitive impairment as they get older. Once someone has been diagnosed with Alzheimer’s, for instance, their memory is already starting to be negatively impacted. They may find it increasingly difficult to recall facts and stories from their past. Therefore, compiling life stories before a diagnosis is hugely important. It’s never too early to start documenting your own, or a loved one’s, life history. If you put in the effort now, you will inevitably thank yourself later.

How to Create a Life Story

There are different ways you can approach a Life Story. You might decide to interview someone and video record them talking about their life. Or you might decide to compile all their stories into a book with or without pictures. Another option is to use an online platform like Storii to compile an interactive life story over time, selecting the questions you want to answer and setting up email reminders. Once you decide on the format, you can consider what questions to ask and how the story should be told.

The most important aspect of creating a life story is to involve the person it’s about as much as possible if they aren’t taking the initiative already. This ensures that their likes and preferences are considered. It also gives them a sense of ownership, dignity and independence. Only help where needed and be sure to discuss ahead of time what they want out of this or what they envision it forming into.

If you are creating a life story for someone who has already been diagnosed with dementia, they might get anxious or upset if they can’t remember things as you ask questions. If this happens, stay calm and reassuring. Move on to another question or take a break. Keep in mind that using photos, music, or other memorabilia may be helpful for prompting memories. If someone finds it difficult to communicate life events, their friends and relatives might be good resources for providing key information.

You may also find these articles helpful:

10 Great Tips for a Life Story Interview

Tips for Doing Life Story Work With Someone Who Has Dementia

Life Story Content

What a life story addresses and focuses on is completely up to the individual. That said, in terms of capturing information that will support future carers, Dementia UK suggests covering:

Their profile, ie, basic information: name, age, where they live etc.
Significant relationships with family and friends
Their childhood
Working life
Significant places and life events
Preferences with their appearance
Food likes and dislikes
Their routines
Music/TV preferences
Activities they enjoy/don’t enjoy
General likes and dislikes

Benefits Life Story Work For People With Dementia

Having life story information documented prior to a dementia diagnosis can:

Improve care outcomes by giving care providers a deep understanding of the individual’s background, personality, interests and needs. This enables them to communicate and care for them in the most person-centered and tailored way possible.
Help an individual connect with their identity and sense of self as their condition progresses. Being able to engage with their own memories and convey who they are or what is important to them can boost confidence, engagement and communication. In the later stages of dementia, things like collages and memory boxes can aid reminiscence therapy and be particularly helpful for those with sensory impairments.
Support loved ones through a difficult time by providing them with a keepsake they will treasure forever. The process of recording a life story with your loved one can be a beautiful, emotional, healing, and bonding experience. Furthermore, a Life Story is a legacy that enables future generations to gain an understanding of who this person was and the incredible life they lived.

Preserving Memories Before They're Gone

Storii 's online platform is inherently collaborative, making it ideal for families affected by dementia. Multiple parties can work on putting the pieces of someone's history together in an easily sharable and incredibly meaningful format.

You can also check out how simple and easy Storii's Life Story Calls makes it to capture your friend or family member's memories and stories. Storii makes a great gift and enables people to build up a legacy over time to be cherished for many lifetimes.

Storii Gift Box

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The use of life story work with people with dementia to enhance person-centred care

Affiliation.

1 Department of Professional and Practice Development, Sheffield Health and Social Care NHS FT, Sheffield, UK. [email protected]
PMID: 20925716
DOI: 10.1111/j.1748-3743.2010.00219.x

Background: Person-centred care has been linked with quality of care but difficulties remain in person-centred care being implemented in care practice. This study explores the use of life story work to enhance person-centred care with people with dementia.

Aims and objectives: The study investigates how life story work is: understood and developed in practice; experienced by all participants and affects the delivery and outcomes of care.

Design and methods: The experience of older people with dementia, family carers and care staff in using life story work was explored within an NHS Health and Social Care Trust. A multiple case study design was adopted within a constructivist approach. Semi-structured interviews, observation, conversations were employed.

Findings: Life story work has the potential to: enable care staff to see the person behind the patient; allow family carers to uphold their relatives' personhood; enable the voice of the person with dementia to be heard, verbally and non-verbally; be enjoyable for all concerned and enable the person with dementia to feel proud about themselves and their lives.

Conclusion and implications for practice: Life story work has the potential to enhance person-centred care for older people with dementia and their families. Taking a practice development approach ensures that life story work can be implemented sensitively and is sustained in practice.

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In nursing care for people with dementia, biographical work is a popular concept. In the literature and practice, many different viewpoints of the way biographical work can/should be promoted exist. In the DEMIAN concept, a nursing concept to promote emotional well-being for people with dementia, it is also of major significance. This article gives an overview of the importance of biographical work in caring for people with dementia. In particular, the role and arrangement of biographical work in the DEMIAN concept are described. Within the anamnesis of the DEMIAN concept, meaningful themes are identified in conversations with different participants (person with dementia, reference persons, and care workers) and through observations. From these findings, specific interventions, aimed at supporting emotional well-being of people with dementia, are derived and integrated into everyday nursing care to promote emotional well-being. The potential of the DEMIAN nursing concept are discuss...

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The use of life stories and its influence on persons with dementia, their relatives and staff – a systematic mixed studies review

Vigdis Abrahamsen Grøndahl 1 ,
Mona Persenius 2 ,
Carina Bååth 2 &
Ann Karin Helgesen 1

BMC Nursing volume 16 , Article number: 28 ( 2017 ) Cite this article

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Dementia is an important predictor of nursing home admissions. Due to progressive dementia symptoms, over time it becomes difficult for persons with dementia to communicate their wishes and participate in decisions concerning their everyday lives. Their well-being, sense of dignity, integrity and personhood are at risk. The persons’ life stories have been highlighted as particularly important in dementia care and are referred to as seeing the person beyond the dementia. The aim of this study was to explore and describe the use of life stories and its influence on persons with dementia living in nursing homes, their relatives and staff.

A systematic mixed studies review was conducted. The literature searches were performed in the following databases: CINAHL, PubMed and PsycINFO and the Cochrane library, as well as by hand searching references in the studies included. An updated search was performed eight months after the first search. Data was synthesised inspired by integrative analysis.

Three studies using quantitative design and two studies (presented in three papers) using qualitative design representing research from 2006 to 2015 were included in the review. Life stories generally had a positive influence on the persons with dementia, their relatives, and staff. The use of life stories might contribute to ‘Maintenance of the person with dementia as a whole person rather than a demented patient’. On the other hand, enabling persons with dementia to tell their own story could be a challenge. For the staff it could be challenging when sensitive information emerged uninvited. Involving relatives could also be difficult as to whose story were uncovered.

Conclusions

The use of person’s life story might be of significance, but there is not enough evidence to make any statement about its importance as the research is scarce. Studies, including randomised controlled trials, are needed to measure the impact of life story work on the physiological and psychological aspects of persons with dementia, and also how it influences their relatives and staff.

Peer Review reports

Due to a greater prevalence of older people in society as a result of demographic changes, the incidence of persons with dementia has increased internationally [ 1 , 2 ]. It is estimated that there will be 48.1 million persons with dementia globally by 2020. This is expected to reach 90.3 million by 2040 [ 3 ]. Persons with dementia need care and support in many areas of their lives [ 2 ] and dementia is an important predictor of nursing home admissions [ 4 , 5 ].

Dementia is a collective term for several diseases that permanently and progressively reduce cognitive functions. Alzheimer’s disease is the most common cause of dementia, followed by vascular dementia, Lewy Body dementia and frontotemporal dementia [ 3 , 6 , 7 ]. As there is no medical curative treatment of dementia [ 2 , 7 ], specific nursing care that positively affects the quality of life of the person is of the utmost importance [ 8 , 9 ]. Kitwood’s work has been very influential in challenging the standard biomedical paradigm and offering an alternative for understanding dementia [ 8 , 10 , 11 ]. His conceptualisation of dementia highlighted the dialectic interplay between neuropathology and the social-psychological context of the individual, and contributed to the development of person-centred care within dementia care [ 11 , 12 , 13 ]. Since Kitwood’s work, various descriptions of person-centred care have been developed [ 14 , 15 ]. Other related concepts such as relationship-centred care [ 16 ], senses framework [ 17 ], and dementia care nursing [ 18 ] are also presented. These descriptions and concepts have much in common by supporting the person’s rights, values and beliefs, and involving the person with dementia in decision making [ 8 , 11 , 14 , 15 , 16 , 18 ].

It has been argued that it is the day-to-day decisions that are really omnipresent for persons with dementia [ 19 , 20 ] as the possibility of participating in decisions concerning their everyday life will most likely impact the person’s well-being and sense of dignity, integrity, and personhood [ 11 , 20 , 21 , 22 ]. However, due to progressive dementia symptoms such as increased cognitive and physical impairment, over time it will become more difficult for persons with dementia to express themselves, make choices, communicate their wishes and understand their present circumstances [ 23 , 24 ].

When this happens, relatives may be entitled, according to political documents, legislation and nurses’ ethical codes [ 25 , 26 , 27 , 28 , 29 ], to participate, together with the person with dementia, in order to take care of the his/her interests. A recent dissertation [ 20 , 30 ] has highlighted that relatives could be a link to good dementia care because by knowing the person’s life story and preferences they could share important information with nursing home staff. In a survey, the majority (98.7%) of relatives stated that they had good knowledge of the person’s habits and preferences. However, about 30% of relatives had not been asked to provide written information about their near ones, which shows that there is room for improvement in this issue [ 31 ]. Life story work that involves recording aspects of a person’s past and present life, and then using this information to benefit the person in his/her present situation [ 32 ], has been used in many countries within a range of health and social care settings [ 33 , 34 , 35 , 36 , 37 ].

Life stories are also used as a part of reminiscence work in which the person’s life reviews, often supported by photographs, artefacts and music, were actively used therapeutically [ 38 , 39 ]. A review of intervention studies that focused on the use of life stories in the care of persons with dementia, found positive changes in the integration of self and that the quality of life was enhanced [ 38 ]. Life story works have been highlighted as particularly important in dementia care [ 40 ] and are referred to as seeing the person beyond the dementia [ 41 ].

Since no recent reviews were found that focused on how the life stories of persons with dementia influence persons with dementia, their relatives and staff, this study was carried out.

The aim of this study was to explore and describe the use of life stories and its influence on persons with dementia living in nursing homes, their relatives and staff.

A systematic mixed studies review with an integrated design was undertaken to integrate and synthesise results from quantitative, qualitative and mixed methods studies [ 42 ]. The design was chosen to explore and describe the use of life stories’ influence on the person with dementia, the relatives and staff. The research group strived to use the methodological guidance of the Cochrane Collaboration [ 43 ] in the search and also to structure the review together with the guidelines from “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA) [ 44 ].

Eligibility criteria

Eligibility criteria were based on the aim of the review and were determined before the literature search started. The aim was explorative and descriptive, and the inclusion criteria reflect this.

Participants and setting

Studies comprising the use of life stories for persons with dementia living in nursing homes were included. Studies concerning the use of life stories for people living at home who received home care were excluded. Furthermore, studies focusing on life stories regarding people with mental health problems were excluded to ensure that the focus remained on persons with dementia.

Type of studies

Peer-reviewed papers using qualitative, quantitative or mixed methods, and presenting research in English, Norwegian, Swedish or Danish, were included. There were no limits regarding date of publication beyond the coverage of the databases themselves. Reviews and books were excluded from the review.

Studies were included when the outcome focused on the consequences of the use of life stories for the person with dementia, relatives and/or staff.

Identification of relevant literature

Information sources.

The literature searches were performed in three electronic databases: CINAHL via EBSCO, PubMed via NCBI and PsycINFO via OVID, as well as the Cochrane Library, 26 January 2015. An updated search was performed on 1 September 2015. ‘Dementia’ covering Dementia, Frontotemporal Dementia, Dementia Vascular, Dementia Multi-Infarct, Levy body Disease, Dementia Senile, Dementia Presenile, was used as a key search term in combination with the Boolean operator ‘AND’ with the search terms ‘biographical approach’ , ‘diary’ , ‘narratives’ , ‘life story’ or ‘life histories’ , and used as appropriate for the database. The full electronic search strategy for Pubmed is shown to exemplify the search: ((dementia [MeSH Major Topic] AND biographical approach), (dementia [MeSH Major Topic] AND diary), (dementia [MeSH Major Topic] AND narratives), (dementia [MeSH Major Topic] AND life story), (dementia [MeSH Major Topic] AND life history)). The references in the selected studies were scrutinised for further studies by looking for the key search phrases in the titles.

Study selection

A modified flow diagram (Fig. 1 ) shows the procedure for the identification and selection process. The electronic database searches revealed 798 papers, with a further six papers identified through the reference lists. Duplicates were removed which resulted in 749 papers. All four authors independently read the titles. All titles were assessed according to their relevance to ensure that the eligibility criteria and the aim of the study were met and screened on a scale from 1 (relevant), 2 (maybe relevant) to 3 (not relevant). There were 706 papers with a score of 3 which were excluded. The papers with scores 1 and 2 on the title (49 papers) were divided into two equal parts and two authors read one half of the abstracts, the other two authors read the other half and gave each abstract a score from 1 to 3. Abstracts with score 1 or 2 were then read by all four authors, and the scores were subsequently discussed until consensus was reached. As a result, 38 papers were excluded, leaving 11 papers. The 11 papers were assessed in full text by all four authors independently to ensure that the inclusion criteria were met. Four papers were excluded, leaving seven papers to be assessed for quality.

Flow diagram of the selection process. Source: modified version of flow diagram as reported by Moher et al. [ 44 ]

Appraisal and data extraction

The quality of each paper included in the review was assessed by two authors independently, using the Critical Appraisal Skills Programme Tools (CASP) for qualitative, quantitative and RCT studies [ 45 ], modified by Nordström and Wilde-Larsson [ 46 , 47 ]. A scoring system was used to rate the studies as low, medium or high quality. Papers with low quality scores were then reassessed by the two other authors. Any differences on quality ratings were discussed in the research group until agreement was reached. One study was excluded based on low quality. In total six papers were included in the synthesis. Information regarding aim, study design, research type, sample, intervention, outcomes and key results were extracted from the studies. See Table 1 for characteristics of included studies and quality assessment.

Methods of synthesis

An integrative analysis inspired by Sandelowski et al. [ 42 ] was conducted. The aim provided direction for the analyses of the results from the included papers.

The included studies represent research from 2006 to 2015 with three studies using quantitative design and two studies (presented in three papers) using qualitative design. Three of the papers are from the United Kingdom, one from the United States, one from Northern Ireland and one from Australia. The number of persons with dementia who participated was 70. In addition, there were 33 relatives and 159 members of staff. Five of the papers specified the age of the person with dementia, all papers specified gender, while three papers described the cognitive ability of the person with dementia. The relatives’ age and gender were specified in, respectively, one and three out of four papers, and their relationship to the person with dementia was described in all four papers. Among the five papers that included staff, four papers described the staff’s professions. The demographic characteristics of the participants included in the studies are shown in Table 1 .

Results from the integrative analyses of the six papers show that the use of life stories might contribute to ‘Maintenance of the person with dementia as a whole person rather than a demented patient’ as it enabled the voice of the person with dementia to be heard, enabled relatives to see their near one as a whole person and enabled staff to understand persons with dementia and their relatives. However, several challenges in creating and using life stories in care were also revealed, as described later.

Enable the voice of the person with dementia to be heard

The results showed that five of the papers concerned how the use of life stories might influence the person with dementia. The life story enabled the voice of persons with dementia to be heard and to feel proud about themselves and their lives [ 48 ]. However, enabling persons with dementia to tell their own life story could be a challenge due to memory loss. Joint authorship is referred to as a way of supporting the ability of persons with dementia to contribute to their own story [ 49 ].

After a life storybook process, persons with mild to moderate dementia scored significantly more positively on the outcome measures of cognition, depression, positive mood and communication than the control group [ 50 ]. Regarding quality of life as measured on the Quality of life-Alzheimer’s disease scale, to take part in the creation of their own life story book had significantly positive benefits for persons with dementia immediately after the life review session had been completed [ 51 ]. Their autobiographical memory also significantly improved. However, no difference was observed between the control and experimental group six weeks after having received the life storybook [ 51 ].

Kellett et al. [ 52 ] found that persons with dementia benefited when life stories were used, as both staff and relatives were more capable of stimulating and provoking memories, as well as knowing how to calm them when necessary.

Enable relatives to see their near one as a whole person

The results showed that two of the papers described how the use of life stories might influence relatives. Family members appreciated that life story work made their near ones more visible, present and heard [ 48 ]. They could now focus on their near ones as persons who had lived a meaningful life and enjoyed accomplishments throughout their lifetime [ 52 ]. Reviewing memories released relatives from the immediate dementia-related care in their everyday experience, thus enabling them to see their near ones as a whole person in new and different ways – even in ways not previously appreciated [ 52 ].

The relatives enjoyed participating in the process of implementing life stories [ 48 ] and they experienced great comfort and confidence in observing the ability of the nursing staff to recognise, value and incorporate life stories in everyday care [ 52 ]. The relatives also gained insight into their own grieving with regard to the process of their near ones’ dementia illness, something that helped them to cope with it more positively [ 52 ].

Enable staff to understand persons with dementia and their relatives

The results showed that five of the papers were about how the use of life stories might influence staff. Introducing a life story collage increased the staffs’ knowledge of the persons with dementia regarding family, jobs/careers, likes, dislikes and interests. It improved the relationship between staff and the persons with dementia, and the staffs’ involvement [ 53 ]. Life story work helped the staff to see the person with dementia as more than a patient and it enhanced their understanding of the person for whom they were caring [ 48 ]. The use of the family biography workshop, which is a structured process to facilitate the involvement of staff, family members and friends of the person with dementia in co-constructing biographies of their lives, gave the staff better knowledge of how to stimulate and provoke memories, and how to calm the person by using his/her biography. The staff discovered points of reference to communicate with the person with dementia and family and view them as part of a family history. The staffs’ understanding and insight into behaviour increased and they felt empowered to provide relationship-centred care rather than task-oriented care [ 52 ]. Further, staff attitudes to persons with dementia measured as hopefulness and person-centeredness, improved when a life story book was developed [ 51 ]. However, another study found that staff perceptions of individualised care or person-centred care practices did not improve significantly after introducing a life story collage [ 53 ].

McKeown et al. [ 49 ] found that life story work may be overused and underused, and that finding a balance is important. From the staff point of view it was sometimes a challenge when sensitive information and personal disclosures emerged uninvited. The results also showed that involving relatives could be a challenge as to whose story is uncovered. Questions were raised about the quality of the life story work when it had been created by relatives [ 49 ]. Developing a life story book either with the participation of the person with dementia or via relatives without involving the person with dementia improved the staff’s knowledge of the person with dementia regarding details such as hobbies, favourite food and school [ 51 ]. The process of creating life story work was perceived by staff as being enjoyable [ 48 ].

Discussions

The results of this review show that research into the use of life stories’ and its influence on persons with dementia, their relatives and staff is still scarce. Even though the literature search resulted in 749 papers once the duplicates had been removed, it was found that the majority of studies focused on the importance of the phenomenon of life story work and, to a much lesser extent, on how to actually use it and its influence on persons with dementia, their relatives and staff. Furthermore, among the included studies, the quality of four of the studies was rated as medium quality and only one was rated as high quality.

The total sample covered in this review is small and the included studies provide little information about persons with dementia, their relatives and staff, as well as the overall context. No specific diagnoses of the persons with dementia were mentioned and only two of the studies provided information about the person’s MMSE score. Consequently, as little or nothing about the diagnoses and the extent of the person’s cognitive impairment are known, it is not possible to explore possible relationships between diagnoses, degree of cognitive impairment, the use of life story and its influence on the persons with dementia, their relatives and staff. This information could be of interest as previous research shows that the more severe the dementia symptoms, the less the care is individualised and the less the relatives are involved in the care [ 20 ].

The integrated and synthesised results from the quantitative and qualitative studies show that use of life stories might contribute to ‘Maintenance of the person with dementia as a whole person rather than a demented patient’. This result is in line with what is referred to as ‘seeing the person beyond the dementia’, which is one of the goals of dementia care [ 11 , 20 , 41 ]. As this group of persons are at risk of becoming objectified and seen as non-persons, especially as the disease progresses [ 11 , 20 ], the use of life stories should be considered an important element of the care in order to preserve and enhance the dignity and well-being of the person with dementia. The latter has been highlighted as particularly important with regard to dementia care in several studies [ 20 , 54 , 55 ]. As no medical curative treatment of dementia exists [ 2 , 7 ], individually tailored care is crucial in order to offer the increasing number of persons with dementia and their relatives [ 1 ] high-quality professional care in the future.

As the results revealed several challenges both in creating and using the life stories in care, life story work has to be taken into consideration with a high level of sensitivity by the staff. It is therefore both worrying and striking that among the staff, there were only a few RNs. This might be a coincidence, but most likely is not. According to previous research, nursing homes are facing major challenges regarding a serious lack of personnel with formal health education [ 56 ] and the utmost need for a high degree of expertise in order to provide high-quality care is emphasised [ 30 ].

Methodological considerations

Using an integrated review method provides an opportunity to present a comprehensive understanding of a phenomenon of relevance to health care [ 57 ]. Even though only three quantitative and two qualitative studies were included in this review, presenting the existing knowledge is valuable, in order to start creating a knowledge base for using the persons’ life stories in dementia care, and also to uncover areas for further research.

The four researchers worked systematically in pairs to minimize subjectivity. The quality of the papers was assessed using a reliable quality assessment tool [ 45 ]. Any uncertainties were discussed in the research team until consensus was reached. This increased the validity and reliability of the selection and quality assessment process [ 43 , 57 ].

Different concepts have been used for describing the use of life stories, which made the search process challenging. To strengthen the validity, we elected to use five concepts based on our own knowledge of the field. These concepts were life histories, life story, narratives, diary and biographical approach. No further concepts were identified during the search process. To strengthen the reliability, a search update was performed in September 2015. No further studies were found. References in the chosen papers were scrutinised, but searches for ‘grey literature’ were not conducted.

The use of life stories was generally found to have a positive influence on persons with dementia, their relatives and staff. The theme ‘Maintenance of the person with dementia as a whole person rather than a demented patient’, was identified as representing a positive influence. Nevertheless, the total sample of studies was few, participants in the included studies were limited and the quality of four of the studies was assessed as medium. This result indicates that a rather simple intervention might have the potential to make positive changes for persons with dementia, their relatives and staff. There is a huge need for studies, including randomised controlled trials, to measure the impact of the use of life stories on physiological and psychological aspects of persons with dementia, and also how it influences their relatives and staff.

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Grøndahl, V.A., Persenius, M., Bååth, C. et al. The use of life stories and its influence on persons with dementia, their relatives and staff – a systematic mixed studies review. BMC Nurs 16 , 28 (2017). https://doi.org/10.1186/s12912-017-0223-5

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20 Reasons Why We Need to Know the Early Life History of People Living With Dementia

by, Eilon Caspi, ChangingAging Guestblogger

1. The human right of all people living with Alzheimer’s disease and other forms of dementia is to be with people who know their life story including cultural habits and religious faith (Bell & Troxel, 2003).

2. Developing friendships, relationships, and trust with people with dementia is the foundation of person-directed care (Bell & Troxel, 2003; Zgola, 1999). Knowing, understanding, and thoughtfully using the life history of the person with dementia are the keys to creating and maintaining this foundation.

3. The only way to truly understand an individual in later life in a holistic manner is to see her or him in a life-course perspective.

4. Although more and more cueing is required as the disease progresses, the long-term memory remains relatively intact until the later stages of Alzheimer’s Disease. Therefore, there is a need to “capitalize on what can be remembered from the distant past to help counter the threat to personhood” (Chaudhury, 2002).

5. “Neurodevelopmental Sequencing Approach” in Dementia. Behavior, movement, and functional losses in people with dementia occur in approximately the reverse order of their original development (Buettner, & Kolanowski, 2003). Functional abilities, skills, and activities a person acquired, learned, and enjoyed in infancy, childhood, and early adult life may be relatively preserved into the later stages of dementia. This key principle can be described in the phrase “What Goes In First, Goes Out Last.”

6. To be able to have a meaningful interaction, connection, and communication with the person with dementia (e.g., conversation prompter) and to be able to attribute meaning to seemingly incoherent speech (Chaudhury, 2002).

7. To be able to identify, focus, and capitalize on the person’s remaining abilities (Yes, we need to understand and proactively compensate for the decreased or lost abilities but we also need to avoid focusing excessively on these). Due to the progressive nature of Alzheimer’s disease, this is a “moving target” that requires regular assessment and adjustment.

8. To be able to plan, encourage, and engage the person in enriching, appropriate, and personally meaningful activities based on her or his life-long interests, current abilities, disabilities, and preferences. This, while remaining open to the possibility that life-long interests may change among certain individuals.

9. To understand the meaning of behavioral expressions for the person living with dementia (Rasin & Kautz, 2007). For example, to be able to identify and address remote triggers from the distant past of distressing behavioral expressions (Landerville et al. 2005). Research and practice have demonstrated a relationship between various early-life stressful events (e.g., life-threatening experiences and traumas) and current distressing behavioral expressions (Cohen-Mansfield & Marx, 1989; Feil, 2002).

10. To be able to design a physical environment in a way that is personalized, familiar to the individual, understandable, and consistent with her or his lifelong positive experiences such as in their homes. This, from general design of physical spaces to cultural, ethnic, and familiar symbols, favorite and personally meaningful objects, and furniture. This, while continuously adapting the physical environment to the person’s cognitive disabilities and remaining abilities.

11. To know what in the person’s life gives her or him hope (Kivnick, 1993) and to use this knowledge to nurture this sense in the present.

12. To know what it is in the person’s life (from her/his perspective) that is most worth living for or that makes her/him feel most alive (Kivnick, 1993).

13. To know whom or what the person especially cares about (Kivnick, 1993) and to use this knowledge to plan conversations, emotional support, meaningful engagement, and personal care.

14. To know the things that have always given the person confidence and made her or him proud (Kivnick & Murray, 2001) and to use this knowledge on a regular basis to promote those feelings and experiences in the person.

15. To know the person’s fears and to make every effort to avoid situations, conversations, activities, and care tasks that may trigger those fears.

16. To be able to anticipate and proactively address the person’s physical, emotional, psychological, social, occupational, cultural, and spiritual needs. Various unmet needs related to the person’s psychosocial history often contribute to distressing and harmful behavioral expressions (Whall & Kolanowski, 2004).

17. Many family members want to remain involved in the care of their relative when the person lives in a long-term care home (such as a nursing home or an assisted living residence). Learning about the unique and rich life-history of the person is a great way to involve family members in her or his support and care (Chaudhury, 2002). This, in turn, could inform and lead to more individualized and effective care and highest practical physical function, emotional / psychological well-being, and safety.

18. To be able to develop an individualized care plan that respects the person’s values, beliefs, faith, personality, lifestyle, daily routine, habits, coping style, areas of sensitivity, fears, traumas, accomplishments, expectations, interests, special skills, likes, dislikes, hobbies, and preferences.

19. To relate to the person with empathetic identification and make her/him feel that she/he is understood as a real person (Chaudhury, 2002).

20. To be able to see the person behind the dementia and/or her/his behavioral expressions and to preserve her or his personhood, identity, sense of self, and dignity as long as possible (Kitwood, 1997).

“People with dementia may have something important to teach the rest of humankind. If we make the venture one of genuine and open engagement, we will learn a great deal about ourselves“

– Professor Tom Kitwood, author of the groundbreaking book: Dementia Reconsidered: The Person Comes First (1997).

Bell, V., & Troxel, D. (2003). The best friends approach to Alzheimer’s care. Baltimore: Health Professions Press. Buettner, L. & Kolanowski, A. (2003). Practice guidelines for Recreation Therapy in the care of people with dementia. Geriatric Nursing, 24(1), 18-25.

Chaudhury, H. (2002). Place-biosketch as a tool in caring for residents with dementia. Alzheimer’s Care Quarterly, 3(1), 42-45.

Cohen-Mansfield, J & Marx, M.S. (1989). Do past experiences predict agitation in nursing home residents? International Journal of Aging and Human Development, 28(4), 285-294.

Feil, N. (2002). The validation breakthrough: Simple techniques for communicating with people with Alzheimer’s-type dementia. (2nd edition). Baltimore: Health Professions Press.

Kitwood, T. (1997). Dementia Reconsidered: The Person Comes First. Berkshire, UK: Open University.

Kivnick, H.Q., & Murray, S.V. (2001). Life strengths interview guide: Assessing elder clients strengths. Journal of Gerontological Social Work, 34(4), 7-32.

Kivnick, H.Q. (1993). Everyday mental health: a guide to assessing life strengths. Generations, 17(1), 13-20.

Landerville, P., Dicaire, L., Verreault, R., & Levesque, L. (2005). A training program for managing agitation of residents in long-term care facilities: Description and preliminary findings. Journal of Gerontological Nursing, 31(3), 34-4.

Rasin, J., & Kautz, D.D. (2007). Knowing the resident with dementia: Perspectives of assisted living facility caregivers. Journal of Gerontological Nursing, 33(9), 30-36.

Whall, A.L. & Kolanowski, A.M. (2004). The need-driven dementia-compromised behavior model – a framework for understanding the behavioral symptoms of dementia. Aging & Mental Health, 8(2), 106-108.

Zgola, J.M. (1999). Care that works: A relationship approach to persons with dementia. Baltimore: The Johns Hopkins University Press.

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Reader Interactions

November 17, 2019 at 11:10 pm

Hello, I am an Aging 320 student at the Erikson School of Aging. I have found this post to be very interesting and educational. It defiantly is very important to know the early life history of the individual. I recently met an immigrant lady staying at a shelter that has been diagnosed with Alzheimer’s disease. As you have stated in your post, her long-term memory is still intact, and she is able to share with me about events that happened in her earlier life. Your post has encouraged me to know more about the things that give her hope and the things that are most worth for. In our class we have learned about activities that can be used to engage individuals with dementia and the things that are most important to them can be included in these activities so that they enjoy it more. In our course work, we learned about the importance of non-drug treatment approaches that are very beneficial to individuals such as listening to music and looking at paints and photographs. These non-drug therapeutic models can include the things that are most important to the individual if we know how their early life was.

November 14, 2019 at 10:06 pm

I am an Aging 320 student at the Erickson School of Aging. I too believe that it is extremely valuable to both dementia patents and family members to get to know the early life history of people who are living with dementia. This semester, we learned a lot of the symptoms and affects of dementia on both the client and its family members. Living with dementia can be difficult for both the patients and its social circle. I believe knowing the previous stories of one’s past with dementia can cognitively stimulate their memories and even restore some of their behaviors and personalities temporarily. I think cognitive stimulation and any recall related to a person with dementia’s memories can also be beneficial as this post discusses. Meaningful interactions with patients with dementia can give supportive care from health professionals and even give relief to families by knowing their loved one is being taken care of. Ultimately, understanding and knowing the personal past life of a person living with dementia can be helpful and increase the overall quality of care given to them.

November 11, 2019 at 10:48 am

Hello, I am an Aging 320 student at the Erickson School of Aging, and I really enjoyed this post. I cannot agree more on the importance of knowing the life stories of those with dementia. This semester we studied progression of dementia and how those living with it are effected every day. While most caregivers of older adults are family members, often those with dementia are either living within healthcare facilities or receiving care from non-related individuals. From my personal experience, I understand how developing individual care plans can be influenced by one’s life course. I believe, if we do not take the time to know the person behind the disease, we are doing an injustice the individual’s dignity.

April 22, 2019 at 6:21 pm

I am not a clinician. I am a writer. More importantly, I am a hospice volunteer who utilizes Life Course Perspective when interviewing patients, collecting insights and reflections on the life events, transitions and altered trajectories of each life. Together (as much as possible) these life course road signs lead to short memoir pieces and poetry. Life Course Perspective is a valuable tool in the writing of our lives.

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Int J Environ Res Public Health

Effectiveness of the Biography and Life Storybook for Nursing Home Residents: A Quasi-Experimental Study

Doraisamy guna.

1 Nursing Administration, Sunlove Nursing Home, Singapore 534190, Singapore

Coral Milburn-Curtis

2 Green Templeton College, University of Oxford, Oxford OX2 6HG, UK; [email protected]

3 Alice Lee Centre for Nursing Studies, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore; gs.ude.sun@hzrun (H.Z.); moc.liamg@shgrun (H.S.G.)

Hongli Sam Goh

Associated data.

The data used and/or analyzed during the current study are available from the corresponding author on request.

There are currently limited studies that have examined the use of the biography and life storybook (BLSB) among the Asian older adult populations in the long-term care setting. This quasi-experimental study aimed to examine its impact on life satisfaction scores, depression, and quality of life among nursing home residents in Singapore. Two wards were assigned to either the intervention or control group. The intervention group was assigned to the BLSB intervention, which comprised eight nurse-facilitated structured sessions over three months and their usual daily activities, whereas the control group was assigned to the routine activities. A total of 74 nursing home residents completed the study, with 37 in each group. The BLSB intervention improved depression, quality of life, and life satisfaction for nursing home residents in Singapore, with significant results observed across all three outcomes over the 3-month period. The study findings support the use of BLSB as an effective reminiscence-based intervention for older adults in an Asian nursing home setting.

1. Introduction

The biography and life storybook (BLSB) involves documenting and compiling an individual’s life experiences, interests, and meaningful events, both past and present, into a single document [ 1 ]. It also comprises various artifacts—diaries, books, photographs, audiovisual recordings, personal collection items, and art pieces that help to illuminate an individual’s memorable events or experiences [ 2 ]. The BLSB creates an opportunity for people to talk about their life experiences, build connections with others, and develop a sense of identity and continuity [ 2 ]. Its use has been traced to social work and healthcare to understand foster children’s and older adults’ life stories during the late 1960s [ 2 , 3 ]. Since then, it has been adapted for various populations, such as older adults and people with intellectual disabilities.

Although various approaches and formats guide BLSB interventions, Kindell et al. identified several key features of BLSB implementation for older adults [ 3 ]. The first step requires trained staff to get participants to share their life stories and collate artifacts. This process helps establish “new connections” by encouraging meaningful conversations between staff, patients, and family members. At the same time, it allows “interactional connections” [ 3 ]. The second step involves the production of the BLSB, which supports the recall of their life stories and creates a shared knowledge about their “identity”. There are several resources and guides on how to produce a BLSB for the older adult population, such as Dementia U.K.’s Life Story Book template and the Agency for Integrated Care’s (AIC) Living with Dementia resource kit [ 3 , 4 ]. The final step outlines ways that the BLSB can be used. For example, the BLSB can create opportunities for older adults to re-establish or enhance “emotional connections” with their families. Another advantage is its “practical care connections”, whereby the BLSB allows care staff to understand the individual better and formulate a more appropriate and person-centered care plan [ 3 ]. The concept of person-centered care has been widely advocated in residential care settings as it espouses the incorporation of an individual’s values and preferences to guide care plans and achieve realistic health and life goals [ 5 ]. The BLSB can promote person-centered care by allowing individuals to share memories, reconcile with their past, and achieve a sense of self-worth and positive aging.

Several systematic reviews have reported growing studies that examined the use of BLSB for patients with dementia and older adults within the long-term care setting [ 2 , 3 , 6 , 7 , 8 ]. Most studies have stated the potential benefits of BLSB in enhancing older adults’ lives, but most of the studies were qualitative. In a more recent systematic review by Doran et al. [ 6 ], they retrieved one randomized controlled trial, one quasi-experimental, and two mixed-method studies from 12 studies. Although these studies reported benefits, such as improvement in staff’s care attitudes and knowledge following BLSB intervention, and improvement in residents’ aggressive behaviors and quality of life scores (QoL), these studies were observed to have low sample sizes from 5 to 73, and were mainly conducted in Western countries. There is currently a lack of research on the Asian older adult populations in the long-term care setting. Additionally, Kindell et al. highlighted insufficient evidence supporting its use for older adults with minimal cognitive impairments [ 3 ]. Most studies were conducted on patients with moderate to severe stages of dementia. Although the authors believed that BLSB can potentially benefit the nursing home residents in Singapore, it is necessary to evaluate its effectiveness before full-scale implementation due to the heterogeneity in BLSB designs and the concerns that the interventions may trigger negative memories for individuals. This study aimed to employ a quantitative method to evaluate the effectiveness and feasibility of BLSB in Singapore residential aged care settings.

2. Materials and Methods

2.1. study design.

The study aimed to investigate the feasibility of the BLSB intervention and examine the possible effects on life satisfaction scores, depression, and quality of life among nursing home residents in Singapore. The research questions were as follows:

Is there a difference in nursing home residents’ depression scores after receiving the BLSB intervention compared to those who participated in usual daily care?
Is there a difference in nursing home residents’ life satisfaction scores after receiving the BLSB intervention compared to those who participated in usual daily care?
Is there a difference in nursing home residents’ QoL scores after receiving the BLSB intervention compared to those who participated in usual daily care?

This study employed a quasi-experimental design and was conducted over six months at a charitable nursing home in Singapore in 2018 [ 9 ]. As controlling for blinding and treatment contamination was impossible, we assigned residents in one ward at the nursing home as the intervention group (n = 37) and another as the control group (n = 37). Assessment of participants’ sociodemographic and outcome variables was determined at baseline before the intervention to rule out any between-group differences in extraneous factors.

2.2. Settings and Participants

The study was conducted in two wards at a charitable nursing home, which received government subsidies and funding. The nursing home is a 242-bed residential geriatric and dementia care facility. The nursing home admits residents who require long-term nursing care, with 50–55% of them requiring moderate functional assistance. The remaining require a high level of nursing care and functional assistance. The study’s inclusion criteria included those: (1) aged 60 years or above; (2) having normal or mild cognitive impairment with a cut-off Mini-Mental State Examination (MMSE) score of 19 or more; and (3) able to communicate and participate in the study. Exclusion criteria included individuals: (1) having a medical condition that results in moderate to severe impairment; (2) having a hearing or speech impairment; or (3) diagnosed with severe depression for welfare and safety reasons.

2.3. Intervention

The BLSB intervention was developed from our literature review and Singapore’s Agency for Integrated Care Dementia Resource Kit. It comprised eight structured sessions over three months (four weekly sessions for the first month, followed by another four bi-weekly follow-up sessions for the next two months) in addition to the participants’ usual daily activities. The BLSB protocol comprised either nurse-facilitated one-to-one or group sessions lasting between 45 and 90 min. The first four sessions involved autobiography, photo reminiscence, and artifact collections from a caregiver. Each participant’s life story was compiled into an individual life storybook at the end of these sessions. The participants were strongly encouraged to actively participate in the production by providing photos, giving feedback, and choosing the design of the life storybook ( Figure 1 —BLSB Protocol). The subsequent four sessions would then involve them conducting sharing sessions with fellow residents, family members, and friends. The intervention group also participated in their usual daily activities in addition to the BLSB intervention. The control group only participated in their routine daily activities, including physical exercises, recreational activities, and self-care training.

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Design of biography and life storybook protocol.

2.4. Data Collection

The study questionnaire comprised four parts: the participants’ demographic data, emotional status, life satisfaction, and quality of life. Demographic information was collected at baseline and included the following information: age, gender, ethnicity, religious beliefs, marital status, educational level, and financial support. Three validated assessment instruments were used to collect the variables of interest for both intervention and control groups at specified time points. Emotional status was measured using the Geriatric Depression Scale-15 (GDS-15), a widely used 15-item instrument for assessing depression in older adults in various settings, including nursing home settings. The instrument has a reported pooled sensitivity of 86% and 76% [ 10 ] and has been well-validated for the local setting [ 11 ]. Each item is a close-ended question with either a “Yes” or “No” response on how the participant agreed to statements reflecting the psychophysiological aspects of depression for the previous week. Higher scores reflect depression, with a cut-off of 10 or above suggestive of a major depressive episode [ 10 ]. Life satisfaction was measured using a modified 20-item Life Satisfaction Index (LSIA). It reflected the participant’s subjective well-being, such as mood tone, zest versus apathy, congruence between desired and achieved goals, and self-concept. Each item requires a response of “agree”, “disagree”, or “don’t know”, and a point was given for “agree”, and no point for “disagree” or “don’t know”. The total score ranges from 0 to 20, with higher scores reflecting higher satisfaction. The LSIA has been validated in similar studies on the older adult population [ 12 , 13 , 14 ]. Quality of life was measured using a modified 50-item QoL scale for Nursing Home Residents (QoL-NHR), which examines 11 QoL domains, such as functional competence [ 15 ]. Each item consists of a 4-point Likert scale ranging from “never—1” to “often—4”. The total score ranges from 50 to 200, with higher scores reflecting the residents’ better-reported quality of life.

The questionnaire was used to collect data at five different time points during the 3-month study period—Week 1, Week 2, Week 4, Week 8, and Week 12. All recruited participants were asked to complete the questionnaire before the study commencement in Week 1. In addition, participants in the intervention group were asked by the researcher (GD) to complete the same questionnaire following the BLSB sessions. In contrast, those in the control group completed the questionnaire at the end of their usual daily activities at the nursing home on a selected day.

2.5. Data Analysis

Data were stored electronically in a secure manner prescribed by university guidelines and analyzed using IBM SPSS Version 24.0. Descriptive statistics were used for univariate analysis to present sociodemographic characteristics, and inferential statistics, independent t -test, or ANOVA were used to examine between-group differences at baseline. In addition, repeated-measures ANOVA was employed to assess treatment effects on intervention and control groups over the different time points. The significance level was set at 0.05 for hypothesis testing.

A total of 74 nursing home residents completed the study, with 37 in each group. Their demographic data are shown in Table 1 . The mean age was 73.0 for the intervention group (SD = 9.16) and 73.2 (SD = 8.37) for the control group. No significant difference was observed between the demographic characteristics except for ethnicity.

Demographic characteristics and baseline outcomes of participants by group.

Demographic Characteristic	Intervention (n = 37)		Control (n = 37)		χ	-Value
	n	(% Within Row)	n	(% Within Row)
Gender					1.51	N.S.
Male	22	(44.9)	27	(55.1)
Female	15	(60.0)	10	(40.0)
Marital Status					4.96	N.S.
Married	23	(52.3)	21	(47.7)
Single	8	(72.7)	3	(27.3)
Divorced/Separated	3	(33.3)	6	(66.7)
Widowed	3	(30.0)	7	(70.0)

Ethnicity					12.92	<0.05
Chinese	13	(31.7)	28	(68.3)
Malay	13	(76.5)	4	(23.5)
Indian	10	(66.7)	5	(33.3)
Others	1	(100)	0	(0)

Religious beliefs					2.66	N.S.
Christianity/Catholicism	6	(28.6)	15	(71.4)
Buddhism	8	(40.0)	12	(60.0)
Taoism	0	(0)	1	(100)
Islam	13	(65.0)	7	(35.0)
Hinduism	9	(81.8)	2	(18.2)
Others	1	(100)	0	(0)

Educational level					2.28	N.S.
Primary school and below	27	(51.9)	25	(48.1)
Secondary level	9	(45.0)	11	(55.0)
Tertiary level	1	(50.0)	1	(50.0)

	M	SD	M	SD	t	-value
GDS-15 scores (Baseline)	8.43	1.04	8.73	1.24	1.12	0.268

LSIA scores (Baseline)	10.24	1.40	9.00	1.78	−3.34	<0.05

QoL-NHR scores (Baseline)	144.64	2.62	146.72	4.55	2.41	0.946

The mean difference is significant at the 0.05 level. N.S.: Not significant. DID—difference-in-difference estimation; t—independent t -test; M—mean; SD—standard deviation; GDS—Geriatric Depression Scale-15; LSIA—Life Satisfaction Index; Quality of Life scale for Nursing Homes Residents (QoL-NHR).

3.1. GDS-15 Depression Scores

The mean GDS-15 depression scores by group over time are shown in Table 2 . Before the intervention, no significant difference was observed in the GDS-15 scores between both groups. However, the average depression score in the intervention group decreased from 8.4 in Week 1 (baseline) to 4.2 at the end of Week 12. In contrast, the average depression score in the control group remained relatively unchanged ( Table 2 ). Using Pillai’s Trace, there was a significant effect of the intervention on the depression score for the nursing home residents in the intervention group (V = 0.61, F (5, 68) = 21.57, p < 0.01). Based on difference-in-difference estimations, significant differences in outcome were observed from Week 4 onwards.

Comparison of mean GDS-15 scores between groups over time.



Baseline (T1)	8.43	1.04	8.43	1.04	-
Week 1 (T2)	8.16	1.50	8.49	1.43	−0.027
Week 2 (T3)	7.35	1.51	8.38	1.36	−0.730
Week 4 (T4)	5.81	0.91	8.43	1.34	−2.324 *
Week 8 (T5)	4.73	1.17	8.76	1.36	−3.730 *
Week 12 (T6)	4.22	0.95	8.24	1.04	−3.730 *

* The mean difference is significant at the 0.05 level; DID—difference-in-difference estimation.

3.2. LSIA (Life Satisfaction) Scores

The mean LSIA scores by group over time are shown in Table 3 . We observed a significant difference in the LSIA scores between both groups at the baseline. Nevertheless, the average life satisfaction score in the intervention group increased from 10.2 in Week 1 (baseline) to 12.3 at the end of Week 12. In contrast, the average LSIA scores in the control group remained relatively unchanged ( Table 3 ). Using Pillai’s Trace, there was a significant effect of the intervention on the LSIA scores for the nursing home residents in the intervention group (V = 0.29, F (5, 68) = 5.62, p < 0.01). Based on difference-in-difference estimations, significant differences in outcome were observed at Week 12.

Comparison of mean LSIA scores between groups over time.



Baseline (T1)	10.24	1.40	9.00	1.78	-
Week 1 (T2)	10.27	1.22	9.62	1.23	−0.595
Week 2 (T3)	10.30	1.13	9.70	1.22	−0.649
Week 4 (T4)	10.59	1.57	9.46	1.04	−0.108
Week 8 (T5)	11.54	2.60	9.51	1.24	0.784
Week 12 (T6)	12.27	2.13	9.73	1.10	1.297 *

3.3. QoL (Quality of Life) Scores

The mean QoL scores by group over time are shown in Table 4 . Before the intervention, no significant difference was observed between both groups’ baseline QoL scores. However, the average QoL scores in the intervention group increased from 144.6 in Week 1 (baseline) to 155.7 at the end of Week 12. In contrast, the average QoL scores in the control group remained relatively unchanged ( Table 4 ). Using Pillai’s Trace, there was a significant effect of the intervention on the QoL scores for the nursing home residents in the intervention group (V = 0.80, F (5, 68) = 53.2, p < 0.01). Based on difference-in-difference estimations, significant differences in outcome were observed from Week 1 onwards.

Comparison of mean QoL scores between groups over time.



Baseline (T1)	144.64	2.62	146.72	4.55	-
Week 1 (T2)	144.35	2.58	144.31	2.58	2.122 *
Week 2 (T3)	151.86	4.11	143.57	1.94	10.378 *
Week 4 (T4)	151.84	3.19	143.73	1.92	10.189 *
Week 8 (T5)	152.11	3.28	144.41	2.54	9.784 *
Week 12 (T6)	155.73	3.05	145.62	2.63	12.189 *

4. Discussion

The BLSB intervention effectively improved depression, quality of life, and life satisfaction for nursing home residents in Singapore. Our analysis showed that the 12-week BLSB intervention resulted in a significant decrease in depression scores among the intervention group compared to the control group based on the GDS-15 depression scores. This result was consistent with several systematic reviews that reported a small to medium effect of BLSB in reducing depressive symptoms among the general older adult populations [ 8 , 16 , 17 ]. Depression has been considered a major health risk among the older adult population due to their increasing vulnerabilities to physical and mental decline. Institutionalized nursing home residents are more likely to experience depression than the general population, as many of them experienced multiple health issues and lacked social contact and autonomy [ 18 , 19 , 20 ]. Although aging is an inevitable part of life, depression need not be part of it. Early recognition, diagnosis, and treatment can counteract and prevent depression’s emotional and physical consequences. BLSB can significantly mitigate social loneliness and depression among the older adult population [ 17 ].

Our study also found that BLSB effectively promoted life satisfaction among nursing home residents. This finding was consistent with two reviews that reported a significant pooled effect favoring the reminiscence-based intervention over control [ 16 , 17 ]. In addition, Tam et al. reported no differences in the BLSB effect on life satisfaction between the type of sessions (individual versus group) [ 17 ]. We also found that the BLSB can potentially improve the quality of life for nursing home residents, which concurs with the results of other similar controlled trials [ 21 , 22 , 23 ]. However, our result differs from the meta-analysis by Tam et al., who found no significant effect of BLSB on quality of life [ 17 ]. One possible reason for the significance of our results may be the time and effort spent to assist the subjects in recalling positive memories and integrating them into a personal collection. Through the process of recall, collection, and sharing of one’s memories and artifacts, the subjects were given greater opportunities to develop “connections” with staff and other residents, thus improving their sense of self-worth and perceived quality of life [ 16 , 23 ].

The mechanism by which BLSB demonstrated benefits for our subjects can be attributed to several important factors. The first factor involved a theoretical framework that guided the design of the life storybook. The BLSB design created opportunities for the residents in the intervention group to reflect on and share the various stages of their lives. This process provided positive affirmation of their lives and helped them establish a sense of identity after months or years of “de-personalization” at the nursing home [ 3 , 24 ]. The second factor pertains to the BSLB structure. Our BLSB intervention comprised eight structured group sessions over three months. Each session was kept to approximately 60 min and a maximum number of 5–6 participants to control the quality of the sessions. The sessions were facilitated by a trained nurse and incorporated as part of the participants’ usual daily activities. The intervention provided the opportunity for “interactional connections” and “establishing of new connections” among the participating residents [ 3 ]. This design was consistent with the recommendations by Yen and Lin, who conducted a systematic review of 16 studies and reported the effective elements underlying successful reminiscence therapy in Taiwan [ 25 ]. The third factor pertains to the outcome of the BLSB, with the formation of a life storybook shared with family members, fellow residents, and staff. The life storybook served as a platform for residents to establish “emotional connections” with their families [ 3 ]. It also established “practical care connections” for staff as they recognized the residents as individuals with their own particular needs and preferences.

In summary, the positive finding supported the use of BLSB as an effective reminiscence-based intervention for older adults in an Asian nursing home setting. Globally, there has been increasing focus on promoting person-centered care across continuing care settings, emphasizing the need to enhance their quality of life and life satisfaction. Our study confirmed the benefits of BLSB not just for people living with dementia, but also for the general older adult population [ 5 ]. It is essential to continue understanding what successful aging looks like in older individuals to adopt meaningful practices and interventions to elicit successful aging responses in those living in the communities. In addition, there is a need to pay more attention to depressed older adults’ social aspects and a need to enhance social networks, social support, and participation in recreational and leisure activities to improve older adults’ life satisfaction and QoL in the social domain. The study has added to the limited Asian studies that have examined the feasibility of BLSB among the older adult population in a nursing home setting [ 8 , 24 ].

There were several limitations to this study. First, the study was conducted on a single site, making it difficult to determine if the same inferences could be drawn if the study was replicated for other nursing homes. Nevertheless, this study can serve as a basis for a more extensive study involving several nursing homes in the future. Second, the Hawthorne effect may have influenced the study’s findings, whereby the participants’ reactions and behaviors became more positive in response to their awareness of being observed as part of the study [ 26 ]. As this effect could potentially make the results appear more favorable, we sought to mitigate it by using a different researcher to collect the responses from the participants [ 26 ]. Third, the sample size and lack of randomized participant allocation might have limited the study’s statistical power and contributed to the differences in ethnicity allocation and life satisfaction scores at baseline [ 9 ]. Although our study observed some significant differences in ethnicity and life satisfaction scores at baseline, our difference-in-difference estimations showed that all three outcomes were significant due to treatment effects. The risk of treatment contamination was also ensured as participants in both groups usually only mingled within their own residential areas, with minimal interactions between groups due to the facility layout [ 9 ]. Moving forward, future studies with a larger sample size are needed to validate its benefits in these settings, and to determine its impact on staff at long-term care facilities.

5. Conclusions

Although successful aging was not a clear topic of analysis in the biomedical literature until the early 1960s, there have been several endeavors to comprehend how to promote longevity and positive states of health once people start becoming older. Aging is a complex process, with contemporary psychiatrists and psychologists thinking that later life may result from initial development tasks, or a period of consistent growth and disagreements that need to be discussed. Hence, the BLSB is particularly suitable for older adults who face a loss of meaning in life and hold a negative view of themselves. If appropriately implemented, BLSB can help provide better care of the aging population, as it can help reduce depression and enhance the quality of life and life satisfaction.

Author Contributions

Conceptualization, D.G.; methodology, D.G. and C.M.-C.; validation, H.S.G. and H.Z.; formal analysis, D.G. and H.S.G.; writing—original draft preparation, D.G. and H.S.G.; writing—review and editing, H.Z. and C.M.-C. All authors have read and agreed to the published version of the manuscript.

This research received no external funding.

Institutional Review Board Statement

The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the PPA Business School Ethics Committee (Reference no: SG/GD/1221).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

Conflicts of interest.

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

3.1 Explain how understanding an individual’s biography/history can facilitate positive interactions

July 4, 2024

Table of Contents

This guide will help you answer the NCFE CACHE Level 2 Award in Awareness of Dementia Unit 3.1 Explain how understanding an individual’s biography/history can facilitate positive interactions.

Understanding an individual’s biography or history is important in the field of dementia care. This knowledge can significantly facilitate positive interactions between care workers and individuals living with dementia. It helps in tailoring the care to meet individual needs, enhancing communication, and building trust. This essay will look into how this understanding can be effectively utilised.

Personalised Care

Why it matters.

Understanding an individual’s past helps in delivering personalised care. Each person with dementia has a unique history that shapes their preferences, likes, and dislikes. Knowing their background allows carers to provide activities and interactions that are meaningful to them.

Tailored Activities : For example, someone who used to enjoy gardening might respond well to activities involving plants and flowers.
Familiar Routines : Implementing a routine that mirrors their past daily life can be very comforting and grounding.

Enhanced Communication

Building a connection.

Knowing an individual’s past experiences, interests, and life events can enhance communication. When carers talk about familiar topics, it can stimulate conversation and help individuals feel valued and understood.

Conversation Starters : Topics like past jobs, hobbies, or family can be excellent conversation starters.
Reduced Anxiety : Familiar topics are less likely to cause confusion and anxiety, common issues for people living with dementia.

Trust and Relationship Building

Establishing trust.

Understanding an individual’s biography allows carers to build a rapport and trust. When individuals feel listened to and understood, they are more likely to cooperate and feel secure.

Emotional Connections : Sharing knowledge of personal history shows empathy and can foster emotional connections.
Consistency : Repetition of known and comforting elements from their past can create a sense of consistency and stability.

Behaviour Management

Addressing challenges.

Behavioural issues are common in dementia care. Understanding an individual’s history can provide insights into behaviours, making it easier to address and manage challenges.

Triggers Identification : Knowing past traumas or stressful events can help in identifying potential triggers for distress.
Positive Reinforcement : Past positive experiences can be used to reinforce good behaviours or calm an agitated person.

Enhancing Well-being

Boosting self-esteem.

When carers incorporate elements of an individual’s history into their daily care, it can boost their self-esteem and overall well-being. It helps them feel respected and valued.

Sense of Identity : Acknowledging and celebrating their past achievements and roles can reinforce their sense of identity.
Emotional Comfort : Familiar stories and reminiscences often bring emotional comfort and joy.

Strategies to Gather Biographical Information

Practical approaches.

Collecting this information can be done through various methods, all of which involve engaging with the individual and their family.

Life Story Books : Creating life story books with photos and short descriptions can be a useful tool for both the individual and the carers.
Family Interviews : Talking to family members can provide important insights that might not come up in direct conversations.
Observation and Engagement : Simple observations and day-to-day interactions can reveal a lot about an individual’s preferences and past.

Case Study: Real-Life Application

Illustration of impact.

Let’s consider Mrs. Smith, a former teacher living with dementia. By discovering her past profession, carers can:

Use Educational Materials : Providing books, teaching aids, or even arranging reading groups can engage her.
Stimulate Conversations : Discussing her favourite subjects or memorable teaching moments can make her feel valued.
Create Structured Activities : Setting up activities that follow a school-like structure can provide a comforting routine.

Understanding an individual’s biography or history is more than just gathering facts; it’s about seeing the person behind the dementia. This knowledge allows carers to provide personalised, compassionate care , which can significantly improve the quality of life for individuals living with dementia. By focusing on their history, carers can enhance communication, build trust , manage behaviours more effectively, and improve overall well-being, leading to more positive interactions and meaningful connections.

Example answers for unit 3.1 Explain how understanding an individual’s biography/history can facilitate positive interactions

Example answer 1: personalised care.

Understanding an individual’s biography plays a significant role in providing personalised care. For instance, I cared for Mr. Johnson, who had been a professional musician. Knowing his background in music, I often played his favourite classical tunes during our interactions. This not only calmed him but also brought a look of recognition and happiness to his face. His mood improved, and he seemed more engaged. By integrating elements of his past into daily routines, I was able to enhance his quality of life significantly.

Example Answer 2: Enhanced Communication

In my experience, knowing an individual’s history greatly enhances communication. I once cared for Mrs. Patel, who had worked as a chef for most of her life. I used this knowledge to engage her in conversations about cooking. Asking her about her favourite recipes and discussing different cuisines made her more responsive and willing to converse. It also provided a sense of familiarity and comfort, reducing her agitation and making our interactions more positive.

Example Answer 3: Trust and Relationship Building

Understanding an individual’s biography is important for building trust and establishing a strong caregiver relationship. For example, I looked after Mr. Clark, who was a retired firefighter. Learning about his career allowed me to acknowledge his bravery and commitment in past conversations, which created mutual respect. This made him feel valued and respected, fostering a sense of trust. Consequently, he was more cooperative during care activities, leading to a more effective caregiving experience.

Example Answer 4: Behaviour Management

I’ve found that knowing an individual’s history is invaluable for managing behavioural issues. I cared for Mrs. Wright, who would often become agitated in the evenings. After delving into her past, I discovered that she had been a nurse who worked night shifts for many years. Understanding this, I adjusted her evening routine to include calming activities that mirrored her past late-night work environment. This significantly reduced her agitation and helped her transition into the evening more smoothly.

Example Answer 5: Enhancing Wellbeing

Enhancing an individual’s wellbeing through their biography is something I’ve seen work wonders. I once worked with Mr. Davies, who had been an avid gardener before his dementia diagnosis. By involving him in simple gardening tasks, like watering plants or organising seed packets, I saw a noticeable improvement in his mood and self-esteem. These activities connected him with his past passions, reinforcing his sense of identity and contributing to his overall emotional wellbeing.

Example Answer 6: Practical Strategies for Gathering Information

When gathering biographical information, I’ve found life story books to be immensely beneficial. For example, with Mrs. Green, I worked with her family to create a life story book filled with photos and short anecdotes from her past. This book became a tool not only for me but for all caregivers working with her. It gave us insights into her likes, dislikes, and significant life events, enabling us to tailor our care to her personal history. This approach made our interactions more meaningful and facilitated better communication and trust.

By incorporating these strategies and understanding the importance of an individual’s biography, I’ve been able to provide more compassionate and tailored care, resulting in positive interactions and improved quality of life for the individuals living with dementia.

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3.3 Explain how involving others may enhance interaction with an individual with dementia

3.2 List different techniques that can be used to facilitate positive interactions with an individual with dementia

2.3 Describe how information about an individual’s preferred methods of communication can be used to reinforce their identity and uniqueness

2.2 Describe how to adapt the style of communication to meet the needs, strengths and abilities of an individual with dementia

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COMMENTS

Creating a life story for a person with dementia
Creating a life story for a person with dementia
Life story resources in dementia care: a review
In a review of life story work in health and social care by McKeown et al. (2006), life story was seen as an important contribution to caring practice but that the literature was "immature" and that there was a "lack of critical debate about the use of life story work in practice" (p. 241). In dementia care, life story work has gained a ...
What is Life Story Work?
Life Story work is an activity in which the person with dementia is supported by family members and/or carers and care staff to gather and review their past life events. The person's personal biography is then recorded in a scrapbook, album, journal, or video. It is used to help the person understand their past experiences and events in their ...
Exploring good practice in life story work with people with dementia
The motives of the people with dementia we spoke to about life story work appeared to be quite different from those of family carers and professionals doing life story work with them. This is a significant finding, as much of the literature to date has failed to report the views of people with dementia themselves (Kaiser & Eley 2017, McKeown ...
The use of life stories and its influence on persons with dementia
The use of the family biography workshop, which is a structured process to facilitate the involvement of staff, family members and friends of the person with dementia in co-constructing biographies of their lives, gave the staff better knowledge of how to stimulate and provoke memories, and how to calm the person by using his/her biography.
PDF Creating a 'life story' for a person with dementia
stand the person's needs.How to create a life storyWhen creating a life story, involve the person with dementia in t. e process as much as you can, or as much as they want. It should reflect the person's wis. es and preferences and encourage a sense of ownership. For example, let the person make a comment about a photograph and use their ...
Life Story Work
Life story work is recognised as vital to person-centred dementia care. It's a tool to get to know someone, and the better you know someone, the better relationships with staff, family and carers can be. A record of experiences, likes and dislikes is very useful when someone is moving between care settings or when different professionals are ...
Supporting those with dementia: Reminiscence therapy and life story work
Key points. Reminiscence therapy and life story work are valuable psychotherapeutic approaches. Reminiscence therapy and life story work can improve the mood, cognitive ability and well-being of those with mild to moderate dementia. Research suggests that the effects of biographical interventions are weaker for people with severe dementia.
Exploring good practice in life story work with people with dementia
person with dementia themselves; the need for training and support for staff, carers and volunteers; and the potential for life story work to celebrate the person's life today and look to the future. Keywords life story work, dementia, good practice, person centred, qualitative, stakeholders Introduction Everybody has a life story.
Benefits of Life Story Work For People With Dementia
Having life story information documented prior to a dementia diagnosis can: Improve care outcomes by giving care providers a deep understanding of the individual's background, personality, interests and needs. This enables them to communicate and care for them in the most person-centered and tailored way possible.
PDF Life story work final PURE
Life story work is more commonly being used as an intervention to enhance person‐centred care. By understanding the biography of the person it can enable care workers to see the individual behind the disease and also enable the person with dementia to be seen and heard (Kellett et al, 2010,
(PDF) Life stories and biography: a means of connecting family and
This will ensure that rather than family biography work being perceived as an additional outcome-orientated task for time starved staff, it becomes an integral part of day to day dementia care (McKeown et al. 2006).
Using biography to enhance the nursing care of older people
In nursing care for people with dementia, biographical work is a popular concept. In the literature and practice, many different viewpoints of the way biographical work can/should be promoted exist.
Life Story Book to enhance communication in persons with dementia: A
The Life Story Work reported by Kindell et al. was an informal activity that the person with dementia could use to engage with relatives or carers while also having the potential to be a formal intervention. The Life Story Book session was reported as being delivered by the researchers, caregivers, nurses, family members, relatives, and dyads ...
The use of life story work with people with dementia to ...
This study explores the use of life story work to enhance person-centred care with people with dementia. Aims and objectives: The study investigates how life story work is: understood and developed in practice; experienced by all participants and affects the delivery and outcomes of care. Design and methods: The experience of older people with ...
The most inspiring memoirs about Alzheimer's and Dementia
Green Vanilla Tea is a true story of love and courage in the face of a deadly and little understood illness. With literary finesse, compassion, and a powerful gift of storytelling, Marie Williams writes poignantly of her husband Dominic's struggles with early onset dementia and amyotrophic lateral sclerosis (ALS) at the age of 40, and how their family found hope amidst the wreckage of a ...
Life stories and biography: a means of connecting family and staff to
This article assesses the Family Biography Workshop (FBW) designed to support family and staff to co‐construct the history of the person with dementia in residential care. Background. ... development and initial feasibility study for evaluation of life story work in dementia care, Health Services and Delivery Research, 10.3310/hsdr04230, 4 ...
[Biographical work in inpatient long-term care for people with dementia
In nursing care for people with dementia, biographical work is a popular concept. In the literature and practice, many different viewpoints of the way biographical work can/should be promoted exist. In the DEMIAN concept, a nursing concept to promote emotional well-being for people with dementia, it is also of major significance.
The use of life stories and its influence on persons with dementia
Dementia is an important predictor of nursing home admissions. Due to progressive dementia symptoms, over time it becomes difficult for persons with dementia to communicate their wishes and participate in decisions concerning their everyday lives. Their well-being, sense of dignity, integrity and personhood are at risk. The persons' life stories have been highlighted as particularly ...
20 Reasons Why We Need to Know the Early Life History of People Living
Knowing, understanding, and thoughtfully using the life history of the person with dementia are the keys to creating and maintaining this foundation. 3. The only way to truly understand an individual in later life in a holistic manner is to see her or him in a life-course perspective. 4. Although more and more cueing is required as the disease ...
Effectiveness of the Biography and Life Storybook for Nursing Home
1. Introduction. The biography and life storybook (BLSB) involves documenting and compiling an individual's life experiences, interests, and meaningful events, both past and present, into a single document [].It also comprises various artifacts—diaries, books, photographs, audiovisual recordings, personal collection items, and art pieces that help to illuminate an individual's memorable ...
3.1 Explain how understanding an individual's biography/history can
This guide will help you answer the NCFE CACHE Level 2 Award in Awareness of Dementia Unit 3.1 Explain how understanding an individual's biography/history can facilitate positive interactions. Understanding an individual's biography or history is important in the field of dementia care. This knowledge can significantly facilitate positive interactions between care workers and individuals ...
Novel biomarker could lead to early diagnosis of Alzheimer's disease
The number of dementia sufferers is anticipated to double every 20 years and the global cost of dementia is forecast to rise to US$2.8 trillion by 2030. In 2024, more than 421,000 Australians live ...