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Table of Contents
ORIGINAL ARTICLE
Year : 2018  |  Volume : 15  |  Issue : 1  |  Page : 48-52

Effectiveness of Remisniscence Thereapy on cognitive function impairment among Geriatric Population living in old age homes of Punjab


1 Organ Transplant Coordinator (MN, PhD Scholar): PGIMER (Chandigarh), Ludhiana, India
2 Formar Professor,College of Nursing, CMC, Ludhiana, India

Date of Web Publication10-Jul-2019

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2231-1505.262506

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  Abstract 


Cognitive function declines with advancing age particularly in older adults aged 60 years and above. Reminiscence therapy does have a role in the effective care of the aged person. The present study aimed to assess and compare the pre test and post test cognitive function impairment among geriatric population. Methodology: The research approach was experimental approach with pre -experimental one group pretest -post test design. The sample consists of 150 study participants. The tool used for data collection was mini mental status examination scale. An interview technique was used to collect the data. Pretest was taken on day one. Six sessions (twice weekly for 3-weeks) of reminiscence was given. Posttest of Geriatric population was taken after 21 days of pretest. Results: The calculated t value was 31.499 is more than table value at df (149) at 0.05 level of significance. This indicated that reminiscence therapy was effective in decreasing the cognitive function impairment among study participants. Research findings regarding the use of reminiscence therapy can help the nurses to utilize this specific intervention in their work with older client.

Keywords: cognitive function impairment, geriatric population and reminiscence therapy


How to cite this article:
Bansal N, Gill K. Effectiveness of Remisniscence Thereapy on cognitive function impairment among Geriatric Population living in old age homes of Punjab. Indian J Psy Nsg 2018;15:48-52

How to cite this URL:
Bansal N, Gill K. Effectiveness of Remisniscence Thereapy on cognitive function impairment among Geriatric Population living in old age homes of Punjab. Indian J Psy Nsg [serial online] 2018 [cited 2022 Oct 6];15:48-52. Available from: https://www.ijpn.in/text.asp?2018/15/1/48/262506




  Background Top


Ageing is a natural course of dynamic biological changes that is also subject to social construction in the determination of its reality and meaning. It is a process of gradual change in physical appearance and mental status that cause a person to grow old. As the birth is an event and the pregnancy a process of it, similarly old age is an event and ageing is its process[1]. India is in a phase of demographic transition and trends reveal that population of elderly is growing faster than general population. In India, the life expectancy has steadily gone up from 32 years at the time of independence to 67.14 years in 20122. According to population census 2011 there are nearly 104 million elderly persons (aged 60 years or above) in India3. India has thus, acquired the label of “an aging nation” with 8.3% of its population being more than 60 years old. The increasing life span and poor health care add to the degree of a mental or neurological disorder and 6.6% of all disability among people over 60 years is attributed to mental and neurological disorders.[3]Declines in memory and other cognitive abilities are a common feature of aging and associated with lowered quality of life, lack of functional independence[4].

Cognitive function declines with advancing age particularly in older adults aged 60 years and above4. Cognitive impairment and dementia are increasing globally and are predicted to increase proportionately more in developing regions[5].

At present, drug therapy and psychotherapy are two commonly used methods for the treatment of depression, and cognitive impairment. However, previous studies also indicated that pharmacologic approaches had numerous side effects. In addition, the elderly cannot learn any skills from the drug therapy. Cognitive or cognitive behavioral therapy, problem-solving therapy and interpersonal therapy are widely accepted as methods in reducing the depression. Based on traditional interventions, reminiscence therapy is specially recommended for geriatric population[6]. Reminiscence therapy is a method of using the memory to protect mental health and improve the quality of life. Reminiscence is not just to recall the past events or experiences, but it is a structured process of systematically reflecting on one’s life with a focus on re-evaluation, resolving conflicts from the past, finding meaning in one’s life and assessing former adaptive coping responses[7]. Reminiscence therapy does have a role in the maintenance of self-esteem, self-value, enhanced self-integration, enhancement of functional activities, improved social functions and activities, prevention of behavioral problems, and in the effective care of the aged person[8].

The objectives of the study was to assess and compare the pre test and post test cognitive function impairment among geriatric population.


  Hypothesis Top


H1 The mean post test cognitive function score of geriatric population will be higher than mean pre test cognitive function

The research approach adopted for the study was experimental approach with pre -experimental one group pretest–post test design. Sample: The study was conducted in three old age home of Punjab, Mullanpur Mohali, kharar Mohali and old age home in Chandigarh. Convenient sampling technique was used to select the old age home and purposive sampling technique was adopted for selecting 150 study participants. Administrative permission was obtained from the administrators of old age homes. Informed written consent was taken from study participants. The tool used for data collection was mini mental status examination scale and a semi structured questionnaire having eighty items on various aspects of life. It took 40-60 minutes per day per study participant. An interview technique was used to collect the data. Pretest was taken on day one followed by six sessions of intervention and posttest was taken after 21 days. Intervention-Reminiscence therapy (RT) was given twice weekly for six days schedule was followed for three weeks. Reminiscence Therapy involves the discussion of past activities, events and experiences with another person or group of people, usually with the aid of tangible prompts such as photographs, household and other familiar items from the past, music and archive sound recordings. While your loved one might not be able to remember what they had for lunch, they are very likely to remember their wedding day, the name of a favourite school teacher, or a childhood holiday. Reminiscence therapy uses this ability to recall events that happened long ago, even when short term memory is failing. It can also help to boost their mood and stimulate wider conversation. It can also improve short-term memory and increase the self-worth and engagement of someone with dementia. As we age we have an increased tendency to remember things that happened to us between the ages of 10 and 30 years, with events from the late teens and early twenties remaining most prominent. Recalling positive memories makes everyone feel happy, good memories can become a powerful way to boost the mood. Reminiscence therapy can turn a ‘bad’ day into a ‘good’ day, or even a good week. Many people say their loved one seems brighter and more able to recall recent events from the past few days or weeks after a session of reminiscence therapy.

As given in [Table 1] that maximum 65(43%) study participants were equal to and above age of 75 years. Majority (83%) were widow/widower. one third 50(33%) were illiterate. More than half 95 (63%) were Hindu. 100(67%) were previously living in joint family. 90(60%) by themselves took decision to stay in old age home where as 60 (40%) came to old age home on decision taken by others/ relatives. Less than half 40 (27%) were previously unemployed. Majority 70(47%) were having previous family income/month less than 5000. Majority 125(83%) were previously living in urban area and remaining 25(17%) were from rural area. Majority 140(93%) were not taking part in yoga or counseling. More than half 95(63%) were not getting pension.
Table 1: Frequency and Percentage Distribution of Study Participants according to their Selected Demographic Variables n=150

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The data presented in the [Table 2], indicates that the mean pre-test cognitive function impairment score (18.73) and mean percentage (62.4%) of study participants, whereas the post-test mean cognitive function impairment score (21.57) and mean percentage (71.89%) of study participants Hence, it can be deduced that cognitive functioning has enhanced and there was reduction in the level of cognitive function impairment among study participants, proving the effectiveness of reminiscence therapy in improving cognitive function impairment.
Table 2: Mean Median, Standard Deviation, Range and Mean Percentage of Cognitive Function Impairment of Study Participants n=150

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As given in [Table 3] that 100(66.7%) study participants had pre test moderate cognitive function impairment, followed by pre test mild cognitive function impairment in 50(33.3%) of study participants. The data further shows that 35(23.3%) of study participants had no cognitive function impairment, 75 (50%) had mild cognitive function impairment, and 40 (26.7%) had moderate cognitive function impairment. Thus, it is evident that there was improvement in cognitive function impairment of study participants after reminiscence therapy.
Table 3: Frequency and Percentage Distribution of Study Participants in Terms of Level of Cognitive Function Impairment n=150

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T (149) =1.98, p= 0.05*(*significant) As given in [Table 4] that the calculated ‘t’ value i.e. 31.499 is more than table value at (df - 49) 0.05 level of significance. This shows that difference in the mean cognitive function impairment scores before reminiscence therapy and after reminiscence therapy is a true difference and not by chance. This indicates that reminiscence therapy was effective in decreasing the cognitive function impairment among study participants significantly.
Table 4: Mean, Mean difference, Standard Deviation of Difference, Standard Error of Mean Difference and t value of Cognitive Function Impairment Score Before and After administration of Reminiscence Therapy (RT) n=150

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Table 5: Area Wise Mean Score, Mean Percentage and Ranking of Cognitive Function Impairment Scores of Study Participants n=150

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As given in [Table 6] that the area wise mean of cognitive function impairment of study participants. Pre test and post test highest score cognitive function impairment score was in area of orientation to time was ranked I with mean percentage 80 % in pretest and in post test with percentage 88%. Registration was having pre test mean percentage 75.56% and ranked as II, in post test mean percentage 84.4% and was ranked as II. Pre test lowest score cognitive function impairment was in area of Complex Commands was ranked VIII with mean percentage 38.33 % and was ranked as VIII in post test with mean percentage 50%. There was decrease of cognitive function impairment in all the five areas after reminiscence therapy. This shows that majority study participants have moderate cognitive function impairment in pretest but had mild cognitive function impairment after reminiscence therapy in all the eight areas.
Table 6: Area Wise Mean Score, Mean difference, standard deviation of difference standard error of mean difference and t value of pre test and post test MMSE of Study Participants N=150

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As given in [Table 6], that the area wise comparison of pretest and post test Cognitive Function Impairment of study participants. The computed ‘t’ value for all eights areas indicates the mean cognitive function impairment score in the post test was significantly higher than pre test at 0.0005 level of significance. Thus, it establishes difference in the obtained mean cognitive function impairment score of study participants in pre test and post test.


  Discussion Top


In western countries, specifically in United States, psychological needs of older individuals have begun to receive relatively greater researcher attention. In contrast, developing counties are still lacking important research regarding aging individuals and their concerns. Thus present study was conducted to evaluate the effectiveness of reminiscence therapy on level of cognitive function impairment among geriatric population living in selected old age home Findings of the present study revealed that reminiscence therapy is effective in lowering the level of cognitive function impairment among geriatric population living in old age home. Findings of the present study are consistent with the findings of Cyril M Cyriac et al who had said that cognitive impairment decreases with the help of reminiscence therapy9. In the present study the mean of cognitive function impairment (18.73) after reminiscence therapy was found to be significantly lower than mean of (21.57) before administration of reminiscence therapy. The similar findings have been reported by Iran Jahanbin, F. that mean cognitive function impairment scores decreased significantly after reminiscence therapy among the elderly of day center in western Iran10. Another study conducted by Wang, J. in which approach used was experimental, showed that in the experimental group, there was significant improvements in cognitive function11. Thus reminiscence therapy was found highly effective in lowering the level of cognitive function impairment among geriatric population living in old age homes


  Conclusion Top


Research findings regarding the use of reminiscence therapy with older adults can help nurses to utilize this specific intervention in their work with older client. As there is no formal gerontological training for nurses in our country, studies like this one can serve as a resource in meeting the continuing education needs of nurses who currently work with the elderly. Today, nurses need to deal with increasingly diverse client populations, including the ever growing number of older individuals worldwide. With the rapidly growing aging population, nursing professionals in India, as well, will face both the challenge and the opportunity to deal with the needs of an aging population.[11]

Thus, the present study can invoke nurses to emphasize aging issues in their course-work. For those nurses who currently work with elderly clients, continuing education and training programs that include up-to-date interventional strategies, such as reminiscence therapy, can be beneficial a great deal. This study can also be inspiring for other nurse researchers in reminiscence therapy and throw light to future aging research.



 
  References Top

1.
Workers N, Wegman D, McGee J. Physical and Cognitive Differences Between Older and Younger Workers [Internet].2016 [cited 31 May 2017]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207703/  Back to cited text no. 1
    
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Mishra R, Mishra R. Is INDIA an Aging Nation??? [Internet].2016 [cited 15 February 2016]. Available from:https://blogs.allizhealth.com/india-aging-nation/  Back to cited text no. 2
    
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Situation Analysis Of The Elderly in India [Internet]. 2011. [cited 16 February 2016]. Available from: http://mospi.nic.in/sites/ default / files / publication reports / elderly in_ india.pdf  Back to cited text no. 3
    
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Mental health of older adults [Internet]. World Health Organization. 2018 [cited 24 June2018]. Available from: http://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults  Back to cited text no. 4
    
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D. James, B. Late-Life Social Activity and Cognitive Decline in Old Age. [Internet].2016 [Accessed 21 Feb. 2018] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206295/  Back to cited text no. 5
    
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Who.int. WHO Prevalence of dementia and cognitive impairment among older people in sub-Saharan Africa: a systematic review. [Internet].2017[Accessed 22 Feb. 2018] Available at: http://www.who.int/bulletin/volumes/91/10/13-118422/en/  Back to cited text no. 6
    
7.
Chen, T., Li, H. and Li, J. The effects of reminiscence therapy on depressive symptoms of Chinese elderly: study protocol of a randomized controlled trial. [Internet]. 2015 [Accessed 21 Feb. 2018] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3507717/ #B9.  Back to cited text no. 7
    
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Ankur Barua,Nilamadhab Kar. Screening for depression in elderly Indian population. Indian J Psychiatry 2010; 52(2): 150–153.  Back to cited text no. 8
    
9.
Cyril Cyriac,Cyril M Cyriac, Shetty Sukesh. Effectiveness of reminiscence therapy on level of cognitive function among dementia patients in selected old age homes in Mangalore [Internet]. Ujconline.net. 2018 [cited 1 May 2017]. Available from: http://ujconline.net/wp-content/uploads/2013/09/3-UJPBS-14108-Rs.pdf  Back to cited text no. 9
    
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Iran Jahanbin F. The Effect of Group Reminiscence on the Cognitive Status of Elderly People Supported by Ilam Welfare Organization in 2013; A Randomized Controlled Clinical Trial [Internet]. PubMed Central (PMC). 2018 [cited 31 May 2018]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4201212/  Back to cited text no. 10
    
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JJ W. Group reminiscence therapy for cognitive and affective function of demented elderly in Taiwan. - PubMed - NCBI [Internet]. Ncbi.nlm.nih.gov. 2018 [cited 31 May 2018]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/17503545  Back to cited text no. 11
    



 
 
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  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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