Why we built ReMe? Reminiscence therapy as a psycho therapeutic approach

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Our aim has always been to build a system that is robust in its outcomes, that is not just an app that offers playful benefits and simple outcomes. That’s not to disparage what are often today being called Digi Pharma, i.e. apps that are downloaded by the public to gain some form of support. But we’ve worked to have ReMe be the next step in the evolution of medical apps; to be of clinical relevance, to be of value across the full care journey and to be of benefit to not only the person cared for and their family, but also to the care providers themselves. And, we aspire to ReMe being what is beginning to be termed in the US, a Digi Therapeutic. That’s a digital tool that can be used by medical practitioners as a valuable care intervention’ either instead of resort to medication, or to be used, even prescribed, alongside and supportive of the use of medication.

These are grand aims and our current work being undertaken with our partners is intended to establish an evidence base for the efficacy of digital interventions such as ReMe. Your participation and use of ReMe is greatly helpful of our intent for ReMe to achieve a social impact in this manner.

Therefore, with these aims in mind, our work with ReMe is based on the work of the leaders in our field and on the research work undertaken over the years that defines those areas of person centred care that we have sought to digitally enhance, with the aim of optimising their strategies and targeted outcomes.

Reminiscence is something we all do regularly, whether when alone or as a social interaction. But in the care setting it bears particular significance. For the memories that we recall define the person that we believe ourselves to be and as cognitive faculties decline, those that we retain will represent the world that we inhabit. There are studies that have illustrated the positive benefits of reminiscence. These use standard cognitive function measures such as the Mini-Mental State Examination (MMSE) method, the Geriatric Depression Scale short form (GDS-SF) method to define the perception of the person cared for on their own well-being, and the Cornell Scale for Depression in Dementia (CSDD) to quantify a carers appraisal of the person cared for’s emotional condition.

There is little doubt that reminiscence work has significant benefit to carers and family, however there are numerous studies (Cochrane Dementia and Cognitive Improvement Group) that show that reminiscence has little impact on cognitive decline retardation. Whilst have measured significantly positive outcomes. The study by IRISS in 2011 puts it succinctly:

  • 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

However, it should be noted that the studies conducted did not use digital technology in the manner deployed by ReMe, to seek to optimise reminiscence delivery or the capturing of outcomes. It is our view and indeed our experience that technology has the power to so significantly improve the process of reminiscence provision, to utilise the outcomes from such sessions to replicate previous sessions, to discover content during a session and to explore the discoveries made during a session at the time of discovery and return to it at a later date to continue the engagement, that this brings a new dimension and potential to the value of reminiscence. For example, the potential for changing direction in a reminiscence session, such that the content presented is no longer fixed and pre-defined but adaptable to the response of the individual, provides the opportunity for a different quality of outcome. We intend to undertake work to evaluate these digital interventions when the opportunity presents itself.

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