Title: STARs- STorytelling for older Adults in Residential settings
Funder: Dunhill Medical Trust

Abstract: Personal stories are core to daily communication, and are important for social roles, identity, and wellbeing (Coupland, 2009). Aging compromises many of the skills required for telling stories, such as word-finding (Heller and Hobbs, 1993) and the maintenance of coherence (Marini et al., 2005), resulting in vague stories that are difficult to follow. Moreover, communication opportunities are limited for many older people, particularly in residential care settings. This means that older people are likely to have fewer opportunities to tell stories (Lubinski, 1996) and that their stories may be of poorer quality, both of which will impact on their quality of life. The STARs programme will promote opportunities for older people to tell stories, focusing on the component skills required to tell stories (e.g., generating a clear story line, articulating key information). Although established programmes use personal story telling (e.g., reminiscence) they do not focus on the linguistic and cognitive skills required to tell stories, and do not support any of the skills that have been shown to deteriorate with age (Marini, 2018). In a meta-analysis of 15 studies, Bohlmeijer and colleagues (Bohlmeijer, Roemer, Cuijpers, and Smit, 2007) found a moderate influence of reminiscence on life-satisfaction and well-being in older adults (an overall effect size of 0.54). Life-review was found to have significantly greater beneficial effect than simple reminiscence. Bohlmeijer and colleagues report that l ife review is more structured and evaluative, and a key component is the integration of important life-events in a coherent, meaningful story. These characteristics rely on good communication skills and so age-related communication difficulties would reduce its effectiveness. Although no linguistic training exists in the UK, an SLT-led programme for maintaining/improving communication skills and confidence ran successfully in Australia (Worrall, Hickson, Barnett & Yiu, 1998). There is also evidence of success for intervention programmes targeting cognitive skills which, like linguistic skills, decline with age. A meta-analysis (Karbach and Verhaeghen, 2014) of cognitive training for younger and older people (aged 60+) showed similar gains in both groups. Such evidence provides indirect support for the potential to successfully intervene to support declining skills in old age. The current project will build on our successful pilot work, by collaborating with key stakeholders to develop the intervention for use in residential care homes. We aim to ameliorate communication difficulties and promote communicative activities, and ultimately improve the lives of older people in residential care.

Lay abstract: Telling stories is an important feature of daily life. Personal stories are fundamental to our sense of identity and play a central role in creating and maintaining relationships. Older adults have reduced opportunities for communication, and ageing disrupts the skills needed to tell stories well. Although older adults are motivated to take part in activities designed to maintain or improve their skills, there are currently no programmes available for developing the skills required to tell a story well. STARs is a short programme of group activities for improving storytelling skills. We have tested it in a day centre with five people aged 75+. The feedback from participants was positive; their storytelling skills improved; and the frequency of their communicative activities increased. This suggests that the programme works and is worth investigating further for its benefits in other care settings. Our work is novel because the group activities were designed to develop linguistic skills, a form of training which is not currently available for older adults in the UK. We want to improve on our pilot work, with the help of a group of interested people, to make it usable in residential care homes. We will: 1) review the published evidence, to ensure that our work is well grounded and builds upon existing theory and research; 2) improve the programme with the help of others (care home residents and their families, care home staff, communication specialists), using their expertise and experience; 3) test whether the storytelling programme works with adults in residential homes by comparing assessment scores before and after the programme; and checking that they are happy with the programme; 4) consider the wider impact by interviewing people (care home residents and their families, care home staff, care home managers) about any beneficial effects of STARs on the ways people communicate in the home, and about staff awareness of the importance for wellbeing of regular communication activities. Once we have completed the project, we will share our findings publicly. We will also apply for money to carry out a project with a larger group of people, to establish that STARs has a beneficial effect. In this larger project we can include people with dementia. The ultimate aim is to create an intervention that can be implemented widely to improve the everyday lives of older people.

Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: MENTAL HEALTH;GENERIC HEALTH RELEVANCE