Catalysts for Developing Productive Life Reviews: A Multiple Case Study

Considered a naturally occurring process common to older adults, the life review becomes a more productive process through facilitation and development and application of effective prompts. The experiences of 6 older adults who participated in a facilitated life review process and the manner in which individualized prompts were developed are described. ********** Older adults have been encouraged, for several decades, to "tell their stories" via an oral life review process in therapeutic settings. Butler (1963) conceptualized this process as a naturally occurring process of all older adults during which their older memories and reminiscences are brought to the present for conscious contemplation. By reviewing experiences and decisions, individuals are able to make sense of their life, come to terms with their choices, and reflect on life and assign meaning. Ideally, their review would also promote successful navigation of Erikson's (1982) eighth psychosocial conflict: integrity versus despair. The life review, therefore, serves an integral role in helping older adults accept their own mortality as they face their impending death. Beyond therapy, the exercise of life review is a process useful for people of any age to solve problems, resolve issues, process forgiveness, promote change, embrace bequeathment of values and ethics, and move toward self-actualization. Historically, therapy dictated that the model for life review was an oral process (Buder, 1963). The evolution and alteration of purpose of life reviews have stretched the model to embrace writing, which makes the process more accessible to more people. According to Burke (1966), through the processes of written and oral life review, individuals use symbols, memories, and language to purposefully reflect on the past, select that which serves the purpose, and deflect reality to perceptions that promote healthy change. Life review, therefore, has the potential to promote individuals' development of new perspectives through reconnection to their constructed memories. These new perspectives allow for empowerment and self-definition. However, the life review process may also lead to a less-than-positive outcome in which the individual is left with feelings of depression, guilt, or anxiety. A life review facilitator may be able to enhance the individual's experience by carefully guiding the individual through the process and maintaining awareness of the individual's feelings arising from the life review. By providing prompts and questions in response to a client's expressed story, a facilitator can help that client more easily work through any negative feelings that surface. The purpose of this article is to present a brief explanation of the theory behind the life review process and the results of a qualitative research study. The experiences of 6 individuals who created written life reviews are described, and the process by which effective prompts were chosen are explored. The processes of both the researcher (first author; hereinafter referred to as the researcher) and the participants are reflected in the multiple case study. Suggestions for further research and implications for counselors are discussed. THEORETICAL BASIS FOR LIFE REVIEW Life reviews are naturally occurring processes in which individuals share their stories through written or oral means. Individuals depend on language to make sense of mental images and on constructed symbols to communicate ideas and intents to others. As Butler (1963) noted, life reviews are generated as individuals become cognizant of their own mortality. Awareness of mortality occurs not only for older adults but also for people facing terminal illnesses. Existing literature has shown that the life review can be a therapeutically beneficial experience that assists people in coming to terms with advancing age and impending death (Hanaoka & Okamura, 2004), decreasing feelings of depression and hopelessness (Mastel-Smith et al. …