The Effectiveness of Life Story Book on Depression and Meaning in Life for Mentally Alert Residents of Nursing Homes

Background and Purpose: Recent studies have found that over 50% of residents of nursing homes (NH) have a diagnosis of depression and are at increased risk of developing depression. In addition, studies have found a lack of meaning in life (MIL) significantly increases the likelihood of depression. It is important to develop efficient, non-pharmacological interventions which address the quality of life for all residents-those with dementia and those who are mentally alert. Reminiscence interventions have been shown to have significant effects on depression and psychological well-being. The reminiscence intervention Life Story Work collects a person’s stories, history, memorabilia into a tangible product such as a Life Story Book (LSB). For this study, a three-1-hour LSB intervention provided participants with the opportunity to chronologically share their life experiences and memories and capture their life story into a book. The LSB included a combination of written information, photographs of significant people, places or events, and personal narratives from the stages of life that the participant wanted to include. There have been multiple studies of LSB with persons with dementia. The purpose of the study was to examine the effects of LSB on depressive symptoms and MIL for mentally alert residents of NHs.

Methods: Using a quasi-experimental switching replication design, two comparable NHs (NH-A and NH-B) and 21 mentally alert residents participated in this study. Participants in NH-A received three weeks of the LSB intervention, while NH-B received three weeks of care-as-usual; the interventions were then switched. Depressive symptoms were measured using the Geriatric Depression Scale Residential (GDS-12R) and MIL was measured using the Meaning in Life Questionnaire (MLQ). Surveys were collected at baseline-Time 1, Time 2, and Time 3.

Results: Participants were between 57 and 95 years of age (M = 75; SD = 11.34), technical training or some college (42.9%) or a GED or high school diploma (28.6%), widowed (52%) or divorced (28.6%), female (81%), African American (33%) or non-Hispanic white (52%), and Protestant (76.2%). Results from a one-way MANCOVA found no statistically significant difference on the GDS-12R and MLQ (F(3, 14) = 2.50, p = .102; Wilks’ Lambda = .652; η² = .35). Further analyses comparing the pre-LSB intervention and post-LSB intervention scores for the entire sample (N=21) found a significant reduction in depressive symptoms (M = 2.67; SD = 2.52) and (M =1.67, SD = 2.29); (t (20) = 2.21, p = 0.039).

Conclusions and Implications: Although the MANCOVA results were statistically non-significant, the size of the moderate effect (η² = 0.35) was not trivial. While further analyses conducted using the depression scores of all participants, both before and after participation in LSB, found a reduction in depressive symptoms it is recommended to replicate this study with a larger sample size. Social workers build trusting relationships through listening. The LSB intervention may provide opportunities for NH residents to reminisce and to be heard. Furthermore, personalized interventions, such as LSB, should be preferred to meet the diverse health and cultural backgrounds of NH residents.