Impact of the revised life review program on quality of life for residents with Alzheimer’s disease in South Taiwan’s long term care facilities.

Abstract

Quality of life (QOL) is the goal for services to elders particularly those with Alzheimer's Disease (AD) for whom successful outcomes are likely to mean small improvements. There is no universal definition of QOL or consensus on what components constitute the phenomena. Therefore, it is difficult to compare efficacy of services or service providers, or to know whether or not QOL has been achieved. Lawton (1997) advocates for defining QOL as a multidimensional phenomenon that cannot be evaluated as a single entity nor measured by one instrument and that must be evaluated from subjective and objective perspectives. This study investigates the efficacy of a revised version of the life review program (LRP-TW) to influence improvement in the QOL of elders with mild to moderate AD in four long term care facilities in South Taiwan when QOL is construed as a multidimensional entity (i.e. SF-36, MMSE, and GDS). An experimental, repeated-measure design was employed with 34 residents in four facilities randomly assigned to experimental and control groups. The experimental group participated in the 10-week, bi-weekly, LRP-TW; the control group received the typical programs routinely delivered to the residents in each of the facilities. The LRP-TW, framed by continuity and developmental theories (Erikson, 1950; Atchley, 1989) and life review reminiscence (Butler, 1963), included life stage relevant activities reflective of the Taiwan culture of earlier times that correspond to the dates when the subjects would have been at each successive stage. Quantitative analyses of data revealed that objective and subjective indicators of QOL were significantly intercorrelated to each other, but the LRP-TW did not significantly affect the objective and subjective measures of QOL. However, qualitative analyses of data revealed that the LRP-TW successfully applies a variety of leisure activities as tools to trigger each participant's past leisure experiences and related memories. The LRP-TW is promotable as a recreational therapy intervention in long term care facilities throughout Taiwan. Further study with a larger sample size and efficient measuring strategy continuing the search for reliable methods for measuring QOL as a multi-dimensional compound model are needed.