< Culture Change

Storytelling

Poor old Miss Nancy has lost her memory and young Wilfrid wants to help her find it - once he understands what they are looking for.

"What's a memory?" he asks his friends at the old people's home where Miss Nancy lives.

"Something warm," replies one.

"Something from long ago," says another.

"Something that makes you cry," responds a third.

"Makes you laugh, answers a fourth.

"As precious as gold," muses a fifth.

Back home, Wilfrid looks for memories to replace the ones Miss Nancy has lost. Into a basket he places a warm, freshly laid hen's egg; seashells he found long ago; a war medal he sadly recalls his grandfather giving him; a puppet that makes him laugh; and last but not least, his precious football.

He gives his basket to a surprised and delighted Miss Nancy. She pulls the items out one by one and begins to remember when she was a child. She tells about a bird's nest she found, the beach she used to visit, a big brother who never returned from war, a puppet that made her little sister laugh, the day she met her friend Wilfrid, and the secrets they share.

And the two of them smiled and smiled because Miss Nancy's memory had been found again by a small boy, who wasn't very old either. (2)

Published in 1984, this children's story gives a vivid example of how and why caregivers should encourage reminiscing and storytelling among elders, says Cynthia Barnard, CTRS, Volunteer Coordinator and Elder Life Specialist at Maine Medical Center in Portland.

She and her volunteers create their own baskets of memories, called "reminiscence boxes", to keep minds active and prevent delirium among patients in the hospital's Elder Life Unit. A shoebox full of magazine clippings, photographs, holiday symbols and trinkets often trigger strong memories even in those with severe cognitive deficits.

"Then you can get them to tell the story.. it may not be totally accurate, but at least for the moment they're engaging their minds," says Barnard.

It also helps them connect with caregivers and feel comfortable in their new surroundings, she adds.

Stories Heal

The same is true at any age. Around the warm glow of campfires, oral tradition and storytelling wove the fabric of society before the dawn of recorded history. It binds families and communities, preserves culture, reveals the wisdom of experience, brings history to life, and - research indicates - has immediate health benefits.

"We found evidence that strongly suggests that when people listen to 'remember when' stories that are meaningful, their systolic blood pressure and heart rate are lowered significantly," report Drs. Howard Thorsheim and Bruce Roberts of St. Olaf College in Northfield, MN. (3)

Their research included 10,000 persons in 24 communities. Some said reminiscing and listening to friends reminisce about their life stories are like "being picked up and relaxed, all rolled into one. " (4)

Growing evidence supports Thorsheim and Robert's preliminary results, including is a Harvard study that finds socializing as important as exercise for prolonging life among persons 65 and older. (5)

For those at death's door, storytelling connects them with their loved ones and helps bring closure, says Barbara Spring, PhD, former Executive Director and co-founder of Life's End Institute at the Missoula Demonstration Project in Montana.

"As we do our life story, it reminds us we might wish to say 'thank you', 'forgive me', 'I forgive you' or 'I love you'," says Spring, who currently is the Institute's Director of Research and Program. She also volunteers with StoryKeepers, an organization working to perpetuate and celebrate the art of storytelling.

Richard Stone, author and founder of StoryWork Institute, promotes storytelling as an antidote for alienation and isolation in a society "addicted to speed and the bottom line" and mesmerized by television and computer screens.

"Community, if it exists, is relegated to sterile settings such as virtual reality and talk rooms on the internet. Real intimacy has become scarce.. We have become a culture obsessed with instant gratification and building a future without regard for our past, and we are in trouble." (6)

Hospitals and other health care environments, he says, "must be totally reassessed, making room for institutional models of healing that incorporate storytelling and other art forms such as dance and song." (7)

Nowhere is the need for singing, dancing and storytelling greater than in long-term care, where workers are uniquely positioned to help reconnect society with its past through the eyes of elders.

Community Learning Circles

"Whenever there are more than 3 or 4 people present, be sure to sit in a circle."

- Richard Stone, The Healing Art of Storytelling

But how can busy staff draw stories from elders, many with cognitive deficits much greater than Wilfred's friend, Miss Nancy?

The Community Learning Circle is one way.

Action Pact Executive Leader LaVrene Norton designed learning circles in the 1980s to spark involvement by all stakeholders, including frail residents, in changing the culture of long-term care. With everyone given opportunity and encouragement to speak without interruption or judgment, even the most shy and inarticulate contribute to decision-making, and a sense of community emerges.

Inspired by late dementia researcher Dr. Thomas Kitwood, Action Pact's Megan Hannan has modified Norton's model to better accommodate the cognitively impaired. (8)

The model often yields astounding results:

"The lady is crazy," thought Linda Frey, Nursing Director, when Hannan suggested residents from the Meadowlark Hills Nursing Home Special Care Area join in an evening Community Learning Circle with staff and family members.

Included were those with the most severe cognitive deficits. Their "behavioral management problems" normally escalated during evening hours, so Frey feared they would disrupt the meeting and gain nothing from the experience.

She was in for a big surprise.

"I was totally delighted with everything.. it was incredible.. when we started talking and including [residents] in the conversation, they all shared," says Frey.

Residents were well-behaved as staff and family members escorted them to their seats in the circle. The facilitator welcomed everyone and asked a resident to start the group off with a song, My Darlin' Clementine, its lyrics so familiar even elders suffering from severe memory loss sang along.

Next, the facilitator asked each to tell something about themselves: What's a story about you, Mary, what's important to you?

Some needed family members or staff to help tell their stories:

"She likes to eat chicken and greens, she likes to talk, and she likes money," a caregiver answered, looking at Mary.

A few residents responded only with gestures and facial expressions, all the while basking in the glow of attention as they heard their names spoken and their stories told.

Family members smiled and workers' mouths went agape at what they heard from elders who until then seldom spoke coherently: tales of childrearing, growing up on the farm, former careers and lovers, even possible sightings of the gangster, John Dillinger.

Household pets roamed freely, providing a pleasant diversion when the conversation ebbed. Eventually, the facilitator engaged everyone in the circle.

As residents began to tire, they ended the circle by singing another familiar song.

The experience proved residents are capable of much more than employees have come to expect, and can function in a social model if given encouragement, says Frey.

"If we had learning circles say, twice a day, over time it may really change life for those residents.. I'm very excited about that," she concludes. (9)

Life Story Circles

"I promise you, the richness of personal stories will make almost everything on TV pale by comparison."

- Richard Stone, The Healing Art of Storytelling

A similar technique, Life Story Circles, is used in long-term care settings by Spring and her colleagues at StoryKeepers, a subsidiary of Life's End Institute. The process is described on the Institute's website, and in Richard Stone's book referenced herein.

The circle's success depends a great deal on the skill of the facilitator, especially in larger groups, says Spring. The ideal size is four to six persons, though the Institute has led groups as large as 18.

The facilitator describes procedures, chooses topics, tells the first story to reveal something about herself and gives a brief closure after everyone else has told their story.

She reminds participants of time restraints, and urges them to listen rather than thinking about what they are going to say. When their turn comes, they are encouraged to tell their story spontaneously and from the heart.

Listening, an essential art for carrying on oral history, is further encouraged with an ancient Native American tradition, the "talking stick". She who holds the brightly painted stick also holds the undivided attention of circle participants. When she finishes her story, she passes stick to the next storyteller.

Fire is an important ingredient: People since the beginning of time have told their stories around campfires and hearths, and should do so today, says Stone.

"The light and heat of burning embers and the tales of ancestors, adventure and triumph go hand in hand, creating a powerful mood for sharing." (10)

As campfires may not be feasible in eldercare environments, Stone suggests turning the lights down and lighting a candle in the center of the circle to "create an edge of anticipation as well as an air of relaxation." (11)

Lastly, adds Spring of StoryKeepers, accept what is said in the circle. "Don't judge whether it's the absolute truth or not, it really doesn't matter."

What matters far more are the bonds of community formed, the links to the past forged and the wisdom revealed.

Alex Haley (1921-92), who helped connect America with its Afro-American heritage through his popular book Roots, said, "Every time an old person dies, it is as if a library had burned down."

It follows then, that long-term care providers hold the keys to a virtual Library of Congress, where generations of old people sequestered from the rest of society are dying to tell their stories.

Society to a great extent has lost her memory. By listening to and encouraging storytelling, caregivers have a unique opportunity to help her find it.

References

(1), (6), (7), (10), (11) The Healing Art of Storytelling: A Sacred Journey of Personal Discovery, by Richard Stone, (Hyperion, 1996, N.Y.), recently republished by iUniverse, available at amazon.com and (soon) at www.storywork.com.

(2) Wilfrid Gordon McDonald Partridge, written by Mem Fox, Illustrated by Julier Vivas, (Kane/Missler Book Publishers, 1985; originally published in Australia by Omnibus Books, 1984)

(3), (4) Reminiscing, Social Support and Well-Being, by Howard Thorsheim PhD and Bruce Roberts PhD, St. Olaf College, Northfield, MN.

(5) Population-Based Study of Social and Productive Activities as Predictors of Survival Among Elderly Americans, Glass, Mendes de Leon, Marottoli & Berkman; British Medical Journal (August 21, 1999, 478-483)

(8) Learning Circles: Creating Community for Elders Living With Dementia, by Megan Hannan, Culture Change Now!, Volume One, Action Pact, http://www.culturechangenow.com

(9) Becoming Who They Were: Skills for Building Community Among Elders with Dementia, VHS, Action Pact, 2001

Other Resources

www.intensivejournal.org: Ira Progoff, a father of journal writing techniques, studied under Carl Jung.

www.journaltherapy.com: Kathleen Adams has done extensive work on using journal writing in therapy.

www.storyhelp.com: Tristine Rainer is author of The New Diary and other books on journal writing.

The Artist's Way by Julia Cameron outlines helpful writing practices.

www.nataliegoldberg.com: Natalie Goldberg's Writing Down The Bones: Freeing The Writer Within (1986), broke open the world of creativity and started a revolution in the way we practice writing in this country.

www.iwitnesstohistory.org: "Our mission is to help preserve and share the memories of our elders." -Terryl M. Asla, Director.

Writing the Natural Way, by Gabriele Lusser Rico, gives hints on using word webs or word clusters.

One to One: Self-Understanding Through Journal Writing; Life's Companion, Journal Writing as a Spiritual Quest; and Calling the Circle, The First and Future Culture, all by Christina Baldwin.