Today the world’s population is ageing, due to both an ongoing decline in fertility and an accompanying increase in longevity. This poses a myriad of challenges for the elderly, most notably the creative use of leisure time. In this context, drama has the potential to promote a sense of meaning in life. A common relevant practice is reminiscence theatre, which aims to produce performances based on participants’ recorded stories of the past. Reminiscence drama and theatre is based on the theory of “life review,” according to which life is a sequence of choices that the individual can recollect towards the end of their life in order to acquire a sense of personal identity and appreciation, so as to be reconciled with the concept of loss. This paper seeks to explore the use of this theoretical framework in Greece, one of the world’s most ageing countries.
Keywords: Ageing, Reminiscence Theatre, Reminiscence Drama, life review, ego-integrity
Introduction: Researching the Elderly
Τhe increasing number of elderly people explains the surge of geriatric interest in recent years, but, unfortunately, it does not seem to have altered our dislike of old age. From antiquity to the present day, old age is associated with decline and death (Lowenthal 1985). In modern culture, youth, beauty and an active life are valued more than anything else. On the other hand, old age and the consequent age-related diseases, functional impairment and physical inability constitute the downside of Western civilization, where even the word “old” is considered as an insult (Dionigi 2015).
The truth is far from these stereotyped perceptions. An older adult is a person who continues to grow. S/he is still an apprentice in the pursuit of happiness, joy and pleasure. In addition, s/he is a person who deserves respect and appreciation and whose job can be to synthesize the experience of his/her long life and to shape it into a legacy for future generations (Weiss 1984). This developmental dimension of old age opens up a new creative action aimed at improving the lives of older people and, in turn, changing society’s attitude towards ageing.
Various interventions for the elderly have been proposed throughout the world. These include workshops on art, crafts, gardening, games, literature, history, music, painting and physical exercise (Age Concern 2002; Loveland 12). Often, these laboratories draw their themes from the past of the elderly, tending to establish the practice of “life review,” as it is called by Robert Butler (1963), who argued that, in order to reach a satisfying level of enjoyment of life, the old person must develop mechanisms to renegotiate the lived experience by remembering what s/he has lived. It is precisely this enjoyment of life, the “ego-integrity” as Erik Erikson (1950) had previously called it, that is the prime aim of the third age movement, which deals with the basic need of humans to reconcile with what s/he has lived, his/her successes and failures, and to move forward with courage towards the inevitable end.
The elderly have basic needs that differentiate them from others; they need to develop skills for making friends, coping with physical and mental deterioration, responding to the threat of loneliness and depression, and meeting boredom and loss (Haight and Haight 2007). Hence a research approach such as the present one is particularly interesting for our ageing world. Given that Greece is one of the most ageing countries in the world (United Nations 2017), but also that specialized researchers have not yet dealt with the issue, the need to enrich research around this subject in this country is imperative.
This article suggests a possible framework for reinforcing the enjoyment of life, the “ego-integrity” of older people, in accordance with Erikson’s (1950) and Butler’s (1963) theories. It involves older people in a Greek local community and explores the connection between drama and their enjoyment of life.
Reminiscence Drama and Theatre
The international interest in developing interventions for the elderly has paved the way for the development of “cultural gerontology,” which explores the phenomenon of ageing in a wider social and cultural context, not as a problem, but as a cultural value (Rickett and Bernard 4-5).
Several relevant programmes and examples of good practice have been developed around the world. During the 1980s, an organization called Age Exchange was created in England by Pam Schweitzer with the aim of organizing performances based on the memories of older people, produced via specially structured reminiscence sessions or oral history programmes. The shows took place in community spaces, day care centres and retirement homes (Vandegrift 2014; Quinn 1989; Schweitzer 2007; Schweitzer 2013a). During the 1990s the interest in such programmes was broadened in Europe. In this context, theatre programmes with/for seniors were developed, often with intergenerational and intercultural content, including even groups of older adults suffering from cognitive impairment (Darling and Rymer 2014; Schweitzer 2013b; London Centre for Dementia Care 2009; Wilder 27-28; Wimmer 2006; Amann 2003).
Based on this experience, I chose as subject for my research the exploration of an approach to the elderly through reminiscence drama. Its purpose was to explore the deeper relationship linking this practice with the approach of “ego-integrity” as an overall well-being parameter for people in the third age.
Research Restrictions, Aim and Method
A mixed approach, of quantitative and qualitative orientation, according to the principles of empirical grounded theory (Charmaz 1995; Greene 2007; Victor et al. 2007) was considered the most appropriate method for this research.
The research questions were:
- Can an older adult’s “ego-integrity” be positively impacted by drama?
- If so, how can drama enhance the “ego-integrity” of an older person?
The qualitative approach responded to both of the research questions raised above, while the quantitative approach complemented and reinforced the qualitative in relation to the first question.
Fourteen (14) interventions with a group of elderly members of the local community of Nea Peramos, a semi-rural area of Attica near Athens, were conducted to collect qualitative and quantitative data.
For the collection of control group data, a randomly matched age group was set up in the nearby town of Megara and asked to fill in two questionnaires, before and after the intervention in the experimental group. The sampling was therefore theoretical: the sample members were twenty-five (25) for the experimental group and twenty (20) for the control group, all over sixty-five (65) years old. Hence, the research design was quasi-experimental (Victor et al. 2007).
Since the research exclusively concerns the population of a small provincial Greek community, it is restricted, without claims to generalization. Its significance lies in the fact that it attempts to investigate the relationship between reminiscence drama and the third age, highlighting the possible influence of drama and theatre in the “ego-integrity” of older people, specifically while monitoring and describing the process of formulating causal relationships.
The Accepting the Past / Reminiscing about the Past (ACPAST / REM) scale is a methodological tool for measuring acceptance of and reminiscence about the past in correlation to depressive symptoms. This was used to measure past acceptance and reminiscence as key components of ego-integrity (Corcoran and Fischer 2013; Santor and Zuroff 1994). The questionnaire was translated, piloted and tested for its validity using the Cronbach alpha statistical criterion, with acceptable values (see Table 1).
Table 1. Cronbach’s alpha
|Cronbach’s Alpha Based on Standardized Items||0,854||0,962|
|N of Items||27||27|
Data were processed by using SPSS v.20 and the procedure followed the principles of descriptive and inferential statistics. The conclusions according to the principles of inductive statistics were based on t-test for independent samples. At the same time, the randomness and normality of the sample were checked and confirmed by the runs and Shapiro-Wilk tests respectively.
The effect of experimental manipulation was clear on the variable of “ego-integrity,” as the elderly in the experimental group showed statistically significant improvements compared to the control group (see Table 2).
Table 2. T-test values during pre-test and post-test
Neither gender nor individual age groups were differentiated.
The findings of the quantitative analysis were further explored through the qualitative approach, in which the fourteen interventions performed in the experimental group were analyzed one by one. These interventions focused on subjects such as refugees, entertainment, school memories, marriage, old professions, old neighborhood, and so on. The qualitative data were analyzed immediately after the end of each session to identify saturated categories and search for new ones, in accordance with the principles of grounded theory. Meetings were held weekly at the Nea Peramos Community Centre.
Qualitative data indicated that reminiscence drama positively mobilized the mechanisms of remembrance for older people, gradually creating a more positive outlook towards their past and their overall lives:
During these sessions I realized that nothing is lost, because we still remember it.Male participant, 81+ years old
Initially, participation in drama felt rather embarrassing to the elderly. However, storytelling proved to have the potential to activate memory and enhance speech. Starting from simple stories of the past, participants gradually passed on stories that sought their deepest ego and which could shape their “ego-integrity,” proving drama to be the factor that shaped these memories:
It was so nice! Like real theatre. And I think that you don’t have to be an actor; I was myself.Female participant, 81+ years old
During reminiscence drama, participants were reconciled with their past and seemed to gain a new relationship with their dead parents. They saw life more positively. They also grasped that their life experience is still useful today in our postmodern society, which needs values to move forward. Even traumatic experiences were met by the participants with the awareness that they were not determining their quality of life. All of the above elements appear to be of particular importance for their “ego-integrity”:
I was a poor man, but I was a man who lived beautifully and worked hard all his life. My house was not luxurious, but I had friends and honesty in my heart. So, in this house I taught my children to respect work and value it and to be human.Male participant, 81+ years old
Therefore, these sessions proved that, though initially embarrassed, the elderly became acquainted with reminiscence drama and approached it with increasing eagerness. They gradually gained the opportunity to deal with their past and approach it creatively, thus being enabled to manage troubled situations they had lived in before. This fact demonstrates that maintaining the processes and results of such interventions requires time, perseverance and faith in the dynamics of drama as a tool for improving human life:
I felt a little pressed at first. I didn’t understand why I had to play. It seemed very childish to me. Then I realized that it was good for me and I felt good.Female participant, 71-80 years old
During the drama sessions, it was common for participants to repeat the same stories. At times funny and at others full of pain and frustration, these stories did not tire the group; instead, they were always welcomed with warm interest, trust and openness, perhaps because it satisfied the need of participants to be “lightened” from the burden of the past. The opportunity to repeat the same stories through drama satisfied the participants who needed it, given that their relatives were likely to deny these recurring stories:
I haven’t figured it out. Some people tell us, “Why do you remember the old time? It’s not good for you.” And we come here, and we remember and laugh, and we are fine. I have been thinking about it for days now and I think that I like it so much—I find a way to forget, not to worry. And I feel like an actor, on a stage; I’m proud of myself.Female participant, 81+ years old
The Reminiscence Show
Two months after the completion of the interventions, some participants requested that I edit a play based on the testimonies and stories submitted by them. The time available, about three weeks in the summer, was very limited, but I couldn’t refuse such a challenge.
Initially, the whole group of seniors who participated in the programme was invited, but the response (during summer holidays) was very limited; only fifteen (15) women hastened to participate in this new project. Their wish was to prepare a show on love and marriage, so this was the theme of our play.
First, the task force re-edited the transcribed stories recorded during the respective sessions and supplemented the narratives with some further sources. The elderly women wanted to present a single love story in the context of traditional society. Their proposal had a folklore profile, which was eventually adopted, despite my scepticism at this point. After a material processing session, the presentation framework was agreed upon.
The script was agreed to start in the present day and use the technique of retrospective storytelling to look back on the past and tell the story of the marriage of a local couple. I undertook the writing of the text; however, after the script was completed, the participants inspected it for any improvements to its structure and content. At the same time, the elderly women proposed traditional songs and dances to frame the show.
As soon as the script was completed, members of various ages from the local community were invited to take on the key roles of the couple in the past, as well as their friends and relatives. Thus, the project took on an intergenerational profile, bringing together different age groups, who benefited mutually from this collaboration (Kosti, Drama for the Elderly 273; Kosti, Life Stories 27). Most of the older participants took on minor roles and participated in overseeing the rehearsals.
After only two weeks of intense rehearsal, the play was ready to be presented to the local community. The performance took place in an open air theatre at the old port of Nea Peramos and was proven successful, as evidenced by the reactions of both audience and participants:
It was a great story of our grandparents; I enjoyed it. I wish I had participated in this performance and I would love to participate in a similar project in the future.Female viewer, 20 years old
The performance satisfied the group of elderly women who were involved in the conception and development of the idea. Of course, the other members of the experimental group also watched the performance with great emotion:
This is our life; it’s nice to remember, to relive, and to have the sense of being young again. It’s wonderful for all of us. It was an honour to watch my story on the stage. I’m so happy! I feel that my life was worth it!Female participant, 81+ years old
“Ego-integrity” is not an easy task. The real “integers” do not overlook any previous problems; instead, they re-appropriate their life with a renewed philosophy without prejudice. Elderly participants in the reminiscence drama context embraced this philosophy as a personal construct and treated their lifelong mistakes with a refreshing courage, which is perhaps the most important component of “ego-integrity.”
Reminiscence drama opens up the prospect of a different view of the future for the elderly. Such a perspective is needed in our ever-ageing world, which should be driven by the accumulated wisdom of the elderly.
 In this paper, all people over sixty-five years old are considered “elderly.”
Age Concern. Leisure and Learning. Age Concern, 2002.
Amann, Sylvia. Programmes and Activities of the EU in the Fields of Culture and the Arts in Austria and the Central-Eastern European Countries. European Commission – Culture 2000, 2003.
Butler, Robert N. “The Life Review: An Interpretation of Reminiscence in the Aged.” Psychiatry, vol.26, 1963, pp. 65-70.
Charmaz, Kathy. “Grounded Theory.” Rethinking Methods in Psychology, edited by Jonathan A. Smith, Rom Harré, and Luk Van Langenhove, Sage, 1995, pp. 27-49.
Corcoran, Kevin, and Joel Fischer. Measures for Clinical Practice and Research: A Sourcebook, Volume 2: Adults. Oxford UP, 2013.
Darling, Fiona, and Anna Rymer. A Pocket Guide to Arts Activities for People with Dementia. Collective Encounters, 2014.
Dionigi, Rylee A. “Stereotypes of Ageing: Their Effects on the Health of Older Adults.” Journal of Geriatrics, 2015.
Erikson, Erik H. Childhood and Society. W. W. Norton and Company, 1950.
Greene, Jennifer. Mixed Methods in Social Inquiry. Wiley, 2007.
Haight, Barbara K., & Barrett S. Haight. The Handbook of Structured Life Review. Health Professions Press, 2007.
Kosti, Katerina. Drama for the Elderly as a Means for Fostering “Ego Integrity”: Field Research on the Effect of Drama Techniques on Older People. 2018. University of Peloponnese, Postdoctoral dissertation.
—. “Life Stories in Reminiscence Theatre.” Education and Theatre, vol. 18, no. 24-31, 2017, pp. 24-31.
London Centre for Dementia Care. Over the Moon: Effectiveness of Using Interactive Drama in a Dementia Care Setting, Part 3: Evaluation Report. Central and Cecil, 2009.
Loveland, Jean. “Leisure Activity Packages for Rural Aged.” Activities, Adaptation and Ageing, vol. 2, no.1, 1981, pp. 11-20.
Lowenthal, David. The Past is a Foreign Country. Cambridge UP, 1985.
Quinn, Catherine. Honouring Memories: An Evaluation of the Work of the Age Exchange Reminiscence Project. Centre for Policy on Ageing, 1989.
Rickett, Michelle, and Miriam Bernard. Ageing, Drama and Creativity: A Critical Review. Arts and Humanities Research Council, 2014.
Santor, Darcy A., and David C. Zuroff, D.C. “Depressive Symptoms: Effects of Negative Affectivity and Failing to Accept the Past.” Journal of Personality Assessment, vol. 63, no. 2, 1994, pp. 294-312.
Schweitzer, Pam. “Making Memories Matter: Reminiscence and Creativity. A Thirty-year Retrospective.” Oral History, vol. 41, no. 1, 2013a, pp. 85-97.
—. “Reminiscence in Dementia Care.” The International Journal of Reminiscence and Life Review, vol. 1, no. 1, 2013b, pp. 42-47.
—. Reminiscence Theatre: Making Theatre from Memories. Jessica Kingsley Publishers, 2007.
United Nations. World Population Ageing 2017 Highlights. U. N. Department of Economic and Social Affairs, 2017.
Vandegrift, Juliana. Annual Report 2014. Oral History Society, Regional Network, 2014.
Victor, Christina, Gerben J. Westrhof, and John Bond. (2007). “Researching Age.” Ageing in Society, edited by John Bond, Sheila Peace, Freya Dittmann-Kohli, and Gerben Westerhof. Sage, 2007, pp. 85-112
Weiss, Jules C. Expressive Therapy with Elders and the Disabled. Routledge, 1984.
Wilder, Rosylin. “Life Drama with Elders.” Interactive and Improvisational Drama, edited by Adam Blatner and Daniel J. Wiener, iUniverse, Inc., 2007, pp. 23-33.
*Katerina Kosti has a Ph.D. in Theatre and Drama Education from the University of Peloponnese. She now teaches in the Department of Theatre Studies of the University of Peloponnese as an adjunct lecturer. Her postdoctoral research was on reminiscence drama and theatre. She also works on drama projects in prisons and day care centers.
Copyright © 2019 Katerina Kosti
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