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An Exploration of Health and Religion in Elderly People Through the Lens of Scriptural Reminiscence. Opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor and Francis. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, systematic supply, or distribution to anyone is expressly forbidden.
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An Exploration of Health and Religion in Elderly People Through the Lens of Scriptural Reminiscence
An Exploration of Health and Religion in Elderly People Through the Lens of Scriptural Reminiscence. Opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor and Francis. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, systematic supply, or distribution to anyone is expressly forbidden.
An Exploration of Health and Religion in Elderly People Through the Lens of Scriptural Reminiscence. Opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor and Francis. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, systematic supply, or distribution to anyone is expressly forbidden.
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Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK Journal of Religion, Spirituality & Aging Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/wrsa20 An Exploration of Health and Religion in Elderly People Through the Lens of Scriptural Reminiscence Elizabeth MacKinlay a & Colin Dundon a a Charles Sturt University , Canberra , Australia Published online: 10 Jan 2012. To cite this article: Elizabeth MacKinlay & Colin Dundon (2012) An Exploration of Health and Religion in Elderly People Through the Lens of Scriptural Reminiscence, Journal of Religion, Spirituality & Aging, 24:1-2, 42-54, DOI: 10.1080/15528030.2012.632714 To link to this article: http://dx.doi.org/10.1080/15528030.2012.632714 PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the Content) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms- and-conditions Journal of Religion, Spirituality & Aging, 24:4254, 2012 Copyright Taylor & Francis Group, LLC ISSN: 1552-8030 print/1552-8049 online DOI: 10.1080/15528030.2012.632714 An Exploration of Health and Religion in Elderly People Through the Lens of Scriptural Reminiscence ELIZABETH MACKINLAY and COLIN DUNDON Charles Sturt University, Canberra, Australia An extensive body of quantitative research associates well-being in later life with religious involvement. This article reports on a pilot study of one specic aspect of religious involvement hitherto insuf- ciently investigated, namely, Scriptural Reminiscence (SR). SR is the interpreting of biography in the light of Scripture in recognition of Scriptures unique place in the self-as-narrative of older people of faith. The study was of two small groups of older people meet- ing weekly over a six-week period with a follow-up focus group to explore SR, their faith journey, practice of religion, and mental health. The qualitative ndings are reported in this article. KEYWORDS Ageing, religion, Scriptural Reminiscence, mental health INTRODUCTION An extensive body of quantitative research associates well-being in later life with religious involvement. Yet, little is known of the reasons for these nd- ings, particularly because religious involvement is too broad a category for ready analysis. We aimed to study one specic aspect of religious involve- ment hitherto insufciently investigated, namely, Scriptural Reminiscence (SR) (Anstey, 2008). SR is the interpreting of biography in the light of Scripture in recognition of Scriptures unique place in the self-as-narrative of older people of faith. This article reports on a pilot study of SR, consisting of two small groups of older people meeting weekly over a six-week period Address correspondence to Elizabeth MacKinlay, Centre for Ageing and Pastoral Studies, 15 Blackall Street, Barton, ACT 2600, Australia. E-mail: EMackinlay@csu.edu.au 42 D o w n l o a d e d
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Scriptural Reminiscence 43 with a follow-up focus group to explore SR and their faith journey, practice of religion and mental health. Pre- and posttests revealed signicant decrease on the Geriatric Depression Scale (GDS) scores, slight decrease in religious practices, and self-reported agitation (anxiety) and negative religious cop- ing decreased, whereas a positive attitude to ageing and positive religious coping increased. It is important to note that this was a pilot study with small numbers thus statistical analysis cannot be relied upon. The qualitative ndings are reported in this article. To what extent do older Christians engage with Scripture? Is there a link between engaging with Scripture and health? Often it is assumed that adult Christians have a good grasp of Scripture and can readily apply Scripture as a guide to living. A comment from a participant in the focus group held after completion of this pilot study was typical of the participants in the two groups: Speaking personally, I mean Im not used to engaging in Scripture at all, and therefore it was a learning experience for me to even nd out that there are three ways that you can do it. And I certainly found the method that we used helpful. LITERATURE The Relationship Between Scripture and Health The effects of religion on health are still not well understood in spite of the abundant literature from epidemiological data and increasing evidence from clinical trials that there is a positive relationship between religion and health (Koenig, 1998; Koenig, McCullough, & Larson, 2001; Moberg, 2001). As yet, little is known of the reasons for these ndings, particularly because religious involvement is too broad a category for ready analysis. Further, caution has been urged in the too-ready inclusion of religious activities as a means of medical treatment (Sloan et al., 2000; Sloan & Bagiella, 2002). Knowing what about the practice of religion makes a difference to the health of older people is much more difcult to discover. While measures of church attendance have shown correlations of health and religion, it is still difcult to account for the differences between churchgoers and those who do not attend. The actual nature of the relationship between health and the practice of religion needs to be more fully understood to be of value in clinical settings. A way of understanding the differences, at least in the Abrahamic faiths, may be through examination of the relationship of individual believers and their God. Joel Green (2003) describes the way that Western societies have come to consider relationship of health, in isolated ways, for instance (my need, my treatment, my health) and in ways more segregated (spiritual, physical, relational versus genetic) (Green, 2003, p. 6061). Green goes on to assert that it is: D o w n l o a d e d
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44 E. MacKinlay and C. Dundon precisely here that the witness of scripture holds out its promise and challenge. Rather than begging to be applied to our lives, seeking for its message to be molded to the contours of our worlds, the scriptures yearn to reshape and reconstitute the categories by which we comprehend our lives, our worlds, even our greatest needs. Reading scripture, we enter into its evaluation of our condition, but also encounter its promise of restoration, its hope of health. (Green, 2003, p. 61) This constitutes a re-evaluation of life challenged by scripture, Green calls this an autobiographical reconstruction (Green, 2003, p. 116), noting that this generally comes through understanding ones place within the history of Gods purpose (2003, p. 116). Scripture contains the central stories of faith, it is through linking these stories of faith with the life of the person journeying in their faith that healing and health can come. Recognition of the central place of story in the lives of human beings is one of the important developments being seen in the early years of the twenty-rst century. Reminiscence, life review, autobiography, narrative gerontology, spiritual reminiscence, and spiritual autobiography, reminiscence therapy, spiritual reminiscence work, whichever term is applied, there is growing interest in human story (Coleman, 1994; Gibson, 1998, 2004; Haight & Webster, 1995; MacKinlay, 2006; Webster & Haight, 2002). In the current busyness of work and social spheres of Western societies, story has been neglected until relatively recently. Without these connections of story between generations we are lessened in our humanity and in our communities. Kenyon, Clark, and de Vries (2001) note that a basic assump- tion of narrative gerontology is that storytelling and story listening are not just things we do occasionally, rather they constitute the process by which we create and discover our personal identity as human beings (Kenyon, 2003, p. 30). He enlarges on this to include the function of story-telling and listening, to not only ideas, but emotions and behaviour. As well, we are each a part of the larger stories of our families, our faith, our communi- ties, our nation and our own story is interwoven with each of these larger stories. Reminiscence is the general term that refers to remembering events from the past and it is a naturally occurring event (Butler, 1995). Coleman (1999) describes the characteristics of a successful story as being one that bears on the subject of reconciliation or harmony between the past, present, and future. Spiritual reminiscence is reminiscence that focuses on life meaning in remembering and in particular, this strategy seeks to consider the persons story in relation to his or her spiritual life journey, that is, ones life journey as an individual, with family and community, and with God (MacKinlay, 2006, Moberg, 2001). D o w n l o a d e d
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Scriptural Reminiscence 45 Reminiscence is now used as a therapy by Haight and Webster (Webster & Haight, 2002). Faith Gibson (1998, 2004) has used the term reminiscence work in her study and research. This view of reminiscence is a valuable one as it places reminiscence as a process for engagement by older adults. In our work (MacKinlay, Trevitt, & Coady 20022005 1 ) with people who have dementia, we have chosen to use the term reminiscence work as it seems to more accurately reect the interaction with the participants in the study; the participants do work with their memories. In fact we have further rened the term in our work to focus on spiritual reminiscence work; in that perspective, we are examining issues of meaning in later life, including relationship with others and/or God. Coleman describes four characteristics of story: the need for coherence, assimilation of life events into the story, a convincing structure, and a truth value that is, story has an ethical dimension (Coleman, 1999). These four characteristics t well into a spiritual understanding of being human and ageing. First, to say that we are story, is to acknowledge that story connects us to our deepest points of being, to our souls. Story is deeply tied to our individual identity, to the core of our being. Second, stories being composed of both facts and possibilities leaves open the possibility of spiritual journey through the life span. Conversion, change, and renewal of being may occur; the future is open and remains so as long as we live. Third, the meaning and nature of time can also be considered at a spiritual level. At the spiritual level it is suggested that story time becomes more relevant than clock time; again, there is an air of openness to the future and the possibility of connection to our past. Fourth, the interrelated dimensions of both the personal and the larger story link very well to the spiritual dimension. We are individuals, but we are part of a larger whole, and we yearn for connections with others, with the stories of others and with God, or a sense of otherness, however perceived by the person. Thus reminiscence, or narrative gerontology, is a central component of being human, and part of the spiritual journey in life. Increasingly this is being recognised in our ageing society and in residential aged care. A biomedical model for ageing simply does not paint the whole picture; story lies at the centre of what it means to be human and growing older. Butler notes that in later life people tend to have a particularly vivid imagination and memory for the past and can recall with sudden and remarkable clarity early life events (Butler, 1995, p. xvii). He writes that the personal myths of invulnerability and immortality are no longer satisfying and this results in reassessment of past life that may result in depression, acceptance, or satisfaction. Butler contends that this process occurs in all older people in their nal years, while Coleman (1986) found in his research that some older people did not appear to engage in reminiscence. There may be various reasons for this; perhaps they have already processed their life story, perhaps very privately or perhaps they feel unable to deal with D o w n l o a d e d
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46 E. MacKinlay and C. Dundon some aspects of their story and a blockage to reminiscence may be experi- enced. However, Butlers assumption of the universal nature of reminiscence seems now to be well accepted. Possibilities for Health and Well-being Through Story Application of Erikson, Erikson, and Kivnicks (1986) stages of psychosocial development, lead to an inclusion of all life experiences, and the struggle that occurs in the nal stage of life development between integrity and despair may enable the person to review and reframe earlier life experiences. In fact, the remembering and reprocessing of earlier negative memories may enable the person to move towards ego-integrity in later life. To deny the existence of disturbing or negative memories may move the person towards a blockage of psychosocial and spiritual growth in later life (MacKinlay, 2006). Taking this perspective, Coleman found that normally reminiscence is rewarding for both the speaker and the listener; however, this is obviously not so with painful memories (Coleman, 1999). Coleman notes that the healing and reconciling activity of life review has been neglected, despite Butlers early work in the 1960s. In a study of older people and their war memories (WWII) Coleman noted that where disturb- ing memories remained unintegrated it was necessary to make the original experience explicit by categorizing and understanding it, for it to lose its power to haunt us (Coleman, 1999, p. 136). The techniques needed to do this may be found in reframing. Birren has developed a process of guided autobiography over the past 25 years that is valuable in this process (Birren & Cochran, 2001). Scriptural Reminiscence Reminiscence is already established as a valuable means of assisting older people to nd meaning in their later years; our work with spiritual reminiscence has taken this further (MacKinlay, 2006; MacKinlay & Trevitt, 2006). We propose to take this already established work to develop a pro- cess of scriptural reminiscence that will harness the naturally occurring reminiscence with the story of Scripture. Thus we intend to intentionally link the peoples story with Gods story to assist older people to come to a sense of the purpose and meaning of their lives. Faith Stages Among Older People It is assumed that the older people in the study may be at different stages of their faith development, based on the work of Fowler and subsequent study of stages of faith development (Fowler, 1986; Fowler, Nipkow, & Schweitzer, 1992). Thus participants in a study may respond to engage- ment with scripture at different levels. Some guidance for these stages may D o w n l o a d e d
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Scriptural Reminiscence 47 be given. Fowler has asserted that meaning, relationships, and a sense of othernessthe supraordinate valuesare at the centre of his framework of faith. This framework assumes the possibility of progression through a number of stages of faith development. It is assumed that not all people will progress through all stages, and, according to Fowler older people are more likely to be at stages 3 to 5 of his 7-stage model (0-VI) (Fowler, 1986). 2 These stages are: Stage III: Synthetic-conventional faith, a faith stance of late child- hood that may remain through life, where the judgments and expectations of others are important and it is accepted without question and is con- formist. Next, Stage IV, Individuative-reective faith, which sees a relocation of authority in the self, with a critical distancing from previously held value systems, may be a nal stage for some. Stage V: Paradoxical-consolidative or conjunctive faith is described as balanced faith, inclusive faith, a both/and faith (Astley & Francis, 1992, p. viii) and may be found among older adults. Finally, Stage VI, the so-called Universalizing faith, is described as a seless faith and involves relinquishing and transcending of the self. It is seen by Fowler (1981) as being rare. It is noted, however, that this stage of spiritual development is seen in numbers of frail elderly people and has been reported by numbers of authors. Fowler did not interview people in the fourth age of life and this may account for his view that this nal stage of faith or spiritual development is rare. A more recent article by Fowler (1986) responds to critique from a postmodern perspective and in it he argues the place of stages and types of faith, suggesting that stages may be relevant for perhaps half of the picture seen in faith development. How relevant is it to consider faith stages in this study? In later life, it is argued that spiritual development is a dynamic pro- cess with individuals being able to respond to the deep stirrings of spirit; to life-meaning and choice-making in their spiritual lives. Further, there may be blockages to continued spiritual development that may include such things as a sense of meaninglessness or hopelessness in life, resentment, anger, unforgiveness, or unresolved grief. Conversely, these factors may also serve as triggers for spiritual growth (MacKinlay, 2006). It is asked how much of this understanding of faith development might be relevant for older people intentionally linking study of scripture with their faith journey? How might this affect their mental health? Research Questions The questions for the pilot study were:
What is the relationship between mental health, religious practices, and
beliefs of the study group of elderly people?
Does scriptural reminiscence increase a small groups capacity to foster
trust and connectedness between members?
Rene the method of scriptural reminiscence for a larger study.
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48 E. MacKinlay and C. Dundon MATERIALS AND METHODOLOGY Recruitment of Participants All members of two separate Christian congregations of 65 years and over were invited to participate, making it clear that this was a pilot study, and only one group from each congregation could be formed. The study was advertised during the notice time of the weekly church services, and infor- mation sheets and consent forms were distributed to interested people. The full study, of which this study was a part, had been approved by the Ethics Committee of Charles Sturt University. Characteristics of the Group Members All over 65 (one about to turn 65) and all practising members of a Christian community of faith, they were able to speak English, and were cognitively competent. All participants were living independently in the community. The Study A mixed-methods study was used to provide an evaluation of the men- tal health and religious and spiritual well-being of participants. The items used were Geriatric Depression Scale (GDS), short form; Philadelphia Morale Scale (PMS), Religious scales: Fetzer Daily Spiritual Exercises, Fetzer Private Religious Practice Scale, Fetzer Religious Coping Scale and Fetzer Religious Support Scale. Analysis was by Statistical Package for the Social Sciences (SPSS). The GDS and PMS were both used to provide a broad perspective on participant affect, both depression and positive morale. The religious scales were used to examine the religious practices used by the participants; these asked questions that provided richer data than typical questions used in study of religion, that have traditionally only asked frequency of church attendance and frequency of prayer. It was recognised that these measures used over such a short time frame of the pilot study could not be relied upon for as justication of results. The religious measures were all designed in the United States and have not been previously used in Australia. It was important to test these in the pilot groups before attempting to use them in a wider study. Qualitative measures of the weekly meetings over the six sessions were taken by audiorecording and transcribing all sessions, and a research assistant keeping a journal of nonverbal interactions of participants. Qualitative data were analysed using NVivo8. Each of the two groups was facilitated by an experienced, but different facilitator. D o w n l o a d e d
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Scriptural Reminiscence 49 STRUCTURE OF THE SESSIONS Group Themes The themes for the Scriptural Reminiscence were all stories from the New Testament, with a focus on Advent, as the groups were conducted in the Advent season of the Christian liturgical year. The six sessions were titled Becoming Who We Are, Accepting Healing, Facing Our Fears, Being Response-Able, Finding Sight, and Taking Our Time. 3 Length of Groups Two groups met for approximately one hour each week for six weeks (one group had a preliminary information and orientation meeting, while the sec- ond group only met six times, with the orientation incorporated into the rst session). Both groups participated in their own focus group meeting after the conclusion of the sessions. The reason for group two having the orien- tation in the rst session was to allow the whole exercise to be completed prior to Christmas, after which it was anticipated that numbers of the group members would be unavailable. The short duration of only six weeks of the two group sessions meant that it could not be expected that any of the quantitative measures would change over the duration of the study; however, it was decided that the short group sessions would provide valuable information on the nature and faith experience of the group members and the way that they were able to use the process of Scriptural Reminiscence to address life issues. RESULTS Quantitative PARTICIPANTS A total of 13 participants contributed responses to the questionnaires of the Pilot Study, of which 4 were male and 9 were female. Average age of the participants was 75.15 years, with a range of 65 to 91 (SD = 7.57). Analysis of the pilot study data showed signicant decrease on the Geriatric Depression Scale from the pretest to the posttest session. This result is remarkable as only 6 of the 13 participants could be included in this analysis (due to participants being removed from the analysis if they had missing responses anywhere in the GDS on either the pretest session or the posttest session). Therefore, from pretest to posttest, a signicant decrease in depression scores was observed, on average, for the 6 participants with a complete set of responses on the GDS. It is noted however, that none of the D o w n l o a d e d
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50 E. MacKinlay and C. Dundon scores of the participants were indicative of having depression, only that the scores changed signicantly over the six-week period. A signicant difference was also observed on the Private Religious Practices Questionnaire (PRP) of the Multidimensional Measurement of Religiousness/Spirituality for Use in Health Research scales. This scale was reversed for interpretation such that a high score indicates frequent engagement in religious practices (PRP). On this scale a small but sig- nicant decrease in religious practice was observed between pretest and posttest. All scales have been scored, except the Daily Spiritual Experiences (DSE) questionnaire. The failure to score the DSE is due to the fact that item responses vary from 1 to 4 on some items, and 1 to 6 on others, and so neither adding item responses nor averaging item responses (as was undertaken with other scales) would be appropriate. It is noted that these results were found on a study of a very small number of participants. A larger study is needed to obtain useful data. With only 13 participants, the current pilot study did not have sufcient statistical power to detect even moderate effects in the data. Thus, it is important to note between pretest and posttest that self-reported agitation (anxiety) and negative religious coping decreased, whereas a positive attitude to ageing and positive religious coping increased. Comparison of these gures suggests that the signicant improvement between pretest and posttest can be attributed to higher ratings of life sat- isfaction and an engagement (or re-engagement) in (unspecied) activities. Despite the overall decrease in depression levels, and specic gains in some areas, there was a decrease in overall energy levels reported by partic- ipants between pretest and posttest, which cannot be explained from the data. Qualitative Qualitative analysis of the weekly sessions of Scriptural Reminiscence, using NVivo8 produced themes of identity and faith, relationships, wisdom and meaning, vulnerability and transcendence, mental health and faith, and identifying with the text as being important. The two groups responded differently in the sessions and it is noted that the different facilitation methods of the group leaders could be a factor in these differences. Another factor to be considered is the faith development stage of the participants, in line with faith development stages identied by Fowler (1986, 1992), so that older people could be expected to be in any of the last four stages of faith development from stage four through to the nal seventh stage (Stage VI, in Fowlers stages of 0 to VI), described earlier in this article. D o w n l o a d e d
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Scriptural Reminiscence 51 Focus Groups A focus group was held for each of the study groups, after the completion of all six sessions. The focus groups were led by a research assistant. Group members found all themes for the sessions helpful. When asked: Which ones (themes) were most meaningful for you? The rst responses from the one group were on accepting healing. With the participant saying that: SB07: Um, my memory has gone. It was, no, it, it was comforting for me. Another participant said: SB05: The theme, . . . that I remember most distinctly, and it was the theme of loneliness and addressing loneliness. And I dont think its in the, quite in the set, and its actually forgiveness that is the important factor, forgiving others and forgiving yourself. The members of the one group noted that forgiveness had not been the focus of a session and believed that it would be important to include in future work. In response to the questions by the facilitator of, Why did they think that forgiveness is important to include, SB05 replied: We were having a joke before about cultural awareness, and I think its part of the Australian character, particularly the male character, not to address your emotions . . . kind of run away from your emotions and pretend they dont exist. And whats been helpful in this process has been to have people talking about their experiences. And becoming aware that, you know, you can actively engage in a forgiveness exercise which will, in fact, relieve some of the emotional pressures that exist for you. In response to the question: How do you understand your own biogra- phy, your own self, in relation to Scripture? Has that changed as a result of these sessions? SB07: It was delicious and pleasing and brought every- thing together on past experiences within Scripture. SB06: I found week 4, actually, Being Response-Able, about, um, Anna and so on, Simeon, that, and the whole idea of the wisdom of the age, I found that good. Did that impact on my biography? I suppose the thinking about my own wisdom or whatever. Yeah, that was good. Further reecting on health, the life story and faith, SB03 responded: I think those two and health, not necessarily in the state of being in abundant physical health, but in being, I suppose, in the frame of mind and body, health in that sense, even if you might be physically sick. You know, I think its not being contradictory to say that you can, there can be a sense of health, even if youve got a terminal illness. I think, might say its quite subjective, but the three of them are integrated, you cant put them into nicely measured doses; its more of a state of being than anything. D o w n l o a d e d
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52 E. MacKinlay and C. Dundon DISCUSSION This study should be replicated to examine the factors in mental health and ageing, associated with the use of Scriptural Reminiscence. The depression measures used in this study would not be expected to show any change in such a short study, however they did show signicant changes. If this can be shown in a larger study, this kind of program may have important application in the alleviation of depression and raising levels of well-being in older adults. Other elements of this study lacked the statistical power to provide meaningful results. Yet this leaves some important issues in religious prac- tice and spirituality in older people unresolved, especially the role of SR in fostering trust and connectedness, the qualitative materials suggest a fruitful research eld. Furthermore, those materials also suggest that it may now be possible to explore the extent to which Fowlers (1981) Stage VI is found among older people and how SR may contribute to that. This study was conducted with two small groups (total participants = 13) all of whom were Christians. The content of the program used Christian Scriptures to engage with the life journey. In a larger study, other ways of engaging with the story of the ageing person will also be developed and comparisons made of the use of Christian Scriptures and other major faith groups with their Scriptures, and for people without a faith, an attempt will be made to connect with secular values and stories. CONCLUSION The small pilot study showed surprising and unexpected results. In this short study, two groups of older adults engaged in Scriptural Reminiscence in weekly sessions over six weeks. All participants said that they found the sessions helpful, and despite most of the participants having been members of Christian congregations for many years, few had any knowledge of the methods used to deepen their knowledge and understanding of Scripture and engaging with it in living their daily lives. Statistically signicant results from this short study would need to be replicated in a much larger study. If they can be, there are clear implications for mental health of older people who actively engage with their life stories and Scripture. Story goes to the very core of what it means to be human; it is closely connected with identity and its formation in a context that creates a structure of meaning and value. Would this be the case for other older people who do not hold a faith? Can a similar process be used to engage older adults with their life story and a process of life meaning that will be effective in alleviating depression and increasing well-being in older people. At this stage, it is not possible to say. Further study into both these areas may produce important results for the well-being of older adults. D o w n l o a d e d
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Scriptural Reminiscence 53 NOTES 1. Finding meaning in the experience of dementia: The place of spiritual reminiscence work. ARC Linkage grant # LP0214980. 2. Fowler (1986) wrote that few older people reached the nal stage of his faith development model, that of Universalising Faith. In my studies I have interviewed numbers of older people whose faith perspective ts into this stage. I would thus disagree with Fowlers writings, that his studies contained perhaps too few older people to draw this assumption. 3. Program designed by Dr. Elizabeth West, LCM. REFERENCES Anstey, M. (2008). Scriptural reminiscence and narrative gerontology: Jacobs wrestling with the unknown. In E. MacKinlay (Ed.), Ageing, disability and spirituality (pp. 106117). London, England: Jessica Kingsley Publishers. Astley, J., & Francis, L. J. (1992). Christian perspectives on faith development. Grand Rapids, MI: William B. Eerdmans Publishing Company. Birren, J. E., & Cochran, K. N. (2001). Telling the stories of life through guided autobiography groups. Baltimore, MD: The John Hopkins University Press. Butler, R. (1995). Foreword. In B. K. Haight and J. D. Webster (Eds.), The art and science of reminiscence: Theory, research, methods, and application (pp. xviixxi). Washington, DC: Taylor & Francis. Coleman, P. G. (1986). Ageing and reminiscence processes: Social and clinical implications. Chichester, England: John Wiley & Sons. Coleman, P. G. (1994). Reminiscence within the study of ageing: The social sig- nicance of story. In J. Bornat (Ed.), Reminiscence reviewed (pp. 820). Buckingham, England: Open University Press. Coleman, P. G. (1999). Creating a life story: The task of reconciliation. The Gerontologist, 39(2), 133139. Erikson, E. H., Erikson, J. M., & Kivnick, H. Q. (1986). Vital involvement in old age. New York, NY: W. W. Norton & Co. Fowler, J. W. (1981). Stages of faith: The psychology of human development and the quest for meaning. San Francisco, CA: Harper. Fowler, J. W. (1986). Dialogue towards a future. In C. Dykstra & S. Parks (Eds.), Faith development and Fowler (pp. 251271). Birmingham, AL: Religious Education Press. Fowler, J. W., Nipkow, K. E., & Schweitzer, F. (Eds.). (1992). Stages of faith and religious development: Implications for church, education, and society. London, England: SCM Press Ltd. Gibson, F. (1998). Reminiscence and recall: A guide to good practice. London: Age Concern Books. Gibson, F. (2004). The past in the present: Using reminiscence in health and social care. Baltimore, MD: Health Professions Press. Green, J. B. (2003). Salvation. St Louis, MO: Chalice Press. Haight, B. K., & Webster, J. D. (Eds). (1995). The art and science of reminiscence: Theory, research, methods, and applications. Washington, DC: Taylor and Francis. D o w n l o a d e d
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54 E. MacKinlay and C. Dundon Kenyon, G. M. (2003). Telling and listening to stories: Creating a wisdom environment for older people. Generations, 27(3), 3033. Kenyon, G. M., Clark, P., & de Vries, B. (Eds.). (2001). Narrative gerontology: Theory, research, and practice. New York: Springer. Koenig, H. G. (Ed) (1998). Handbook of religion and mental health. San Diego, CA: Academic Press. Koenig, H. G., McCullough, M. E., & Larson, D. B. (2001). Handbook of religion and health. New York, NY: Oxford University Press. MacKinlay, E. B. (2006). Spiritual growth and care in the fourth age of life. London, England: Jessica Kingsley Publishers. MacKinlay, E., & Trevitt, C. (2006). Facilitating spiritual reminiscence for older people with dementia: A learning package. Canberra: CAPS Publishing. Moberg, D. O. (Ed). (2001). Aging and spirituality: Spiritual dimensions of aging theory, research, practice, and policy. Binghamton, NY: Haworth Pastoral Press. Sloan, R. P., & Bagiella, E. (2002). Claims about religious involvement and health outcomes. Annals of Behavioral Medicine, 24(1), 1421. Sloan, R. P., Bagiella, E., VandeCreek, L., Hover, M., Casalone, C., Hirsch, T. J., Hasan, Y., . . . Poulos, P. (2000). Should physicians prescribe religious activities? The New England Journal of Medicine, 342(25), 19131916. Webster, J. D., & Haight, B. K. (Eds.). (2002). Critical advances in reminiscence work: From theory to application. New York: Springer. D o w n l o a d e d