Life Review

STITCHED TOGETHER BY MEMORIES:

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Mother’s quilt provides a warmth
Beyond its fiber down.
Each night I’m wrapped in love,
Our family history, and my wedding gown.

Mother cut with care her patterns
Each scrap to trim and save-
Just as she did with the numerous fabric remnants
that to her others gave.

Each patterned square reveals a story
Of our family’s growth and change.
It is far better than an album, for this memento speaks to me
Of many precious moments the camera did not see.

Part of each marriage ceremony was mother’s quilt-gift to the bride.
It makes me smile just to recall the sparkles in their eyes.
Lambs and teddy bears announced each baby’s birth,
And pink and green pajama scraps retell of Christmas mirth.

When winter days were turning cold and all the canning done
Daddy would set the frame up firm, for quilting time had begun.
I’m so glad I still can hear them today, as I am wrapped
Inside this priceless heirloom, that warms me as I nap.

There you are mom, I see you…among the colours bright,
In your kitchen dresses, gingham aprons and your gowns for night.
They all remind of you and of the things that you’ve been through.
The smiles and tears, the strife, but mostly of your teaching of the wrong and of the right.

My quilt would not have been the same without your understanding care,
My sorrow and joy are sewn in, and hemmed by time and prayer.
Our lives were joined by chance they say, I believe by choice – and this is my great pleasure,
For a quilter of love and story like you, is indeed a priceless treasure.

It matters not that my coverlet is frayed and has tiny little tears,
Years of life and warmth and time, have helped to put them there.
So I wrap myself inside your quilt and feel your love and care,
And dream of how I will impart, to those I leave behind,
the strength and courage you have shared with so many of humankind.

I have fond memories connecting my mother to the beautiful quilts she designed and crafted. Her quilts are her legacy. Her life’s story, her ability to overcome the odds, her values, her beliefs, all are intricately interwoven into the very being of her creations.

Crafts people, from the Middle-Ages, believed we infuse our soul’s energy into that which we create. I feel sure that each of mother’s children, grandchildren, great-grandchildren, friends and relative also believe that mother’s soul energy is imprinted into the fabric of her quilts. We are each aware that the love she conveyed, throughout her life-time is stitched into the fibers and continues to surround and nurture anytime we have a need to cocoon.

Legacy and Life Review

A legacy can be defined as the tangible and intangible assets that are transferred to another and may be treasured as a symbol of the originator’s immortality (Ebersole & Hess, 1990). Legacies transcend time. They provide a continuation with future generations. As long as one’s story is told one remains alive in the mind of others.

We all transcend beyond ourselves. Every word we speak, and each of our creations, is an extension of who we are. We transcend ourselves and connect ourselves to future generations in art forms, crafts, autobiographies, quilts, etc. All of these provide for assurance of meaning and purpose in life and transcendence beyond death.

In preparation for our mother’s ninetieth birthday my sister requested that each of mother’s children photograph the quilts mother had, over the years, given to us, our children and grandchildren. My sister was designing a “quilt book.” Clipping and snipping she was fashioning a chapter for each of mother’s children. Our individual stories were being braided into the story of mother’s life, symbolically depicting her sharing of each of our journeys as we moved through the hills and valleys of our own experiences.

While mother did not live to view the final product, the overall goal for designing the quilt book had been well achieved. For it was the process, the very undertaking of its creation, that achieved the outcome. The process unlocked memories and stimulated the telling and retelling of stories – of narratives that needed to be shared and re-examined in order to ease past hurt, and thereby weld generational bonds.

While my mother had not been ill when the idea for the quilt book was formulated, I recognized that for about two years previous she had been actively engaged in a process of life review. I initially observed little notes inside some of her tea cups and tags attached to some of her other “treasures.” She shared that the tags named the person she desired the object to be bequeathed to. I was also very much aware that during this period mother spoke much of her relationship with her own mother. I had never before heard her speak of most of the things she discussed. And most significantly, during these conversations she “dared” to say things that had been less than positive about her childhood and her early life. My mother lived the motto: “If you can’t say anything nice, don’t say anything at all.” Yet, this unaccustomed behaviour and her descriptions of events the way she saw them and the sharing of her emotions around these circumstances was an important part of her process of sorting and then of re-framing the aspects of her life that had not been the way she would have liked them to be.

Years previous, I had the opportunity to be present during the dying of a man who had spent much of his life as a trapper in the far North. He shared many stories of these experiences before I recognized that he was engaged in a process of life review. I also became aware that I was receiving privileged material and the stories he was relating would be treasured, beyond measure, by his only son who, because of distance and commitments, was able to visit only rarely.

Since the illness no longer afforded the physical strength he needed for writing, arrangements were made to have a tape recorder brought to his bedside. Each time he felt like chatting the trapper would lean over and flip the “on” switch. While I was no longer required as the necessary agent for receiving the thrilling stories of his life review, many of his memories were recorded for those whose lives would be enriched in the hearing.

What is Life Review?

A number of decades ago Eric Erickson and Robin Butler described the process of “life review.” These theorists characterize life review as a time of “sorting.” Erickson (1963) viewed the process as a time of determining if the gods are pleased with the life that has been led. Butler (1982) perceived the life review to be a time of doing a “balance sheet.” According to these theorists, in doing a life review we examine the life we have led and conclude with feelings of integrity – feeling that we have done the best we could, or we conclude with feelings of despair – feeling that our life has not turned out the way we would have liked it to. And there in lies a great opportunity for those of us who walk beside another in their time of processing the events and circumstances of their life.

Stimulating the Process

I have come to recognize that life review is a process that is stimulated bit-by-bit. The pace of the stimulation appears to be directly related to the urgency as well as to the length of time the process will require relative to the circumstances. Like any healing process, however, I believe we can “prime the pump” and gently guide the process in a positive direction. The life review is naturally stimulated by crisis events. It can also be stimulated naturally and therapeutically by visits, photographs, history books, news reels, music, song, art, etc. (Burnside, 1992; Gustafson, 1994).

For a time I was a nursing-director in a long-term care facility. I like to sing and often sang for the residents. I would ask them to choose what I was to sing. The selection would frequently bring tears as it stimulated memories. I was intentionally using song as a therapeutic way of stimulating memories and would later invite the resident to share what came to mind as we were singing.

Once memories have been stimulated they can be reviewed. Happy memories can be relived and re-enjoyed and ways can be found to release the emotional load of the difficult memories. In most cases, all that is required in the releasing of difficult memories is the sharing of a painful story with a trusted other (Parker, 1995).

Doing a Balance Sheet

Doing or assisting another in the creation of a balance sheet is one way to stimulate memories and to facilitate healing surrounding any difficult emotions that might surface during the process. The therapeutic goal in doing this work is to guide the process in a direction of increased self-worth. I believe the major question anyone assisting another individual during their process of life review, is: “How can I assist this person to see their life as a meaningful whole?” For even though some may initially view their life as bleak, every life is made up of positive and less than positive circumstances. Any therapeutic work in this regard must, therefore, focus on assisting the other in recognizing that there are many possible outcomes to every event. People often need to be reminded that when we move through a difficult life experience the “difficulty” tends to saturate consciousness and that most of us, at one time or another, require assistance in viewing the positive aspects that have resulted from what initially appeared to be a very difficult circumstance.

I am often reminded of this when I work with women in the prison system. Frequently, incarcerated women have told me that if they had not been sent to prison they would now be dead. These women have been able to reframe their circumstance. They are able to see some of the positive outcomes in what initially appeared to be a most negative experience. The process of self-evaluation these women engage in, in order to see the positive outcomes, is similar to the process Butler referred to when he recommended doing a balance sheet to initiate life review.

When I assist in doing a balance sheet exercise, I ask the person to identify, in writing and in chronological chart form, the major events in their life. If the person is unable to write, I create the chart as they list the events. I treat this work with the highest regard and with the greatest respect. I try to continually remind myself of the need to be totally accepting of this person, of their circumstances, and of their view of reality. I believe assisting another in doing a life review is sacred work. I believe when I view and discuss the circumstances surrounding the events listed on a balance sheet, that I have been given permission and an opportunity to peek at the soul of another.

This basic information obtained when doing the balance sheet provides an overview about how this person perceives their life. Do they feel a sense of integrity or do they feel a sense of despair?

Many times doing the balance sheet is all that is required to move the person in a more positive direction. In listing the major events in life, many are able to quickly identify that their life was made up of many positive experiences. Others, however, require more direction. In these cases, I attempt to have these people identify any possible positive outcomes surrounding the difficult experiences. Questions that work well here are: “Tell me what happened after that?” followed by “And then what happened?” and again followed by “And then what happened?” I find that using this type of circular questioning can usually quite quickly facilitate the person in seeing some positive outcome. I find the following folklore beneficial when teaching or guiding this process:

It is an old story about a Chinese farmer who was the only one in the village to own a horse.

One day the farmer’s horse ran away. “How unfortunate” the villagers said. But the elder said, “Time will tell if is good or bad.”

Several days later the horse returned bringing a wild horse with it. “How fortunate” the villagers said. But the elder said, “Time will tell it is good or bad.”

While trying to tame the wild horse the farmer’s son was thrown off and broke his leg. “How unfortunate” the villagers said. But the elder said, “Time will tell it is good or bad.”

Soon after the Emperor’s press gang came to the village to seize recruits for the army but left the farmer’s son because he was unfit. “How fortunate” the villagers said. But the elder said… “Time will tell …”

Affirming and Reconciling

I believe it is important to recognize and to affirm the contributions others have made during their lifetime. Even if, as in some very difficult life circumstances, this means relying on the contributions of the cohort group. In discussing the contributions of the cohort group we encourage the examination of the collective contributions of the generation that the person most strongly identifies with. The strongest generational identification usually occurs between 20 to 40 years of age. Some samples of questions that can affirm the contributions of the cohort group for persons who are presently in their eighth and ninth decade might be: “How did your family every manage to survive the depression?” and “How did your troop ever win against such odds?” Affirming another and acknowledging their strengths, tells another that we recognize, that under these circumstances, they have done the best they could.

We often view past happenings out of context. I do not find this to be therapeutic. We tend to judge the past based on the knowledge, education, strength, skills, and resources that we now have. But in many cases, if we were to place ourselves right back in the exact same circumstances we are now judging, we would likely make very similar choices again. I believe this is an important message to communicate to those we are assisting in doing their life review. I like to bring people to the place of affirming, “Yes, I would make different choices now but back then I did the very best I could and if I have the chance I will make very different choices from now on.”

My father’s life review process was quite different from that of my mother’s. In creating her quilts she was able to leave behind some very tangible evidence of the mark she has made on the lives of those she influenced. The dialogues that flowed around the creation of this legacy aided her life review and allowed her to experience deep feelings of satisfaction and integrity. My father, however, and according to today’s standards died “young.” He lived only six weeks after a terminal diagnosis and was never able to return home to rearrange the order of his tangible effects.

Over the years I have recalled my father’s life review. I am now aware that an important part of bringing closure, for him, meant being able to bless the various aspects of his life. I believe he desired to know he had done the best he could. As I review my journey with him I also believe he longed for reconciliation for those circumstances where he felt he had not done the best he could.

My last visit with my father began three days before his passing. I had known my father as a man of few words, and so the intensity and the depth of the conversation we shared around the life we had spent together marked me indelibly. My father stressed he wished he had been “able to do more for me” to “give me more.” My simple response, “Daddy, you gave me my education. I could ask for nothing more,” affirmed the roles he had played in my life. His “balance sheet,” which had placed me on one end of the “teeter totter” and him on the other, was now in balance. Little more needed saying. My father was able to rest knowing he could now bless the aspects of life he had shared with me. I, in turn, was able to bless the aspects of life I had shared with him.

Life Review as a Life-Long Process

While we tend to think of life review as a process that happens prior to death, life review actually takes place during numerous other times of life. While those who are dying do a major life review in an effort to bring a satisfactory closure to their life, we do a life review each time we move through a significant life change. We do a life review anytime we must adjust to a circumstance after which life, as we knew it, will never again be the same. Such circumstances include the loss of a body part, a career change, relocation, or the loss of a loved one (either to death, separation or divorce). We do a mini life review each time we examine what, up to this point, we have accomplished or become, for indeed this is its purpose.

Robin Butler encouraged that we engage frequently in the process. He stressed that by doing life review on a regular basis throughout life we avoid the overwhelming feelings of despair that can surface, for some who must review their life, when there is no time left to make the changes. He emphasized that occasionally stopping to examine where we are in life affords us the opportunity to set new goals, to make a turn in the road, or to completely change the course of our life.

In Conclusion

In this paper I have described life review as a process that provides opportunities for resolving past hurts and conflict. This journey within leads to new understandings of life and can generate feelings of accomplishment at having tried to do one’s best.

While much of the article focused on facilitating the process for another, great personal benefits await those who establish a regular pattern of conducting a personal life review. This is encouraged, for it affords the opportunity to make life changes while there is still time. When we have done so, we will be able to bless our life and at its closing know that we have done the best we could and that our Creator delights in this one creation.

Dr. Jane A. Simington, BA, BSN, MN, PhD

References

Burnside, I. (1992). Reminiscence and life review: Analyzing each concept. Journal of Advanced Nursing, 17: 855-862.

Butler, RN (1982). Aging and Mental Health: Positive Psychosocial and Biomedical Approaches, 3rd ed. Mosby.

Ebersole, P. & Hess, P. (1990). Transcendence, legacies and death, in P. Ebersole and P Hess (eds.), Toward Healthy Aging, 3rd ed. Mosby.

Erickson, E. (1963). Childhood and Society, 2nd ed. Horton.

Gustafson, M. (1994). Reminiscence, her way. American Journal of Nursing, 6: 64.

Parker, R. G. (1995). Reminiscence: A Continuity theory framework. The Gerontologist, 35(4): 515-524.

Have you answered the question yet? It’s really another way of asking the age-old questions – Who am I? Why am I here? and What’s the Meaning of my life? No small task. But one that is vital if you wish to have a successful midlife transition and a healthy aging process.
Why wait until you are about to die to find out why you lived? Most people are too busy existing to figure out what they really want out of life. But, if you are reading this, perhaps you are not one of them. Good for you!

George Bernard Shaw once wrote “True Joy of Life”

This is the true joy of life.
The being used for a purpose
Recognized by yourself as a mighty one.
The being a force of nature
Instead of a feverish, selfish
Little clod of ailments and grievances
Complaining that the world will not
Devote itself to making you happy.
I am of the opinion that my life
Belongs to the whole community
And as long as I live,
It is my privilege to do for it
Whatever I can.
I want to be thoroughly
Used up when I die,
For the harder I work the more I live.
I rejoice in life for its own sake.
Life is no brief candle to me.
It is a sort of splendid torch
Which I’ve got hold of
For the moment
And I want to make it burn
As brightly as possible before
Handling it on to future generations.

Over the next few weeks, I’ll keep this subject going and I’d love to hear your thoughts. How many of you have a bucket list? How did you go about creating it? Is it something you are truly working through? Is it what is giving your life meaning? If not, why not?

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I just finished four days of training with Tidewell here in Sarasota as a Hospice volunteer. What awesome work they do and I’m delighted to be taking part in it even for a small bit.

I couldn’t help reflecting during all the training on how important it is to be able to look at end of life issues long before they are immanent.  For example, one of the ‘creative arts’ projects they do is to create a legacy booklet to leave with their families. In it, they answer questions such as what were your favorite memories, things you liked to do, etc. On the front cover, they trace their hand and in each finger write what these hands have done.  Why wait until the end to do work like this? It could be a fun project to do with the whole family.

Do you have a scrapbook of memories? There are so many wonderful scrapbooking stores and techniques these days that could make this also a fun and meaningful project – perhaps one to do with your family.  Years ago, I created a scrapbook that contained ONE page for every year of my life.  In it, I put pictures (where I had them available) as well as a list of the people and events that were important during that year. Of course, I couldn’t remember all of it – so it became a fun exercise to do with my family and especially with my parents (while they both could remember).  It sparked lots of conversations with my young nephews and over the years we’ve continued to share the things we discovered we have in common.

 

Life Review is not just an end of life phenomena. It is something worth doing in midlife and beyond. Do it for yourself as well as for your loved ones.

I’ve been talking lately about Life Review. I’ve been obsessed with the idea ever since I heard Jane Fonda on Oprah and read her new book, Prime Time. I’ve been reminded of how often when I did reflect on my past in a positive way, I found new energy for the present. That’s the only reason to focus on the past. In it, are the seeds of possibility and possibly even the answer to any question you are currently posing.

Today I read an article about people dying and making choices about how they wanted to live the rest of their lives. Of course, the message was, “Why wait until you are dying?”  I believe that a good Life Review tells you about what you once thought was important, and what things, people and ideas still are. How would you spend your last year if it were truly your last one? We never know. Why spend time fussing over what isn’t working? Why not discover what gives you the most Joy and start doing and being more of that. Right now.

I’m talking about real joy – not just eating more chocolate or having better sex. What are the qualities you want to experience in life? Who can you show your love for today? Go ahead, do it now.