Memo to Care Providers: Focus on Older Adults' Strengths
The tools currently used by health and social service agencies to assess older adults sell them short, limiting their opportunities, a recent study reports.
Traditional assessment tools are designed to get a large amount of information quickly, such as an older person's dependencies and support network. And while they provide valuable information, they focus on older adults' deficiencies and ignore their strengths.
"Programs designed to support an older person's strengths have the potential to reduce the number of elders who may later need extensive health and social services," says study author Dr. Nieli Langer, a researcher at College of New Rochelle in New York.
The study appeared in the August 2004 issue of the journal, Educational Gerontology.
Adults who age well, believe in themselves and their capabilities, remain active, and stay engaged intellectually, according to current research.
Also, as people grow older, they call on inner resources such as spirituality (meaningfulness) and mastery (control) to deal with adversity and help buffer the stresses of aging.
"Spirituality and resilience are dimensions of human life that evolve throughout life and gain momentum in the later years," says Langer . Even when adults have become frail, they are capable of making the necessary modifications in goals and aspirations.
Langer calls for a shift to "whole person care" with a focus on older adults' strengths.
However, if social service and health care professionals are to provide whole person care, they need to know the lens through which clients view their current and past lives. In other words, they must understand "how older adults manage a variety of crises, including changes in health, social network, finances, and the ability to live independently," the study says.
This will require health and social service professionals to use assessment tools that focus on the capabilities, assets, and positive attributes of older people.
For example, assessing older adults' spirituality and resiliency by means of individual counseling, may assist older persons to recognize their capacity to readjust during periods of disruption and loss.
"Serious illness is a loss of the 'destination and map' that had previously guided the ill person's life," points out sociologist Arthur Frank of the University of Calgary. Part of the process of healing and getting on with life requires those who are ill learn to find a new map - to create a new story for their lives.
"They learn by hearing themselves tell their stories, absorbing others' reactions and experiencing their stories being shared," Frank says.
The new story makes action and change possible. People grow from strength, not from weakness.
Therefore, if health and social services agencies are to help older persons to live independently for as long as possible, they must adopt a whole person care approach, focusing on older adults strengths, not just their deficits.
Older persons need a dream as well as a memory.
- Abraham Joshua Heschel
The Treasures We Keep: Author
"Gloria said that her mother had kept all these things safe for her in her cedar box, and she spoke about the importance of discovering them there after her mother's death."
This sentence, taken from Treasures: the Stories
Women Tell About the Things They Keep, by
Kathleen V. Cairns and Elaine Leslau Silverman,
will probably evoke another image for most of us.
It will remind us of something we ourselves keep
to bring back someone from our past.
Researchers Cairns and Silverman from the
University of Calgary found that women
keep a wide assortment of materials including
letters, photos, plaques, tiny boxes, wall
hangings, and items of clothing. And
these objects are often preserved and
handed down to family members, or passed along to other women, thereby connecting generations of women.
In Treasures, the researchers tell stories culled from interviews with more than 100 women, aged 14 to 92, and representing women's diverse lives and circumstances. These stories are rich, compelling and sometimes haunting.
Ruth Dempsey reached co-author Dr. Kathleen Cairns in her office at the University of Calgary to speak about the book.
RD: You begin with: "Every woman's story is a story of creating herself. The act of keeping a particular thing is always an act of self-definition." Can you talk to us about the treasures women keep and the role these objects play in their lives?
KC: I often return to my own memory box to revisit events and people, or moments in time that have been central to my understanding of who I am as a person, a woman and a mother. Understanding that other women also practice this kind of life review - that they use objects as keys to experiencing again the people, places and events that are central to their lives - confirms my belief that every woman's life contains both great joy and great tragedy, and that these experiences are active in shaping our present and our future.
I believe that our efforts to understand ourselves are central to our ability to support and nurture others, and to our ability to forgive ourselves for our past errors and work through present difficulties. In a sense, these objects are containers for experience, gateways to memory, confirmation that we lived and struggled. They are anchors that represent our values and commitments and that will keep us alive in the memories of the people who cared for us and understand their meanings.
RD: This idea of 'objects as containers and anchors for experience' emerges as a powerful theme in the book. In other words, it's not the objects themselves, but the meanings women invest in them that give them their importance. Can you tell us about two or three of the women and their treasures?
KC: Several different examples stand out for me as particularly clear instances of the role of these 'treasures' in women's lives. One was the travel documents kept by a refugee to remind her of her many losses and of her new freedom.
Another was the thick braid of hair cut off by a girl at the age of about 13 when her father abandoned her (as she saw it) to be with another woman. They had had an evening ritual together of his combing and braiding her long hair in preparation for going off to bed. When he left, she cut the braids off, sent him one and kept one in her memory box - a reminder of lost love and a marker of a sea change in her life.
Anne's dolls have an opposite message - confirming her father's love for her by recalling how he struggled against poverty and a severe winter to get the new eyes for a cherished baby doll that her brother had broken.
I think that the other kind of story that had the strongest impact on me were the larger number of objects used to remember grandmothers. I think that going into the study neither Elly nor I had any idea how important grandmothers are in girls' lives. But they are hugely important.
RD: Your book struck a personal chord - so many of the stories resonated with my own. Please tell us about your feelings on completing the study.
KC: I felt that I had learned a great deal from the women we interviewed, and very grateful for their willingness to spend time with us and to trust us with their stories. I felt too that I wanted as many women as possible to read it - get on Oprah with it, since it speaks to something we all experience.
I thought that women who read it might feel more strongly connected to other women and more accepting of their own need to keep these treasures. I still feel that way about it, but it's not, after all, the kind of book that is a 'good read' - the kind you read in one or two sittings. It is a book meant to be read in pieces and to provide 'food for thought.' So, probably not likely to be widely read, sadly.
Treasures is published by the University of Calgary Press and can be bought in most bookstores.
The Possibilities of Age
"We have barely even considered the possibilities in age for new kinds of loving intimacy, purposeful work and activity, learning and knowing, community and care. We have hardly explored the transcendental reaches of ultimate self-realization in age that go beyond "normal" aging. For to see age as continued human development involves a revolutionary paradigm shift."
- Betty Friedan, The Fountain of Age
Daring Second Acts
Garry planned to ride his motorcycle across the country from Ottawa to Seattle. But back then, a job offer, followed by marriage and the birth of his son, Jonathan, had forced him to put his plans on hold.
Now Garry has a new set of maps and has started planning again, as he counts down the months to retirement in spring 2007. His wife, Ann, will join him in Seattle. They plan to spend the summer visiting family scattered throughout BC. In September, Ann will return to her teaching position in downtown Ottawa. And Garry? He plans to continue working. Doing what? He's still not sure.
Now, just in time, a book by husband and wife team Jeri Sedlar and Rick Miners offers practical guidance for people like Garry who are asking themselves, what next?
"Forget about retiring," the authors advise. "Rewire instead."
How do people rewire?
By taking the energy they used to spend in their full-time work and rerouting it into a customized package of deeply satisfying activities, that fill their needs, not just their time.
Sadler and Miners have made a career out of helping people in their roles as executive recruiters. In Don't Retire, Rewire! (ALPHA Books, Indianapolis, IN), the two researchers discuss a five-step process.
1. Know what makes you tick? Retirement is different for each person. Figuring out what you want to do depends on knowing what motivates you. What are the things that drive you today? Is it visibility, power, a paycheck? Maybe, it's a passion, or the desire for new experiences? These are your "drivers." The key is to focus on the drivers that are really you. To continue growing, to be fully alive- is as personal as a fingerprint.
2. Dreams. Think about all the things you have ever dreamed of doing. Write them down. What haven't you done? If money were no object, what would you do? Still stumped? Think about your legacy. What values do you want to pass on to the next generation, to your grandchildren? Ask yourself what you want your life to stand for.
3. Interests. What is it about the world that fascinates you? Why? In what situations and with what people do you find yourself energized? Who are some of the people working in your area of interest who inspire you? What do you want to achieve with your interest?
Think back to your childhood. What activities captivated you for hours without the need of anyone else around? Are there some of these interests you would like to revisit?
4. Accomplishments. Think back over your life, what are you most proud of having accomplished? Jot down your accomplishments, big and small, professional and personal. Take a breather from reflecting. When you return, list your top 10 accomplishments. And beside each, jot down the strengths and skills you used to bring them about.
Now think about what you would you like to accomplish in your second act. Give yourself this as a homework assignment. Mull it over. Play with possibilities.
5. Strengths and skills. You have been living with your strengths and skills for a long time. Which of these strengths and skills have figured prominently in your accomplishments? Which ones remain underdeveloped? Which strengths and skills do you want to focus on in Act 2?
The search for a daring second act isn't only about a rewired career, however. It's also about your search for meaning.
As the authors note: "If you want to continue to have a fulfilled life, you need to find activities, paid or free, that keep expanding your life, so you stay true to yourself and your needs."
Hearts of Gold
Older Canadians are among the most active and socially engaged citizens in the country. However, those organizations seeking their services will need to adopt new strategies to attract their attention, according to the National Advisory Council on Aging (NACA).
In a recent bulletin, NACA reports:
- Seventy-seven per cent of Canadians aged 65 and older made direct contributions to charities in 2000, donating a total of $854 million.
- While less that a quarter of all people aged 55 and older volunteer officially, many retirees (16 per cent of men and 15 per cent of women) regularly engage in caring for friends, relatives and neighbours.
- Three million retirees spend five billion hours of their time each year on productive activities, adding about $ 60 billion to Canada' s economy.
- And almost two-thirds of older Canadians volunteered informally in 2003 (Statistics Canada).
Clearly older Canadians have hearts of gold but expect the battle to win them to be hard-fought. "Gone are the days of seniors looking for ways to fill up their time," NACA says.
The report also suggests that organizations keep in mind that volunteering is a two-way exchange. Older adults today "are used to being productive members of society and to experiences that provide intrinsic rewards (such as learning, sense of accomplishment and problem solving) and a few extrinsic rewards (for example, thanks and recognition, transportation subsidies or input into programming)."
Today, those organizations that are capable of offering older adults meaningful and challenging experiences that tap into their wide-range of skills are the most likely to attract their services.
Seniors Contribute! (January 2006) is available at: www.naca.ca
On the Web
Musica Humana: Danish doctors and musicians combine familiar sounds from the natural world with the rhythm of the human heart to create music that relaxes nervous patients, calms busy nurses, and awakens deeply anaesthetized patients. www.musicahumana.com
AgeLab: Discover how pill pets, smart personal advisors, and home health stations may become part of your home decor in the future. http://web.mit.edu/agelab
Confused by conflicting media reports on the latest drug or medical treatment to arrive on the market? Visit Media Doctor. The website is run by academics and clinicians from the University of British Columbia, York University and the University of Victoria who have teamed up help improve the accuracy of media reports about new medical treatments. www.mediadoctor.ca
Editor's Note: Our January issue on the middle years evoked a hearty response. AHB readers wished to draw our attention to the work of cultural anthropologist Angeles Arrien. In her recent book, The Second Half of Life: Opening the Eight Gates of Wisdom, Dr. Arrien reveals how the wisdom of indigenous peoples can provide another lens on the middle years. For more, please visit: www.angelesarrien.com
Aging Horizons Bulletin is published free of charge as a public service. We welcome your comments and suggestions. Send them to info@AgingHorizons.com - R.D.
