counseling
Successful Aging Takes a Team!
Successful Aging Takes A Team!
Let’s talk about why it’s critical to their quality of life to have a strong support team around seniors who are growing older.
Why?
Because I see so many older people in my private practice who face, for example, situations where they are grappling with:
- family members or loved ones with very strong opinions about what is best for them – opinions danabol that may or may not be informed and wise
- *no* family members or close friends at all to advocate for them
- a primary care physician who is prescribing medications but not following them in after-care. What is known as the “diagnose and adios” routine.
- a specialist or two who is also prescribing – say for instance a cardiologist or endocrinologist – but who is not tracking the interaction of *all* of the medications involved
- a psychiatrist who may be also be treating and prescribing psychiatric medications
- possibly a nutritionist, alternative health practitioner or two prescribing supplements, vitamins and minerals which may all be fine but which also carry side effects that can contribute to mood problems.
Way more often than not, there is very little, if any, communication and coordination amongst the health professionals. This coordinator function may have been done in the past by the primary care doc who managed the broad perspective overview of how each of his patients were doing. But nowadays primary docs are under so much time pressure in their practices that they just do not have time take on this role.
In order to build that coordinated team which will support an individual’s successful aging, it takes someone stepping into the role of being a skilled ADVOCATE. A person who knows how to coordinate effective communication amongst team members and who is in charge of reaching out on behalf of the patient to represent their concerns. Someone who can help the patient communicate their concerns and questions to other team members, and who also helps the patient remember the answers and instructions of doctors. Team members need to work in concert with each other, supporting the various lens through which each patient is viewed.
All of this process needs to be done with the utmost RESPECT for each patient where the patient has TRUST in the advocate that he or she is representing the wishes of the patient towards the goal of the best possible quality of life at any stage.
Gerontologists and mental health professionals who understand the importance of building good communication and coordination amongst care teams can be invaluable to the patient and family. Sometimes, it is care managers who provide this role, sometimes it’s an adult child, and sometimes it’s gerontological counselor.
Whoever it is that takes the lead in this role, a support team that is identified, built, coordinated and in good communication, will result in a patient who is much more likely to thrive and much less likely to fall through the cracks.
This is the health care situation for older people in our country today. Just the facts. And totally doable to navigate through it successfully. With help. With a solid, caring team.
Why Gerontological Counseling for Older People & Their Families?
Why Does Gerontological Counseling Yield the Most Effective Healing?
If you or your loved one is a senior, the counselor you or she sees absolutely, in my opinion, needs to be up to date on the latest research involving aging.
Take, for example, the topic of brain neuroplasticity and neurogenesis. Why is it critical to know about this when counseling older people? Because, not even 10 years ago in graduate psychology programs around the country, interns were taught that brains decline from age 30 on! That things were was all “downhill” – brain cells wise – from there. The explosion of current, ground-breaking brain research that we’re seeing absolutely refutes this dire and incorrect belief. Not only is that attitude false, it is anti-healing!
Our brains are changing all the time. This is called neurogenesis. It happens until our very last breath. In order to support good brain health, we need to provide some basic tools such as good nutrition, limiting sugar and processed carbs, making sure we get plenty of daily exercise, not smoking, reducing environmental toxins, decreasing stress as much as possible, practicing good mental health habits/practices, staying involved socially with family and friends, making sure we take the appropriate supplements, vitamins and minerals, etc.
When I studied psychology as a graduate student, I learned about Eric and Joan Erikson’s famous Stages of Human Development. They had first published their theories and discoveries when they themselves were very young. As they grew older they realized what the research is showing now. That is, that the years from midlife to 90 years old and up are full of rich experiences, new discoveries, and constant evolution. As Eric and Joan moved through their 60’s, 70’s, 80’s and 90’s, they abashedly apologized for making ill informed assumptions that our brains basically stagnate after a certain age.
Now, I am not saying that our memories or that the way we think doesn’t change. We all experience what is called age-related cognitive change as we grow older. That is most often because we have so much more data in the “hard drives” of our brains! We can also suffer from ill health of various sorts, inflammatory conditions that affect our thinking, the side effects of medications that can impact us negatively, and depression and anxiety that can also cause foggy thinking. It’s important to approach conditions like these from a looking at the whole person approach to see what the underlying root problems may be.
The important thing to realize is that it is wrong to believe that older age inevitably leads to bleak depression and cognitive decline. Rather, we can and do grow into wisdom and the ability to cut through the chaff to the gist of what is needed to thrive. In fact, the root meaning of word wisdom, Joan Erikson wrote, is “to know how to”.
I’ll end by saying that too often I hear therapists say that they see anybody, that people are all the same. I think we may be similar but I know, without a doubt from my years of professional practice and my life experience, that the issues we face in older years are different and often far more complex, multi-layered and nuanced than when we are young. Plus, our American culture adds an often-harmful overlay of ageism to the mix.
Therapy with a gerontological counselor can help you get more quickly to the root of what is happening with you and/or your loved one and is up-to-date on other resources that can help you get the attention, care and healing support you need.
The Sageness of the Serenity Prayer
In working with midlife and older age adults and their families for over a decade now, I have come to believe more and more in the eloquence and truth of the Serenity Prayer. I am not an AA member which is how, I think, most of us have heard of this prayer. But I have come to love it. It is written in large letters on a framed poster outside my office. More people have stopped on the way into a therapy session with me to stand before it and read it over and over. It creates an immediate opening for talking about what concerns people bring in to the session. For those of you who don’t know the prayer or don’t remember the words, it goes like this:
God, grant me the serenity to accept the things I cannot change,
The courage to change the things I can,
And the wisdom to know the difference.
In my counseling sessions, we remark on how we can often see a few things we can’t change. We can often see a few things we can change. Those ends of the continuum are fewer and seem more black and white. But it’s that middle section – that wide grey confusing amorphous middle ground, i.e. “the wisdom to know the difference” is often what challenges us the most and forms the basis for many a counseling session.
The photo below is one I found online that many of my people relate to. It speaks to how little we are in control of the elements in our lives, and that “the wisdom to know the difference” may just entail hunkering down, saying a prayer and riding out the storm.
Neighbors Helping Neighbors: Online Community for “Tweeniors” and Older Adults in Marin
Neighbors Helping Neighbors: Building an Online Information/Community Hub in Marin
Prior to my career as a Marriage & Family Therapist, and gerontologist, I was involved in starting and growing several online communities. I have seen the tremendous benefits to individuals of a well-organized online information hub focused on the needs and interests of a particular demographic or special interest group.
This type of Online Information Resource Center assembles links, reviews and articles in an easily searchable, Central Hub to provide ease-of-use and convenience to the target population. I think we need such a Hub in Marin.
A vibrant, free, online information hub focused on older adults, adult children of older parents, baby boomers, “tweeniors”, and sandwich generation-ers – focused on life in Marin – would link Marinites up to the rich range of excellent resources, services, service providers, products, agencies and activities we have right here in our own backyards.
Plus, we would be able to share with each other how we have solved the wide variety of challenges and successes that come with growing older in general and in our local communities. We participants could serve as a kind of living encyclopedia of help and answers and ideas. Which leads me to the topic of…
Social Media (Online Community) Building Friendships
What we now call social media and used to call online community is a central part of such a community and demographic-focused web site. Members will come, attracted to the information resources, and stay, becoming participants, because of the supportive and interesting community of others with similar concerns and interests. Support and bonds and connections and friendships grow.
There are many examples of successful online communities which offer wonderful stories of mutual support. Some of you may remember The WELL (Whole Earth ‘Lectronic Link) which started in Sausalito in the 1980’s as a pioneering and legendary online community affiliated with the Whole Earth Review magazine. The WELL is still thriving and some of its members have been friends online now for 25 years. Dupont Circle Village offers a thriving senior online community as part of its Village membership in the DC area.
Older Population Thriving & Online Too
We are the fastest aging county in California. The fastest growing part of our population is the 85+ age group. Older people are turning to social media tools in droves. Something like 18,000,000 U.S. Facebook users are 55 and older.
For those older people who are not online, some simple and gentle classes and instruction would introduce them to the potential benefits of learning how to access resources and friends/family. I believe it would be empowering for them to at least have the opportunity to make an informed choice about whether the tools are for them or not.
Help! How Do We Find Answers?
The main complaint I hear from older people and their adult children or other loved ones is that they have an extremely difficult time finding answers and help for the dilemmas they are facing. They don’t know where to turn and when they do find phone numbers, they encounter what feels like a land of endless voice mail.
Many older people end up going to the ER’s with problems that would have been easily preventable if they had had help, knowledge, answers and support earlier on.
Isolation is a Major Health Issue
In addition, isolation becomes a tremendous issue for our older people as they experience vision impairment or physical conditions that prevent them from driving. Their worlds start to shrink.
We are blessed to have Whistlestop Wheels in Marin but it is important to note that Whistlestop is ADA paratransit – thus it is not senior transit – it is disabled transit with a rigorous screening process.
Isolation affects so many quality of life issues for seniors – it can lead to loneliness and depression, decline in cognitive capability and even lead to poor nutrition if the individual has no easy access to groceries and little inspiration to eat well-balanced meals.
An Invaluable Tool in Communication Toolkits
Vibrant online communities can provide a bridge between homebound people, give answers to those who are looking for ideas and shared personal experiences, referrals and tips for places to go for help, and friendly connections that can grow into friendships.
Experienced managers train volunteer moderators in conversation and group facilitation and various writing and administration tools. Online policies are crafted, posted and enforced to prevent scam artists from taking hold. Webinars and a host of free online classes can be offered.
Neighbors Helping Neighbors: An Online Information/Community Hub
As our federal, state and county budgets decrease, and at the same time our population is aging (“the Silver Tsunami” we’ve all heard about), what will be our plans for taking care of ourselves as we grow older? Will we choose to “age in place” or, as its being referred to now, “age in community”?
Will we need to look after each other along the lines of what our parents and grandparents did in smaller towns and closer-knit neighborhoods across the country?
Many people think so. There is a growing Village movement across the US and a growing NORC movement (NORC = Naturally Occurring Retirement Communities). These movements represent efforts by thousands of people in hundreds of communities to come up with ways to support each other as we get older.
We in Marin can also look out for each other as we grow older. We only need a will to do so. As I wrote last week for the Patch, the Mill Valley Village will join the group of 4 other Marin Villages (Ross Valley, Homestead Valley, Tiburon/Belvedere and Sausalito) later this year.
As we come up with a variety of ways to help each other out, we will benefit from a full use of a variety of communication tools to help us connect and collaboratively develop answers and support:
- face to face events to facilitate information exchange and relationships
- telephone help lines staffed by live operators
- an up-to-date central online information resource hub on aging in Marin
- vibrant and thriving grassroots online communities that offer us the ability to connect, form and maintain strong and caring relationships
Anybody else interested in exploring these possibilities? I’d love to hear from you!
Fall Prevention
Fall Prevention. Falls are a high priority concern for middle age and older people since they are at increased risk for bone fractures and other fall-related injuries. Using a cane or eventually a walker helps many individuals to be steadier and more confident while walking. Some of the reasons, clients cite for falling are: tripping on something, their legs just “giving out”, and feeling dizzy. One often overlooked cause of unsteadiness and lightheadedness is dehydration. As we age, our sense of thirst tends to decrease – so it is important that we consciously make sure to drink plenty of water every day. An easy way to help fight the dehydration that can occur over the course of the night is to keep a glass of water on your night stand. When you wake up, sit up and drink the water before getting out of bed. Also, squeezing your calves and circling your ankles *before you get out of bed* will help increase your lower body circulation and make you feel steadier when you do get up and on your feet. For more fall prevention tips, check out http://www.mayoclinic.com/health/fall-prevention/HQ00657 .
The Top 10 Therapists of Recent Decades
This is a wonderfully insightful and thought-provoking article from Psychotherapy Networker about a survey of APA members who select the most influential and ground-breaking therapists of recent decades and why.
It’s called “The Top 10”. I hope you enjoy it.
Senior Peer Counseling in Marin
Volunteering is often talked about in terms of benefits for society and for the volunteers themselves. Older adults who reach out to share their wisdom, kindness and service in their communities generally experience higher self-esteem, less depression, an increase in friends and less overall decline in health. One of our wonderful volunteer opportunities in Marin is the Senior Peer Counseling (SPC) program, managed for 20 years by Community Mental Health.
Peer counselors receive 8 weeks of initial training in issues facing older adults. These include aging, medical problems, isolation and family conflicts. Then, after being taught basic counseling skills and introduced to Marin’s extensive range of services for seniors, they are matched with one or more homebound older adults in need of counseling. Services are offered in English and Spanish. SPC’s next training will be held in April, 2010 in San Rafael.
SPC volunteers come from all walks of life: they are retired actors, directors, nurses, mental health professionals, professors, and computer entrepreneurs. Nan Heflin MFT, one of the coordinators of SPC, says, “Our volunteers are from diverse backgrounds, but they all have in common an interest in their own aging process and personal growth, and a belief that one can change at any age… Over and over I hear from the volunteers that they get as much from being counselors as the clients get from them.”
Peter Schmid of Greenbrae and Cynthia Wood of Bolinas are among the program’s 35 volunteer counselors. “Counseling is a chance to do something for humanity,” says Schmid, age 79, who has been a volunteer for 15 years. Adds Wood, age 77: “People are really appreciative.”
For more information on how to volunteer with Senior Peer Counseling and the next training, call 415-499-6802.