FOCUS ON AGING AND ISSUES WITH SENIORS

 

As a licensed consulting psychologist in 1975, I founded Geriatric Psychological Services to provide diagnostic assessment and psychotherapeutic services to geriatric patients residing in long term care facilities. I sought additional training from a gerontology program at the University of Minnesota and worked under the supervision of geriatric psychiatrist Floyd Garetz, M.D. Through the years I have provided diagnostic, counseling, and consultation psychological service to seniors and their families dealing with a variety of aging issues such as:

 

  • Adjustment to retirement and pre-retirement
  • Healthy senior wellbeing/quality of life
  • Later career choices
  • Coping with geriatric health issues
  • Understanding and caring for Alzheimer’s and other disorders causing dementia
  • Coping with loss/death/grief
  • Lifestyle coaching for seniors

 

When retirement approaches, many people feel more relaxed and satisfied. They look forward to this time in their life when they can do what they want and when they want. However, after a short period of retirement, many people start to feel more stress and less happy because their life seems to lack purpose and they may feel stagnation. Thus, people go from a retirement stage of exhilaration to a stage of disenchantment. This period of discontent is a time to reconsider their lifestyle plan to set realistic and satisfying goals and then readjust their daily routine to fulfill them. The next phase is a regeneration stage of retirement when they change attitudes, values, and behaviors to cope effectively with adjusted lifestyle changes.

 

I have a variety of assessments dealing with retirement, which includes:

 

  • Retirement stages
  • Retirement readiness
  • Readiness to make transition and life changes
  • Areas of strength and motivation
  • Potential for growth in senior years
  • Planning for the next part of life and achieving those goals
  • Role changes (new roles, roles to continue, roles to discontinue)
  • Future values and priorities
  • Location priorities
  • Life purpose
  • Couple togetherness as seniors, compatible goals
  • Retirement factors (money, division of housework, grand parenting, social contacts, meaningful activities, smoothness of transition, health, goal direction, avoiding boredom, alone time, problem solving,    maintaining the best level of functioning)

 

I also have a variety of assessments dealing with aging issues, including:

  • Anxiety
  • Depression
  • Cognitive ability
  • Adaptive and functional behaviors
  • Socialization and communication

 

The retirement years are those in which healthy wellbeing and quality of life take on more importance. This is a time for seniors to maintain a healthy lifestyle and to be happy and social. Seniors can learn new habits of healthy eating, exercise, and reducing stress. It could also be an excellent time to explore and expand new horizons. They can still make use of the knowledge and experience they have learned in new ways. They will still want to be engaged, stimulated, and challenged in their daily activities. For some, they can find new roles, creative outlets, and new motivations to continue making positive and meaningful contributions to society. Seniors will still be able to use their thinking skills of vision, discernment, excitement, gratitude, courage, solitude, confidence, joy, resilience, creativity, and wisdom to consider a new area of learning, a new role to play, or even a new job. They can also think of opportunities to live a new vigorous and active life.

 

As aging continues, more people will be living with health issues causing loss, pain, and/or illness. However, they can seek interventions for chronic conditions and set specific health related goals to enhance their quality of life. Some goals may include:

 

  • Prepare for and recover from surgery or medical procedures
  • Manage pain and discomfort
  • Develop and maintain an exercise routine
  • Increase brain training activities
  • Increase heart health techniques
  • Manage blood pressure, cholesterol levels, medications, weight, stress, and other health concerns
  • Increase social and recreational activities
  • Adjust to living alone
  • Create and maintain positive, fulfilling, and loving relationships with those you already know and develop new relationships
  • Balance daily life with original and imaginative interests and passions for self expression

 

As people live longer, the frequency of Alzheimer’s and other dementias rises dramatically so that it is a major health issue for seniors. Complications of dementia not only impact the afflicted individual but also their family and friends. Services I provide to help with this disorder include diagnostic and various assessment procedures, as well as follow-up counseling and coaching techniques to the individual, their family, close friends, and other caregivers.

 

It is important to obtain an accurate diagnosis for several reasons in order to be able to:

 

  • Distinguish normal aging from early stages of dementia
  • Identify various stages of dementia
  • Slow down the progression of dementia
  • Improve areas that can be enhanced
  • Help family and other caregivers plan ahead and problem solve
  • Treat mental health problems associated with dementia such as depression, anxiety, grief, frustration, anger, etc.
  • Develop cognitive stimulation training and reminiscence therapy

 

Assessments associated with dementia could include:

 

  • Short term and long term memory and concentration
  • Memory strengths and weaknesses
  • Learning ability
  • Language skills
  • Orientation
  • Judgment
  • Social functioning
  • Turn off behaviors
  • Communication skills and family interactions
  • Self care, activities of daily living, and environment
  • Executive skills, such as time management, task completion, following directions, organizing, planning, working memory, etc.
  • Intellectual and cognitive traits
  • Social and emotional status

 

Although the dementia patient is unlikely to seek help, their caregivers are often in need of services because of the heavy and constant burden they experience. Caregivers often report feelings of fear, loneliness, alienation, exhaustion, depression, anger, anxiety, helplessness, and sleep problems. I am able to help caregivers in the following ways:

 

  • Understand their roles, responsibilities, and relationships with the patient
  • Clarify job duties on activities of daily living
  • Making decisions about living arrangements, handling finances, driving, medication management, diet, social relations, travel, community resources, meaningful activities, intimacy, personal freedom, remaining independent, safety and wellbeing, legal issues, etc.
  • Obtaining a consensus or solution when differences exist between family members about care decisions, plans, and other care giving issues
  • Communication techniques with the patient (active listening, calming tone, encouraging expression, problem solving, conflict resolution, planning for the future, engaging in meaningful activities, etc.)
  • Avoid being private and self sufficient by reaching out for help rather than “going it alone”
  • Be better prepared to understand and incorporate advice from physicians and other professionals
  • Accept changes in the dementia patient’s relationship with caregivers and with the patient’s relatives and friends
  • Help the patient prepare to depart home, arrive at the new facility, make the new environment safe and personal, and explain the care plan to the patient
  • Help the patient with “brain” exercises and mental stimulation to keep memory from rapid deterioration
  • Help the patient who recognizes their symptoms to gain a deeper appreciation of life and pleasures, to cherish memories, to express compassion and gratitude, and to review their meaningful life
  • Develop better ways of handling crisis situations
  • Learn to balance your needs with those of the patient
  • Address your own feeling of grief, overwhelming frustration, depression, worry, and other negative feelings
  • Improve communication with the patient, family members, relatives, and friends
  • Discover your inner resources
  • Manage a leadership role
  • Explore the use of community resources
  • Facilitate working relations with other professionals
  • Manage fair or equal division of responsibility within the family caring for the patient
  • Learn about stages and symptoms of the patient and try techniques and interventions to cope with troubling patient behaviors
  • Change the social environment for the patient and include opportunities for meaningful activities

LOSS, GRIEF, DEATH

 

As a person ages they experience more loss, grief, and eventual death. Although many losses are well defined and clearly recognized, other losses are more subtle and less obvious. At the same time, other situations are confining and stressful in the sense that a loss may or may not occur depending on what happens. An example would be waiting for medical test results of a biopsy to determine the presence of cancer. In every case of a loss grief occurs, to some degree, depending on the importance of the loss. Grief is not only felt with negative emotions but also felt physically. Grief reactions are normal and recovery is part of the healing process.

 

There are several stages of recovery, although people may take a short or long time to get through them. The initial stage is a combination of shock, denial, and numbness. This stage is followed by common negative emotions of anger, fear, grief, and depression. The final stage combines understanding, acceptance, and moving forward. These recovery stages are natural, necessary, and part of the healing process. When analyzing and comparing one loss to another, the main difference in recovery is the intensity of the feelings and the duration of the healing process. Thus, an extremely important loss tends to be intense and prolonged.

 

If you believe you need help, seek it immediately. Do not hesitate or “go it alone”. The following are guidelines about when to get help:

 

  • Feeling suicidal or ready to inflict damage
  • Feeling fragile, breaking down, or falling apart
  • Feeling “out of control”
  • Being ready to take action you may later regret
  • Feeling isolated or alone
  • Feeling that you have no one to turn to for support
  • Feeling support from family and friends is not enough
  • When you would turn to alcohol, drugs, or other addictions in time of need
  • When you have a history of emotional disturbance
  • When you repeatedly find yourself in loss situations
  • When your current loss reactivates a previous loss that was unhealed
  • When you have not gotten past stage two of recovery after several months
  • When you feel you have developed a chronic state of psychological and/or physical symptoms that persist for an unreasonable period of time 

 

LIFESTYLE COACHING FOR SENIORS

 

Although there are many services for aging individuals, particularly health centers, there are not enough professionals that coach seniors. Seniors are the most rapidly growing segment of population worldwide but finding ways to serve them has not kept up with their growth in numbers. That is particularly true of healthy elders who are not experiencing major social, emotional, or physical issues. I provide lifestyle coaching for the aging population in the areas I have described above, which are:

 

  • Adjustment to retirement and pre-retirement
  • Healthy wellbeing/quality of life
  • Later career choices
  • Coping with geriatric health issues
  • Understanding and care for Alzheimer’s and other disorders causing dementia
  • Coping with loss, death, and grief

 

In each of the above areas, a lifestyle coach should understand and be knowledgeable about the issues of aging. I have had training and forty years of experience in this field and understand the issues seniors are likely to face. Older adults still have personal and professional goals to improve their life and, sometimes, work situations. For seniors, learning through coaching would maximize their potential to attain new goals, take on new life challenges, and cope with aging issues. Without coaching, most elders do no accomplish as much or fulfill their wishes and potential. Instead, they often scale down their goals and endure undesirable situations. In the following paragraphs I will explain the positive aspects of coaching that will include how coaching works, what benefits can be gained, and what situations would make coaching worthwhile.

 

A coach for senior adults will encourage their client to identify issues, needs, and goals they want to attain or change. The coach will help that person focus on taking action, producing results more rapidly, and doing more than what they might have done on their own. To accomplish more, the coach will provide structure, techniques, support, and strategies to the client. The client should be willing to include someone to help them identify, design, strategize, and implement this plan of action to reach a successful outcome. Coaching methods include training, sharing information, and providing structure which can occur in face to face sessions, by telephone consultations, or by use of the internet. In addition to conversations, the client will be given homework to read, study, and learn. They will also be asked to document behaviors to integrate into a regular routine and to take action. Coaching sessions usually occur three to four times per month and are paid monthly in advance.

 

Coaching is effective for a number of reasons. Coaching interaction requires using the communication skills of listening, guiding, supporting, truth telling, caring, clarifying, training, and challenging. The client receives outside objective influence, creative collaboration, intellectual challenge, continual and quick access, and full confidentiality. The coaching techniques come from psychological and behavioral research, education training skills, sports and teamwork practices, parenting and self help skills, theories of management and business, motivation techniques, practical judgment, and proven wisdom. Thus, the older adult benefits by gaining sharper thinking, meaningful achievements, rewarding goals, more security, faster results, rapid personal development, more money, and a happier and more fulfilling life. Client goals could include positive retirement adjustment, personal development, healthy lifestyle changes, higher quality of life, financial independence, communication and thinking skills, family and home life enhancement, positive care giving for dementia patients, improved relationships, job and life satisfaction, and positive quality of life. Many of these coaching techniques and ideas are stated in “The Coaching Starter Kit” (2003) by CoachVille.com.

 

Before a first session occurs, when a client contacts a coach about services, there are a number of emotions and thoughts that surface. Feelings, such as excitement, curiosity, fear, doubt, worry, or uncertainty would be expected and considered normal even though the person is ready to make a positive change. The client should expect to give the coach honest reporting, direct communication, a positive attitude, completed assignments, an effort to build trust with the coach, timeliness, and fee payments. At the same time, the client should expect the coach to work hard to build trust, to be confidential, available and constructive, to show commitment and integrity, to be tenacious about progress, to be respectful and nonjudgmental in attitude, and to focus on goals and action plans so that the client will have more of what they truly want in life. The coach will ask the client questions to encourage, challenge, clarify, and strengthen their desires so they can refocus, develop, take action, and fully use their talents and resources to make the best decisions.

 

To conclude, coaching for seniors, no matter how old or at what stage, makes a great deal of sense. Elderly individuals have learned a great deal and have many life experiences. Yet they yearn to learn more and have additional experiences. Most seniors would be more satisfied if their potential were fulfilled and their talents and experiences were fully developed. Unfortunately, many older adults have not reached their expectations and are stuck in mediocrity. If an athlete were stuck, they would automatically reach out to a coach for help. This should also be true for seniors at any stage since it affects their daily life to a great extent. The outcome would likely be success, fulfillment, reduction of problems, and greater happiness.