Feeds:
Posts
Comments

Gerontology

Here is an excerpt from the Being There Now Workbook (Gerontology Unit.) We are currently in the process of printing the workbook; as soon as it’s ready we’ll let you know. (The image below is from the University of North Carolina Wilmington website.)

“Old age is like a rock on which many flounder and some find shelter.” (Anonymous)

Goal: To learn the realties of the aging process, to challenge the misconceptions people have about the elderly and to become effectively equipped to help them live full and contented lives.

Who are the Elderly?

The term applies essentially to those people who are who are over 60.  However sometimes being 55 years of age makes you applicable for the same discounts!  In western culture where work is considered primary and the cult of the body beautiful is prevalent everywhere the process of aging is often perceived with fear and trepidation. The elderly are often marginalized and regarded more as a burden on society rather than being able to contribute to the well being of society.  The thought of growing old often fills a young person with feelings of fear.  They often believe that being old implies the loss of the essential functions to live a normal and active life. They fear the loss of sexuality, memory recall and motor functions. In fact, many today try to slow the aging process through cosmetic surgery and medications. But as Alex Comfort says, “Aging has no effect upon you as a person. When you are “old” you will feel no different and be no different from what you are now or were when you were young except that more experience will have happened…. An “Aged” person is simply a person who has been there longer than a young person”. Many people forget this fact and treat the elderly as if they were a different species! Medication and any form of treatment that will slow the aging process is in high demand nowadays.

In 1776, a child born in America could expect to live to be thirty-five years old. The median age for people in 1776 was sixteen! A century later, life expectancy was only forty and the median age was twenty-one. Today, life expectancy has doubled from what it was a century ago according to the National Institute of Health. A person who is 60 years of age can expect to live at least another twenty years. Interestingly, we often forget that nowadays that a 60 year old son or daughter may be caring for an 80 year old parent, and an eighty year old spouse may be caring for his/her eighty–five year old partner!  Many factors have contributed to this amazing increase, but the most significant ones are probably the advances in the field of medical science and nutrition.

Of course, the obvious result of our living longer is what one

author called “the graying of America.” Because people are living longer, it is likely that caregivers will be involved more and more with helping older persons. It is essential, therefore, that caregivers have some knowledge of the aging process and that they learn the essential skills necessary for helping and caring for the elderly.

Muriel Gillick in her book, Lifelines, calls aging “the road to frailty.” While traveling this “road”, people are affected by changes in the basic aspects of life such as bathing, dressing, walking, eating, socializing, sleeping, etc. it is a road that often leads to more and more dependence. As caregivers, you are in a particularly unique position to help people navigate this path with dignity and fortitude.

A Few Thoughts.

Where the aim the of Being There Now workbook and book is our preparedness to be there for our family and friends, those we deal with as professionals in a time of crisis, or even just lending an ear to a minor problem; one thing is important, if we as the listeners are not in the right frame of mind we could do more damage than good or at least be ineffective. I have always found that reading helps keep me on an even keel. One of my favorite writers is Jack Kerouac. Yes he led a somewhat crazy lifestyle but out of all that craziness came some of the most clear thinking I have encountered in a writer. He called it “spontaneous prose” possibly akin to stream of consciousness. Here we have some quotes from Jack Kerouac.

‘‘No man should go through life without once experiencing healthy, even bored solitude in the wilderness, finding himself depending solely on himself and thereby learning his true and hidden strength. Learning for instance, to eat when he’s hungry and sleep when he’s sleepy.

“We were all delighted, we all realized we were leaving confusion and nonsense behind and performing our one and noble function of the time, move.”

“Emotionlessly she kissed me in the vineyard and walked off down the row. We turned at a dozenvinepaces, for love is a duel, and looked up at each other for the last time.” I was going to be left alone on my butt at the other end of the continent. But why think about that when all the golden land’s ahead of you and all kinds of unforseen events wait lurking to surprise you and make you glad you’re alive to see?”


In some strange way I believe these two songs could have a connection on some level with what Being There Now is about. And if not, there are here anyway so enjoy them for what they are. Don’t comment complaining that they are not connected, it’s all about perceptions.

We are currently working hard on the production and publication of our work book Being There Now.PondHere is the introduction taken from the work book.  As soon as its published it will be on sale here, eBay and hopefully in download format too. I’ll keep you updated on our progress… Marty.

To do anything effectively demands knowledge, training and practice. Caregiving is no exception. The authors have written this manual to achieve those objectives by creating a training program for the non-professional caregiver.

One of the unique characteristics of this program is its interactive format. The instructors and the participants will engage in exercises and dialogues that are designed to be interactive, and are meant to help the participants practice the skills being taught.

The authors have built the program around the concept that people wanting to be caregivers are already motivated to help others and that they have the personal life experiences that will allow them to become effective caregivers. As a result, this manual elicits from the participants their thoughts and feelings about the principles and skills that form the foundation for the work of caregiving. This aspect of the program also contributes to its interac­tive dimension.

Being There is a program that is “person centered.” It is centered first on the needs of the person seeking support or help, and secondly on increasing the self-aware­ness of the caregiver. At the same time, it strives to point out and clarify the skills, knowledge and boundaries that the caregiver needs in order to be effective.

This manual is intended to address the increasing demand for properly trained women and men who find themselves by choice or even by happenstance in the role of caregiver. Good intentions may not be enough, but they are the all-important first step on becoming an effective caregiver.
Robert Jones
Derek Smyth

Avoiding Stress.

Before talking about avoiding stress, we need to know what it is and what causes it. Stress is an unpleasant feeling that results when we feel our abilities or our resources are inadequate to meet the demands being placed on us. It doesn’t matter if our abilities or our resources are, in fact, inadequate, but only that we perceive them to be so.Str

For example, a teacher recently explained that because of the budget cuts in her district, she was being moved from her middle school, where she had taught for six years, to the district’s high school. She became extremely stressed because she felt her abilities were not equal to the demands that would be made on them by high school students. An even simpler example might be a man whose income is two thousand dollars a month and whose bills are two thousand five hundred dollars a month. That man will feel stress: his income is insufficient to meet his obligations!

Many people believe that stress is the cause of problems like depression, anxiety, hopelessness, chronic anger etc. Actually stress is not the cause of these or similar feelings; stress is the condition for these feelings. In short, when one is feeling stress, one is likely to experience these other feelings. Perhaps the following analogy may help to explain. Soil is a condition for plants to grow, without it the seed does not take root and mature. Sun and rain are the cause of the seed’s growth. So too with stress. Problems take root and flourish in the fertile soil of stress.

How does knowing this distinction between cause and condition help? Well, quite simply, if one is feeling stress, one can either increase one’s abilities or resources to meet the demands, or decrease the demands. That will begin to deplete the “soil of stress” which, in turn, will mitigate feelings of anxiety, depression, hopelessness etc. Of course, there are other ways to avoid and reduce stress, and these are more fully explained in the “Self-Care” Chapter of the book, Being There, by Robert Jones, LCSW and Dr. Derek Smyth.

Learning Self Care

(From Students Against Depression)

Depression encourages self-neglectwater

The depressed thinking habit of self-bullying is often accompanied by self-neglectful or self-destructive behaviours, such as poor eating and hygiene habits, or binge drinking. It can also lead to physical self-bullying or self harm.

Downward spiral of self-destructiveness

Physical self-neglect or self-destructiveness can be a strong contributor to the downward depression habit spiral, lowering your mood and intensifying self-loathing. In this context, physical self harm can become entrenched as a destructively addictive “coping mechanism”.

Self caring habits break into the spiral

Building up a programme of self caring habits interrupts this vicious downward spiral. Don’t wait to feel like you “deserve” it or are “worth it” – just give it a go!

Strategies

Make a programme of basic self care tasks

Give yourself basic self-care goals for the start of each day: getting up and having a shower (and shave, if relevant), eating breakfast, getting dressed into outdoor clothes even if you don’t plan on going out.
Give yourself recognition for achieving these tasks in the face of the lethargy that depression brings.

Increase body awareness and physical self care

Use your daily washing ritual as an opportunity to focus on your body. Be gentle and soothing when soaping yourself. For example, pat on after-shave instead of slapping it on.
Give yourself a regular “pamper” session. Take a relaxing bath instead of a shower. Rub in lotion from head to toe, taking your time and doing it with gentle care.
Practise relaxation techniques daily. Take up yoga or pilates, or any other gentle form of exercise which helps you to “tune in” to your breathing and your body.

Check depressed thinking habits

Are depressed thinking habits getting in the way of your trying these self care exercises? Check for self-bullying and perfectionism in particular.
If your self-bullying has led to entrenched body image problems or eating disorders then check out how a counsellor or doctor can provide professional help.
Pay attention to your surroundings

Make an effort to tidy up your room. Do it a little at a time – it can be a good distraction technique. Or if it feels like too big a job, get a friend to help you.
Make your room a comfortable, welcoming place. Put up posters of calming natural scenery. Get a few brightly coloured cushions for your bed. Get a plant. Put up photographs of family and friends to remind you of your support network. Include some photos of you having a good time.
Likewise choose nature scenes or photos of friends for your computer screensaver or desktop.
Benefit from massage

Soothing touch can be powerfully restorative and healing. Massage can increase “feel good” brain chemicals, contributing to a reversal of the depression habit spiral.
Some doctors or counselling services can make referrals for massage.
If you can’t get a referral or afford a professional massage, then swap foot or shoulder rubs with a friend.
Self massage can be very effective: gently and slowly squeeze along your shoulder and neck as you breathe deeply in and out; massage each hand in turn.

Practice constructive ways to express feelings

Experiment with different ways to express feelings when they seem to be building up inside, to see what works for you.
Keeping a diary can be a useful habit for getting feelings ‘out’. Just write it all down without censorship, then close it and put it away. Or it might be helpful to do something symbolic like writing it all down then scribbling it out or tearing it up. Vigorous activity or exercise can be another helpful way to get rid of pent up feelings.

Get out into natural surroundings
Most people recognise the sense of “rightness” or inner peace that can be found in connecting with the natural world: watching a beautiful sunset, listening to a babbling brook, breathing in the smell of new-mown grass on a summer-s evening.
Modern lifestyles can mean that these experiences are all too rare. Do what you can to get out into natural surroundings as often as possible – even if it’s an urban park or canal tow-path.

This story of Yeshi Donden and the art of listening is one that I often read and re-read to remind myself of the times I have been present physically but was not listening.not listening

Yeshi Donden was the long-time personal physician to HH the Dalai Lama. In this story, he visits a US hospital.He is to visit a patient unknown to him and give a diagnosis to a gathering of very dubious on-lookers!

“I join the clutch of whitecoats waiting in the small conference room adjacent to the ward selected for the rounds. Yeshi Dhonden, we are told , will examine a patient selected by a member of the staff. The diagnosis is unknown to Yeshi Dhonden as it is to us. We are further informed that for the past two hours Yeshi Dhonden has purified himself by bathing, by fasting, and prayer. I, having breakfasted well, performed only the desultory of ablutions, and given no thought at all to my soul, glance furtively at my fellows. Suddenly we seem a soiled, uncouth lot.
The patient had been awakened early and told that she was to be examined by a foreign doctor, and had been asked to produce a fresh specimen of urine, so when we enter her room, the woman shows no surprise…

Yeshi Dhonden steps to the bedside while the rest stand apart, watching. For a long time he gazes at the woman, favoring no part of her body with his eyes, but seeming to fix his glance at a place just above her supine form. I, too, study her. No physical sign or obvious symptom gives a clue to the nature of her disease. At last he takes her hand, raising it in both of her own. Now he bends over the bed in kind of a crouching stance, his head drawn down into the collar of his robe. His eyes are closed as he feels for her pulse. In a moment he has found the spot, and for the next half hour he remains thus, suspended above the patient like some exotic bird with folded wings, holding the pulse of the woman beneath his fingers, cradling her hand in his. All the power of the man seems to have been drawn down into this one purpose. It is palpitation of the pulse raised to the state of ritual.

I cannot see their hands joined in a correspondence that is exclusive, intimate, his fingertips receiving the voice of her sick body through the rhythm and throb she offers at her wrist. All at once I am envious- not of him but of her. I want to be held like that, touched so, received. And I know that I who have palpated a hundred thousand pulses, have not felt a single one.
At last Yeshi Dhonden straightens, gently places the woman’s hand upon the bed, and steps back. The interpreter produces a small wooden bowl and two sticks. Yeshi Dhonden pours a potion of the urine specimen into the bowl and proceeds to whip the liquid with two sticks. This he does for several minutes until a foam is raised. Then, bowing above the bowl, he inhales the odor three times. He sets down the bowl and turns to leave. All this while he has not uttered a word. As he nears the door, the woman raises her head and calls out to him. “Thank you doctor,” she says, and touches with her other hand the place he had held on her wrist. Yeshi Dhonden turns back for a moment to gaze at her, then steps into the corridor. Rounds are at an end.
We are seated once more in the conference room. Yeshi Dhonden speaks now for the first time. He speaks of winds coursing through the body of the woman, currents that break against barriers, eddying. These vortices are in her blood, he says. The last spendings of an imperfect heart. Between the chambers of her heart, long long before she was born, a wind had come and blown open a deep gate that must never be opened. Through it charge the full waters of her river, as the mountain stream cascades in the springtime, battering, knocking loose the land, and flooding herbreath. Thus he speaks and is now silent…”

The host of the rounds speaks, with the diagnosis he has known: “Congenital heart disease, interventricular septal defect, with resultant heart failure.”

from Mortal Lessons, a book by surgeon, Dr. Richard Selzer

Being There Now
The Being There program arose out of a need for non-professional people to be trained and empowered to help others who were in need of care and assistance. At the same time, there was a growing awareness on the part of many professionals that the ever increasing demands for their services could not be met because of the lack of personnel and the lack of resources. These professionals were also aware that much of what they did could be done by others who were appropriately motivated and trained.

Originally, the program seemed to be a crash program in pop psychology. When Dr. Derek Smyth was asked to assume the responsibility for the program by Riverside County in 2001, however, he quickly realized that the program was in need of significant overhauling. Dr. Smyth asked Mr. Robert Jones, a licensed clinical social worker in California, if he would join him in rewriting and redefining the curriculum and goals of the program. Mr. Jones agreed, and there began a six year collaborative process of writing, rewriting, testing and retesting, presenting and adapting the program.

During those six years, Dr. Smyth and Mr. Jones had the opportunity to present their program to groups of volunteers in parish work, to the volunteers and staff of the local Desert Aids Project, to the chaplains and nurses and Eisenhower Medial Center in Rancho Mirage and at the Desert Regional Medical Center in Palm Springs, to those aspiring to be Deacons in the Archdiocese Of San Bernardino, and to numerous others who found themselves in situations where they were asked to be in a helping relationship of some kind. Although the program was designed primarily for non-professional people who wanted to learn the skills necessary to work effectively in a care experience, many professional people who have participated in the program have found the program helpful in their professional lives as well.

Unit 1 - The Care Experience: Most people have a desire to help people. This desire requires the skills to respond appropriately. A genuine desire to care requires an investment in time to develop the skills necessary to be effective. Otherwise it may be just about you! There is an emotional component to caring that is not innate to helping. Writing a check to an organization that feeds the hungry is helping. Caring requires skill. The danger in helping without having the skill to care is that it can cause damage. Often times a person’s desire to help causes them to take over a situation, attempt to fix problems, organize someone else’s life, and remove obstacles using their own agenda. The door opens up and the neighbor rushes in with their solution.

Unit 2 – The Core Qualities of The Care Experience: Caring requires an understanding that the skills to care aren’t necessarily natural for most of us. It requires identifying and building upon the core qualities for providing an effective care experience. Keep in mind that you are NOT here “to fix a person!” Developing qualities for a particular line of work is easier said than done. The reality is that every quality a person possesses has underlying skills and abilities that cause the quality to manifest and develop. Some of the qualities you may already possess, while others may take some time to develop. The key here is keeping top-of-mind the qualities that are not innate. They may be qualities that you have to develop and hone, so that as you develop your skills, the qualities become more natural. An effective care experience is often about not doing what your normal reaction or response might be. It’s about putting aside what comes naturally. If we truly wish to be with someone, we must learn to go deeper. This process can help them attend to their core pain, fear, or distress. Realize that a person is his or her own best authority. Remember that when you give advice and it goes wrong there will be only one person to blame -YOU!

Unit 3 – Hearing is not “Listening”: Unless born with a physiological impairment, everyone can hear. It essentially never turns off. But there is a real distinction between hearing and listening; not unlike the distinction between helping and caring. Our ears are in a constant state of picking up all the sounds and noises, chirping and barking and of course dialogues and conversations occurring around us every day. However this does not mean that we are actively listening to something specific that we purposely dial into. Hearing is a sense, listening is a skill.None of the core qualities of the care experience can be realized unless listening skills have been developed. Many believe they are good listeners mostly because hearing comes so natural. But, without the training to listen actively, the natural process of hearing is not sufficient enough if the goal is to Be There for someone you care for. Listening involves whether the person receiving care believes they were heard.

Unit 4 - The Five Pillars of a Care Experience: This unit deals with qualities that are more innate, intuitive, if you will, and, in a sense, deeply personal. The pillars are truly about “Being” This unit assists a person who has a call to care to go deep inside themselves and tap into the core of how to Be There.The Five Pillars are:Understanding the connection between thoughts and feelingsAccurately empathizing with the care recipientHaving the capacity for spontaneity and genuinenessCreating a non-threatening, safe and non-possessive environmentDeveloping unconditional positive regard for the care recipient

Unit 5 – Culture: In Culture we explore the importance of cultural awareness and the impact of cultural prejudice when caring for someone. Each one of us grew up within a particular family, tradition and culture. As a result, we have adopted ideas that were shared by our group concerning the ways to act, to think and to feel. In other words, we have learned a system of shared beliefs and values that characterize our relations with other people, with our environment and with ourselves. This “system” is often referred to as our culture.However, culture can quickly become a liability to a relationship when we narrow our vision to believe that a single culture is definitively the “right” one. When one is blind to cultural diversity, good judgment regarding how to respond, react, or engage with someone whose culture is the polar opposite of one’s own, cannot only be impeded, it can even be destroyed

Unit 6 – What is Self Esteem? This unit explores how having self-esteem is central to an effective care experience. One absolutely essential thread, which we all require, is self-esteem. People seeking help often feel their self-esteem is bruised or shattered by what they have experienced or are enduring. In grief work, for example, a woman who has lost her husband may feel becoming a widow reflects not only the loss of her husband, but the loss of some of her self-esteem as well. Through personal work on self-esteem, one can learn to support such people and help them gain or re-gain their self-esteem.

Unit 7 – Loss: In this unit we will raise your awareness level of how to help someone who is experiencing loss and processing their grief. When providing counsel, engaging the “less is more” philosophy is really what’s core. Author Derek Smyth has said, “The measure of our loss is the depth of our grief.” We all experience loss at different levels. Whether it’s financial, personal, physical, emotional, or familial, loss affects people in different ways and can manifest behaviorally in a variety of ways as well. Your role is not to react to the way someone expresses his or her grief, but to facilitate ways to help him or her work through loss.

Unit 8 Crisis Intervention: This unit presents the tools and resources necessary to address a crisis situation responsibly. A crisis is an intense emotional reaction to a situation that a person perceives to be seriously threatening or destructive to their well-being and stability. When people believe they are in a crisis and others do not share that perception, this may intensify feelings of isolation and deepen the crisis. It is important not to negate someone’s perception regardless of how you may perceive the same situation. Crisis intervention involves providing emergency support to those in need in order to help them re-establish their own coping strategies in a healthy and productive way. In many crises situations, one may function as a conduit to professional help. Sometimes the support at the early stages of a crisis may prevent its escalation

Unit 9 – Self Care: This unit explores the importance of self-care for anyone who is being leaned on. It also helps you identify signs of burnout and gives you practical ways to implement self-care in your life. Many people in our society seem to live their lives having lost the zest for life. People can become so absorbed in their work that they fail to recognize the sign of approaching burnout until it’s too late.People are defined not by who they are, but by what they do. The consequences of this are that people care more about work than themselves. You literally run yourself into the ground through your work commitments. The litany of work-related illness continues to grow: back injuries, heart attacks, depression, high blood pressure, premature aging, obesity, anxieties, ulcers, migraine headaches, etc. It is said of Western culture that people spend more time taking care of their possessions than of themselves. If you consider the time, money and effort spent on maintaining your home, car and possessions, you can easily conclude that there is very little left for self-care.