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Transition Issues for the Elderly and Their Families
By: Avrene L. Brandt, Ph.D. Licensed Clinical Psychologist
Caregiver on line, February 15, 2002
In this article we will be looking at the changes that senior adults and
their families encounter as parents transition into being "older
adults". These changes will be described and recommendations made as
to how to adjust to change and maintain a fulfilling lifestyle.
As adults approach their senior years many aspects of life (physical, social, financial, and employment) are changing. For most seniors, the retirement years are anticipated positively and with an expectation of more leisure time and a lessening of demands and responsibilities. Neither seniors nor their families are adequately prepared for the stresses that also accompany aging. The goal during the senior years then is to maximize the positive and develop strategies for coping with the stresses.
Look at Change Realistically
As with anything in life, the discrepancy between what one expects and what actually exists can be a set up for disappointment and frustration. It is therefore important to realistically look at changes which may occur and which may be experienced as losses from life as it was.
To begin with, the aging process brings physical change. Older adults may not feel or look as well as they did. There may be a general slowing down of activity level and cognitive speed. There are also specific losses – of vision, hearing, movement, and memory. Seniors can still do the same things but it can take longer. The changes though, can impact on mobility in terms of going places, driving and pursuing activities.
There are also changes in identity and roles, which accompany retirement. Our jobs typically define much of our identity. Retirement from a job can create a gap and affect self-esteem. It is also not uncommon that seniors are faced with necessary changes in their living situation. Health and safety issues may necessitate a move from a place that was home for many years. There is then a loss of the familiar, of neighbors, of possessions, of a place of worship, and so on. Transitions and losses associated with moving can echo and intensify earlier losses of friends and family through death or through their also moving away.
In addition to the role change that occurs with retirement from a job, gradually, over time, there is a role change that occurs with seniors vis-a-vis their children. Children of adult seniors may begin to take over responsibilities for finances, physical well being, getting places and so forth. Neither senior parents nor their adult children find this role reversal comfortable. For seniors, giving up decision-making and choice is an affront to their self-esteem. For adult children, it may be embarrassing and arouse anxiety to see their parent as dependant and vulnerable. It is a sensitive issue – to know how much to take over and what to leave in the province of a senior parent. For adult children there is also the challenge of balancing their own lives, families, careers and social needs with that of their aging parent. If not handled well, the issue can lead to tension frustration and conflict between adult children and their aging parent.
Empowering Your Senior Parent
Adult children can be an enormous resource for their parents who are navigating through the retirement years. There are adjustments and decisions to be made. The goal to keep in mind is the attainment of a sense of well being, purpose and self-esteem. A primary objective, which is important throughout the life cycle, is "empowerment"- the feeling that one has the ability and opportunity to make choices and have input in ones life. This is a key aspect of older adults feeling fulfilled.
With that as a guiding principle, let us look at some of the areas in which empowerment is a factor.
Where You Live
The primary decisions for seniors are where they will live and how they will spend their free time. For most seniors their preference is to stay in their homes, independently throughout life. Some are fortunate in this regard but for others, they may reach a point where health and safety factors indicate that independent living is no longer possible. Except in cases of acute or sudden onset of a situation, there is usually a gradual increase in signs that an alternate arrangement is needed. Families who wait too long to solve the problems may not use all possible resources and may not involve the senior parent enough. To the extent that families plan long range, explore options and work collaboratively, the transition will work better. To the extent that a rapid emergency decision is made with little choice and input from the elderly, adjustment will be affected. The result may be feelings of malcontent, loss, abandonment and being misunderstood.
Any change, be it arranging for help in the home or moving to a facility, is best done with the senior parent evaluating, and expressing their feelings, preferences and comfort level. There is a "goodness of fit" between a person and a place. All places tell you how fine they are and all the amenities they provide. In fact, facilities vary widely in their ambiance and the specific services that they offer. The person, who will be living there can best assess their comfort level in a given setting. The lack of opportunity to have input can result in the feeling of being "placed" or "put." This combines with feelings of abandonment and is a factor contributing to depression.
What You Do
Wherever the older adult lives they have an increase in available leisure time. The goal is to fill time in a rewarding way rather than to have time hang on one’s hands.
By the time seniors are 60 and older, they have a good sense of what brings them pleasure. If they haven’t fully discovered it, they now have the time to explore it. To begin with it is important that senior adults stay mentally and physically active because this has been shown to improve health and longevity. Staying socially connected is important because isolation has been associated with poor health and depression. Families are a valuable resource here. If the senior adult lives alone, transportation should be set up to get them out. Families are a resource for getting the adult parent out of assisting living and nursing facilities for the day. Seniors rally when they get out. Sometimes getting out even one-week day is an anchor and gives seniors something to look forward to. Families should encourage their loved ones in assisted living and nursing facilities to participate in outings and activities and to be out of their room. Sometimes a family member going along and participating helps the parent begin to progress. In line with this, contact with the community through a religious or volunteer activity can provide a sense of being involved in something that goes beyond oneself and fosters a connection with the world. Families can be involved in finding these resources, setting them up and initially participating to get things going.
Senior citizens possess a wealth of information. They have lived a long time and learned a lot. They need to be appreciated for that fact that what they think and say has value. Family members need to listen to the concerns and ideas of their loved one. Their transition issues are real, their observations valid and not just complaints. If family members minimize, ignore or deny what their loved one says, (i.e. "It’s beautiful here. There’s so much to do. How could you not like it?"), the loved one will feel more isolated, misunderstood and unsupported.
Some older adults have excellent ability to adjust, transition, and keep busy, while others struggle more with change. Family involvement and support is a crucial factor in enhancing and facilitating adjustment and helping parents establish a fulfilling life in the senior years.
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