School Mentor Project: A Conversation with an 82 Year Old Community Member - Essay Example

? Senior Mentor Project: A Conversation with an 82 Year Old Community Member BY YOU YOUR SCHOOL INFO HERE HERE School Mentor Project: A Conversation with an 82 Year Old Community Member Introduction In order to gain insight into what drives sentiment of lifestyle, care needs, death and dying, as well as to enhance self-insights into the aging process, a conversation was conducted with a study participant, Elena Flowers, an 82 year old community member with a rather active lifestyle. This individual is strongly connected with her social network, consisting of other elderly acquaintances, who meet regularly to engage in mall walking, card games and other household recreational activities, shopping and periodic brunches in which discussion about life events and family members is common. To provide effective health care as a practicing caregiver, it was necessary to identify what factors are involved in senior lifestyle and understand the psychological and sociological characteristics important to this demographic, especially pertaining to death, dying, spiritualism and the potential complexities of attitude associated with these dimensions. The conversation indicated that elderly lifestyle can be quite productive and fulfilling, as well as indicating that perceptions of death and dying are quite potent after reaching advanced age. Death, Dying, Socialization and Emotion The researcher was cautious about introducing the concept of death and dying during what was a rather superfluous discussion of social engagement and thoughts regarding the importance of maintaining a strong social network after reaching advanced years. The researcher waited until the participant indicated recent losses that had occurred as a result of advanced age within their social network to begin introducing thoughts about death and dying. However, once the participant became comfortable with the mannerism and sincerity of the researcher, the respondent was forthright about her sentiment and emotional attachment to lost friends and her own mortality. Elizabeth Kubler-Ross (1969) provided a hypothesis indicating that there are specific stages that occur during bereavement that dictate the time it takes to heal from loss and how an individual is able to assess their own feelings or fears related to mortality. The first stage is denial, in which the individual refuses to accept that a loved one has passed on. Flowers had, just in the last three months, lost a very close friend along her network that often engaged in the aforementioned lifestyle activities enjoyed by the participant and her social network. Several of her friends, after the loss, demanded that the brunch party set a serving plate in an empty chair for the individual who had passed on at the age of 78 of a sudden heart attack. This caused Elena Flowers considerable discomfort, however she did not want to frustrate or anger the two friends who were adamant that a place should be provided for the lost acquaintance. When Flowers had suggested, on-time only, that this activity was not productive or necessarily healthy thinking, she met with considerable aggression and accusations that Flowers was heartless and unfeeling. Flowers felt that their own thoughts about mortality, since the lost friend had died so suddenly of a massive heart attack, were what was driving this denial. It was not necessarily denial that the loved one had perished, but attempts to protect themselves from the reality that their life spans were quickly reaching their end. Santrock (2007) states that this type of behavior is common and is designed to protect oneself psychologically from having to face the difficult emotions of losing a loved one. However, Elena Flowers was more of a pragmatist, a realist, who seemed to have come to grips with the reality that she, too, would one day meet her natural end. Though this was only a small sample of potential elderly citizens in today’s society, Flowers was keenly aware that she would one day pass on and wanted very much to get the most out of life she could manage before her body began its inevitable slow-down through progressing age. She was concerned, at the same time, that the denial that was so strongly apparent in the social network would begin damaging the ability to socialize effectively with her peer network. What was interesting about the conversation and unexpected in the research approach, was that one of the friends in the network was in the second stage of Alzheimer’s, a period marked by periodic bouts of memory confusion. This friend, who was only 71, was fully aware in this stage of her escalating problems, often lashing out aggressively against others when frustrated and was subject to significant mood swings. This is common in the earlier stages of Alzheimer’s when the individual is still conscious of their uncertainty and confusion (Tabert, Liu, Doty & Serby, 2005). Flowers mentioned that she was finding it increasingly difficult to maintain close and regular engagements with this particular friend, even though she felt guilty knowing that this was a period where the 71 year old victim of Alzheimer’s required the most support and encouragement. The irrationality of mood swings and aggressive outburst, according to Flowers, were not only frightening when they occurred, but were socially embarrassing as they were occurring more frequently in public venues. Flowers indicated that the loss of the friend to a heart attack, coupled with growing fear of aggression with the 71-year old acquaintance, had built a stronger mindset toward death and trying to keep the mind fresh and stimulate mental growth to avoid loss of faculties. This was obviously a significant fear for Flowers that she would one day, perhaps, lose control of her emotional faculties. Not being an elderly person, the researcher had always maintained a very laissez-faire attitude of death and dying, believing essentially that these emotions would be dealt with as advancing age became a reality. Flowers, however, indicated so much support for the Kubler-Ross model of bereavement especially as it pertains to anger. Her friends in the network were very hostile when Flowers attempted to steer the conversation away from the lost friend who died of the heart attack, seeming to the participant to be a product of emerging from denial and being unable to cope with the difficult psychological feelings of their own transience. Kubler-Ross (1969) indicates that an appropriate strategy is to remain temporarily distanced from someone who is explosive in anger stemming from an inability to cope with death and dying. When the researcher informed the participant that this was a recommended strategy while allowing others to come to grips with their difficult emotional states, she seemed relieved that she had not jeopardized these long-term friendships upon which much of her personal identity was based upon. Craven, Hirnle and Jensen (2013) state that safety is a very prominent motivator, which involves not only providing shelter and physiological needs, but protection from danger and harm. The researcher was able to provide the fundamental reassurance (safety) that seemed to be needed so considerably by Elena Flowers which seemed to create even more trust to be open about her emotional state. According to Campinha-Bacote (2011) it is the responsibility of a caregiver to, primarily, use active listening to attempt to understand a patient’s perception of their problem. This helps to bridge cultural differences and build a repertoire with individuals under care. Though the researcher could not relate specifically to the social lifestyle of Flowers, being able to show empathy and reassure that the participant’s emotional coping mechanisms were common and justified really seemed to relieve a burden that weighed heavily on the participant related to guilt and concerns about her own empathic abilities. Flowers was clearly a collectivist as it pertained to socialization, meaning that group sentiment and opinion strongly determine one’s actions and thought processes, as well as identity formation. What the researcher found so unusual was that a person of this advanced age would still be concerned about moratorium, a phenomenon in adolescents seeking identity through a variety of peer reference groups and other social activities. However, rather than chastising the individual for being what the researcher believed was immaturity (at first) in social perception, instead offering reinforcement for areas in which there was evidence of self-sufficiency seemed to have superior psychological impact with the participant. This conversation assisted the researcher in changing ideas on death and dying when also considering the literature regarding the topic. This experiential conversation with an elderly person indicated that there is a need for having a supportive and rational social network to assist in, essentially, pushing out negative feelings about death and dying. It was not, however, until the researcher indicated a legitimate compassion and understanding without providing judgment that the genuine feelings about death, dying and bereavement can be addressed. Flowers continuously stated her strong will and her determination to stay youthful and active, however her psychologically-based cues indicated a considerable amount of self-esteem issues and self-doubt that surfaced rather unconsciously during the conversation. It became clear that Flowers was in a state of denial, though not severe and maladjusted, in which she attempted to over-compensate to avoid exposing herself to complex emotional concerns about her mortality and death. This experience made the researcher reflect on the nursing model known as the Roy Adaptation Model in which it is recognized that effective care consists of the impact of nurse attitude, values of the nurse and the patient, emotional capacity of the patient, and the perceived self-efficacy of the patient (Rogers & Keller, 2009). Through this conversation, perhaps as a seasoned individual trained to recognize certain psychological cues, the researcher was able to provide trust, instill a sense of openness, and also help the participant understand her strengths rather than having to focus on failings independently. The conversation allowed for shared values to be discussed and it was soon realized how much both the researcher and Flowers really had in common related to spiritualism and death, that is should not be an obsessive concept as this limits forward progress and reliance on self-efficacy to cope through difficult situations. This conversation made the researcher realize that the foundations of effective care is establishing a dialogue, sharing experiences, and making legitimate efforts to understand the psycho-social capacity of the patient before addressing care needs and believing it will produce competent results. Only briefly did the conversation turn toward religion and spiritualism just in an effort to understand how this played into the thoughts and emotions of death and dying with Elena Flowers. Though she initially stated she was a devout atheist, there were several examples in which Flowers seemed to be more inclined to believe in the concept of a soul. Through more rather unconscious dialogue, there was clearly a peaked interest in spiritualism as she approached such an advanced age which allowed some conversation about the role of religion in death and dying to be discussed. Generally, Flowers seemed positive about the potential of a life without end, smiling when mentioning her husband who had passed on in 1996 of a brain embolism. The researcher believed it was an appropriate time to express a similar sentiment about the value of spiritualism in death and dying, again creating a connection (a commonality) that seemed to ease concerns that Flowers may have perceived she was about to receive a proverbial sermon from the mound which would have made her considerably uncomfortable. With a reassuring hand, the researcher merely patted her hand and agreed that uncertainty was what bound us all as it relates to the soul as an everlasting entity. This seemed to provide a sense of peace and serenity which was evident in body language and more animated gesturing throughout the remainder of the discussion. Conclusion This mentoring project indicated many characteristics of older citizens that justify and refute the literature on the death and dying processes. It also assisted the researcher in understanding strengths and weaknesses inherent as it would apply to geriatric care, providing for some thoughtful insights (theory versus practice) that would assist in providing more effective care that has psychological implications for better patient adjustment and coping. It was clearly possible to be of advanced age and still live an active lifestyle, however the dynamics of social networking changes when death becomes more than a concept but reality. It is clear that even the most stoic individuals, such as Flowers, struggle with their emotional problems and self-esteem issues related to aging and death, but will be more reassured with a non-judgmental hand and one that is empathetic and reassuring to patient needs even if they conflict with the caregiver. This experience assisted a great deal in how to provide psychological, sociological and spiritual support in geriatric care. References Campinha-Bacote, J. (2011). Delivering Patient-Centered Care in the midst of a Cultural Conflict: The Role of Cultural Competence, The Online Journal of Issues in Nursing, Retrieved May 20, 2013 from http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/T ableofContents/Vol-16-2011/No2-May-2011/Delivering-Patient-Centered-Care-in-the- Midst-of-a-Cultural-Conflict.aspx Craven, R., Hirnle, C. and Jensen, S. (2013). Fundamentals of Nursing: Human health and function (7th ed.). Wolters, Kluwer and Lippincott. Kubler-Ross, Elizabeth. (1969). On Death and Dying: What the dying have to teach doctors, nurses, clergy and their own families. New York: Touchstone. Rogers, C. & Keller, C. (2009). Roy’s Adaptation Model to Promote Physical Activity among Sedentary Older Adults, Geriatric Nursing, 30(2), pp.21-26. Santrock, J.W. (2007). A Topical Approach to Life-Span Development. New York: McGraw-Hill. Tabert, M.H., Liu, X., Doty, R.L. & Serby, M. (2005). A 10-item Smell Identification Scale Related to Risk for Alzheimer’s Disease, Annals of Neurology, 58(1), pp.155-159. Read More