Support Groups for Older Adult Clients Experiencing Anxiety - Term Paper Example

Bright Cheers To The Twilight Years Getting old and gray is one fear most people have just because they think that life’s options become limited as one ages. While it is true that physically, one’s body may not be as cooperative to active endeavors as before, other areas are still likely to remain alert if one is careful to take care of oneself. Erikson’s (1963) stages of psychosocial development labels the last stage as Integrity vs. Despair and Disgust. Late adulthood is a time when ego integrity over one’s lifetime is evaluated. If one looks back at the life he has lived with few regrets, then ego integrity is achieved. On the other hand, failure to achieve ego integrity leads to feelings of despair, hopelessness, guilt, resentment and self-rejection (Erikson, 1963). Sadly, many older adults fall into the latter category of “despair and disgust” and may cause them anxiety and depression. The fact that for most of them life is almost at its end and there is little chance and time to make up for their mistakes in the past leaves them with much regret and hopelessness for the future. Creating a support group for older adults experiencing anxiety and depression may be a great help in boosting their dispositions and in pushing them to be productive in their twilight years. This paper studies how older adults may deal with ageing and how anxiety comes about. Then, it explains the role of a social worker and how all three interplay in the creation of a group that truly supports older adults’ needs. Group Purpose: The following enumerates the reasons for creating a support group for adults experiencing anxiety: 1. To gain a greater understanding of ageing and its effects on an individual’s emotional and social dispositions. 2. To study causes and effects of anxiety and find ways to deal with it. 3. To plan activities that support the needs of older adults experiencing anxiety. 4. To uplift the moods of anxious, elderly people. Target Group: residents in a Home for the Elderly – men and women 65 years and above who are still lucid in thinking and are open to socializing with others. Setting: Assembly hall of a home for the elderly. Schedule: One afternoon a week for 2-3 hours Duration: Two months Review of Literature Gerontology is the study of the ageing process. In 1954, Clarke Tibbits coined the term Social Gerontology to delineate that area of gerontology concerned with the effect of social and sociological conditions on the ageing process and the consequences of the process. Social gerontologists are interested in how the older population and the diversity of aging experiences affect and are affected by the social structure (Hooyman & Kiyak, n.d.). The older segment of the population is now the fastest growing in America. This gives rise to far-reaching problems in health and long-term care, the workplace,, pension and retirement practices, company facilities, housing design and patterns of government and private spending. This implies that new specialties in health care and long-term care, assisted living and adult day care health programs and a leisure industry are on the rise and are geared towards the older population ((Hooyman & Kiyak, n.d.). However, it is no surprise that at their stage in life, many older adults experience anxiety and depression. The pathetic notion that they have used up their worth and productivity as individuals may come to fore, leaving them to passively dwell on regrets. Several factors trigger anxiety for older adults - symptoms of illnesses crop up, income generation diminishes, loved ones drift away, and hopes for the future are being threatened. Anxiety is normally experienced when one is faced with threat, danger or stressful situations (National Mental Health Strategy, n.d.). Andrews and Hunt (1998) contend that mild to moderate levels of anxiety improve one’s ability to cope, hastens reaction time and makes for better understanding leading to more appropriate responses. Eventually, anxiety helps one achieve mastery of stressful situations and makes one feel fulfilled at that outcome after undergoing such arousal and tension before the important event. This is due to the endorphins released by the brain (Gorman, 2005) which makes one feel good when he has survived the stress. It is however warned that anxiety should not become so severe that it becomes debilitating for the person. Just as moderate levels of anxiety helps one cope, high levels may reduce his capacity to plan, to make accurate judgments and decisions, carry out skilled tasks where before they excelled at or even comprehend simple and useful information (Andrews and Hunt, 1998). Extreme levels of anxiety may come to Anxiety disorders. These are not just one illness but a group of illnesses characterized by nagging feelings of high anxiety, severe discomfort and tension that it actually interferes with an individual’s daily life in a significant manner rendering him unable to do what he normally does and wants to do (National Mental Health Strategy, n.d.). Glazer (2005) enumerates five major types of anxiety disorders as classified by the National Institute of Mental Health as Panic disorder; Post-traumatic stress disorder; Generalized anxiety disorder; Obsessive-compulsive disorder; and Phobias. These share common symptoms of excessive anxiety but have their own specific symptoms exclusive to each too, The Mental Health Association, NSW (2005) have come up with a number of possible causes of Anxiety Disorders. One is an imbalance of certain brain chemicals/hormones. An example would be neurotransmitters controlling the ‘fight or flight’ responses in times of emergencies. A chemical imbalance may mean the individual gets wired up for an emergency even when none exists. That means, the stressful symptoms of anxiety come out and maybe more intensely. Another cause may be an individual’s personality traits. Very sensitive and emotional people are more vulnerable to anxiety. They may have the tendency to be over-concerned about a lot of things beyond their control and/or responsibility which cause them much worry. Still another possible cause is a body’s reaction to the anxiety during periods of high-level stress. The body may not be able to recuperate from the physiological response after the stress has gone. “Having to deal with a lot of stress all at once, or in seemingly endless succession, can stretch the mind and body’s ability to cope, and make a person vulnerable to developing an anxiety disorder” (Mental Health Association, NSW, 2005, p.10) Gorman (2005) explains that when the senses pick up a threatening signal from the environment, the amygdala, the part of the brain that processes such stressful events sends information to the autonomic nervous system to release chemicals and hormones such as adrenaline that prepares the body to cope with danger. It increases blood pressure and puts the body and senses into anxiety mode – a state of intense awareness, sensitivity and hyper alertness (Gorman, 2005; Mental Health Association, NSW, 2005). Emotionally, the individual feels irritable, uneasy and excessively worrisome, strongly feeling that something dreadful is upon him. Physically, the individual experiences heart palpitations or chest pain, muscle tension, sweating, breathing difficulties, faintness, headaches and nausea. He is restless and has difficulty relaxing, concentrating and sleeping. Because hyperventilation is part of this response most patients also complain of dizziness and light-headedness, tingling and numbness (Andrews and Hunt, 1998). Depressed people with anxiety disorder are common with depressive symptoms making it all the worse – a dreadful feeling of depression, loss of interest, loss of energy, loss of self esteem, being prey to morbid thoughts, disturbed sleep, and weight loss (Andrews & Hunt, 1998). Park (2002) outlines the various treatments for anxiety disorders. Since it involves physiological factors, medication is one treatment. Antidepressants called serotonin reuptake inhibitors (SSRI) are prescribed to prevent the brain from reabsorbing too much of the neurotransmitter serotonin which leaves more in nerve synapses for mood improvement. Minor tranquilizers are also recommended by doctors as fast-acting relaxants. Another treatment approach is cognitive and behavioral therapies which work on the management of anxiety behaviors and thoughts. Behavior therapy desensitizes the patient to be more comfortable with the thing that triggers his anxiety by exposing him to it a little at a time until it doesn’t cause him any anxiety anymore. Cognitive therapy trains the mind to reason with the irrational anxiety. A combined Cognitive Behavior Therapy is a popular treatment for anxiety disorders. On his own, the individual may attempt treatment with exercise. Working out regularly helps ease away stress and recalibrate the anxious brain. Yoga is one form of exercise to quiet the mind by focusing one’s attention on breathing. Meditation or massage or any other mind-body relaxing strategy like aromatherapy is known to help a lot in keeping anxiety levels down. In any case, lifestyle changes such as maintaining a healthy diet and work-life balance is key in preventing anxiety disorders from building up. Supporting Older Adults Experiencing Anxiety The best support group elderly people have is their family. Knowing them all their lives make these family members attune to the needs of their elderly members. However, in many cases, the elderly are relegated to nursing homes due to the fact that their families are unable to take care of them and their needs. The responsibility of caring for them on a full-time basis now falls on the shoulders of service providers and social workers. The social worker wears many hats in the implementation of his/her job. Van Nijnatten (2006) says: “The aim is always to help clients to help themselves, to develop new prospects for the future or to simply accept a reality that is difficult to alter.” (p. 141). In order for a social worker to be successful in her career, her broad knowledge of various organizational and networking systems that provide support and services to their clients must be matched with her own vast understanding of how a person’s mind and emotions operate especially in times of crisis. Most of the time, counseling sessions are conducted with her client, or members of her client’s family. Here, the social worker’s communication skills are put to the test. “In conversations with the professional, clients speak out about their pains and sorrows, and about their hope and beliefs.” (Van Nijnatten, 2006, p.133) It becomes an avenue where both the social worker and the client brainstorm on ways to express these emotions so they construct new meanings and new perspectives. Coming from an objective frame of mind, the social worker helps the client distance himself to the concern at hand and explains that such overwhelming emotions that the client is undergoing are normal and can cite cases of others who have survived through the same. Then ways to resolve the problem are discussed. The social worker usually becomes the family’s strongest motivator outside its members. She becomes an indispensable source of support to a family battered by a sense of uncertainty, loss and depression. However, it is her task to help her clients to become independent. She tries to encourage their capacity for reflection and to delineate their persons from the problem itself. This is because clients are often so immersed in their concerns that they perceive that they are unable to change anything, often becoming hopeless (Van Nijnatten, 2006). One way for a social worker to support aging clients’ needs is to encourage them to be more active. The idea of an active lifestyle for the elderly is vital and widely accepted. The World Health Organization defines it to be the “process of optimizing opportunities for health participation and security in order to enhance the quality of life.” This would include all people – those who are frail, disabled or who require assistance with daily activities. Such a definition changes our view that old age is a period of passivity to that of continued participation in the family, community, religious and political life. The elderly would be wise to surround himself with people, especially loved ones. One need not be a recluse. If nursing homes allow their clients to rejoin their families at certain times, it would do the elderly good join family activities – parties, picnics, even short trips. This would imbue the old one with greater respect, security and a sense of belongingness. Also, being a lifelong learner helps keep the mind and spirit young and alive. It is never too late to enroll in a course, even online, or even minor courses on interesting hobbies. Group Support Gathering a group of elderly people experiencing anxiety may be another way of supporting their needs in their twilight years. That way, the goal of helping one will work for more, and even encourage socialization. The benefits that the support group provides will directly affect the well-being of the elderly. This is one way of health promotion. The empowerment approach helps individuals make healthy choices by increasing their control over their physical, social and internal environments. According to Homans and Aggleton (1988), participatory learning techniques help people examine their own values and beliefs and explore the extent to which factors such as past socialization as well as social location affect the choices they make. Participatory learning techniques include group work, problem-solving techniques, client-centered counseling, assertiveness training and social skills training as well as educational drama. The self-empowerment paradigm, with its emphasis upon self-awareness and skills, echoes what Stroebe and Stroebe (1995) refer to as the ‘therapy model’ of health promotion which uses a wide range of psychological techniques such as cognitive restructuring, skill training and self-conditioning in order to help individuals act upon their intentions to adopt health behaviours. The proposed support group includes sessions in Cognitive Behavior Therapy (CBT). Elderly people suffering from psychological problems are assumed to focus more on their flaws that pull them down than on their potentials that may spur them up to success. Aaron Beck, the founder of this psychological intervention, agrees that much of our psychological problems are caused by “cognitive distortions” due to our acknowledged human fallibility. Field (2000) claims that such a belief system may stem from negative experiences from childhood that lead to the development of dysfunctional beliefs about the world which may be triggered by critical incidents in one’s life. Beck (1975) writes that, in the broadest sense, “cognitive therapy consists of all of the approaches that alleviate psychological distress through the medium of correcting faulty conceptions and self-signals” (p. 214) The goal of therapy is to help the client realize that reorganizing the way they view situations will call for a corresponding reorganization in behavior. The therapist uses a variety of therapeutic strategies depending on what he decides will work on his particular client. He also delegates responsibility to his client by expecting him to do homework outside the therapy sessions. The goals of empowering the elderly with effective coping skills are usually met with cooperative clients. However, the elderly are also warned that they might still encounter difficult times in the future even after successful treatment but their newly acquired skills at dispelling negative thoughts and reactions must be at their disposal to use whenever they would need them and maintain the belief that a single difficult event is not a failure on their part. Talking about their problems was seen to be cathartic to the elderly who find relief in unburdening their concerns to someone whom they trust without fear of being judged. Being in a support group encourages participants to think that they are normal after all since everyone else in the group have deep, inner conflicts that are just begging to be heard and understood. Such sharing amongst peers develops camaraderie and strong bonds of friendship The demeanor of the counselor is also a significant factor that may determine the quality of participation of the group members. A well-trained practitioner who exudes warmth and unconditional acceptance is essential to the success of the programme. Developing a fulfilling relationship with one’s adult child or any other significant adult likewise helps an elderly in his journey out of depression. The wisdom and guidance of a mature and experienced adult may indeed help another older person deal with the complexities of his problems. Finally, the attainment of a positive perspective in life must be evident in the elderly as they look back in their dark past and then peek into their bright future. The whole Health Promotion/ Intervention Programme tightly brings together concepts and applications from a variety of disciplines to ensure the mental and emotional health of the target population concerned. It is fondly wished that such a programme be offered to depressed elderly people from different walks of life and initiatives from the private and public sectors in supporting such a programme be felt and acted upon immediately. References Andrews, g. & Hunt, C. (1998) Treatments that work in anxiety disorders. In N.A. Keks & G.D. Burrows (Eds.) Mental health (pp. 26-32). North Sydney: Australasian Medical Publishin Company. Beck, A.T. (1975) Depression: Cause & Treatment. Philadelphia: University of Pennsylvania, Press. Erikson, E. H. (1963). Childhood and society (2nd ed.). New York: Norton. Field, A. (2000) Cognitive Therapy, retrieved on October 28, 2010, from http://www.sussex.ac.uk/Users/andyf/depression.pdf Glazer, S. (2005) Treating Anxiety. In K. G. Duffy (Ed.) Annual Editions of Psychology 0506 (35th ed.). Dubuque, IA, USA: McGraw-Hill Dushkin. Gorman, C. (2005). The Science of Anxiety. In K.G. Duffy (Ed.) Annual Editions of Psychology 05/06 (35th ed.) Dubuque, IA, USA: McGraw-Hill/ Dushkin. Homans, H. and Aggleton, P. (1988) Health education about HIV infection and AIDS. In P. Aggleton antl H. Homans (eds), Social Aspects of AIDS. London: Falmer Press. Hooyman, N.R. & Kiyak, H.A. (n.d.) Social Gerontology: A Multidisciplinary Perspective. Pearson. National Mental Health Strategy (n.d.) Available at :www.health.gov.au/mentalhealth Stroebe and Stroebe (1995) Social Psychology and Health. McGraw-Hill Van Nijnatten, C. (2006) Finding the words: social work from a developmental perspective Journal of Social Work Practice Vol. 20, No. 2, July 2006, pp. 133– 144. Read More