Making Peace with the Past

March 28, 2016

IN_Trees“How has Mrs. Smith handled change in the past?”

This was how we predicted how well a new nursing home resident would cope with adjusting to placement in 1983.

For the most part, this simplistic rule of thumb seemed to work, but I look back now and see that question as but an opening to a deeper conversation, one that might help any organization understand how to best adjust its own practices and environment to support an Elder new to its services.

And the truth is, we didn’t know what to do when the answer was, “not well.”

In our journey of culture change, we’ve examined our own attitudes, reviewed organizational practices, and analyzed the physical environment as loci for the attack on the plagues of loneliness, helplessness, and boredom.  We have challenged wider cultural ageism and ableism that keep institutional models so firmly entrenched. We are rethinking cognitive challenges and embracing new perspectives on living with dementia.

Finally, we have access to a framework of well-being through the Eden Alternative Domains of Well-Being, which help us map those areas essential to deepest life satisfaction, for all members of the care partner team.

I propose that there is an area of our garden that still requires tending, that many Elders and family and employee care partners carry within their hearts and minds and spirits painful memories and ancient traumas that, unhealed, create additional vulnerability to the plagues and rob them of well-being in almost every domain.

Consider the child who, through abuse or neglect, is confronted with the terror of true aloneness, of true helplessness.  That child carries that terror, and a host of beliefs about herself and the world, throughout life and into Elderhood.  New research also shows that she carries a changed neurobiology and a predisposition to the kind of chronic illness that we are most likely to encounter in our work as health care providers.

We are learning that these painful experiences are much more common than was previously believed, and their impact is lifelong.

What if, no matter how thoroughly we strive to create a human habitat, some percentage of the Elders who live and work there are saying to themselves “I don’t deserve this?” And they truly believe it?  Or, no matter how carefully we train our staff, a number of Elders in our care are feeling “I’m not safe!” (and may even strike out) while receiving care?

These are common beliefs and reflexes that come from early traumatic or painful experiences, (such as abuse, neglect, loss, or physical injuries), and they have nothing to do with the good intentions of the care partners.

The good news is that Elderhood is a time of growth, and there are a variety of approaches to address and heal painful memories during this stage of life.  As challenging as these beliefs or responses seem, they have developed as coping skills, and folks who live with them have shown amazing strength. We see them as survivors, and learn from them as Wise Elders.

Trauma-informed care approaches can ensure that your organization is responsive and attuned to the needs of people who may be vulnerable because of early trauma.  All trauma-informed care is person-directed and strengths-based, and in alignment with the values of The Eden Alternative.

Organizations on the path of culture change are beautifully positioned to create the kind of safe havens that people living with painful memories need for true healing.

Please join me at the 2016 Eden Alternative International Conference in Little Rock, where I’ll be talking about “Making Peace with the Past: The Impact of Emotional Trauma on Elder Well-Being and the Importance of Trauma-Informed Care.”

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Lisa Kendall is a social work psychotherapist and clinical gerontologist with a private counseling and consulting practice in Ithaca, NY, with a focus on Aging and Elder care, living with chronic health issues, and recovery from trauma and loss. Formerly Senior Consultant for Work and Family Services at Cornell University and now serving on the Cornell President’s Advisory Council for Work and Family Affairs, Lisa is an Educator and Mentor for The Eden Alternative™, and teaches the Fieldwork course for the Ithaca College Gerontology Institute. She is a popular speaker at the local, state, and national level, and invites you to visit her blog on self-care for all members of the care partner team at www.LisaKendallCounseling.com/blog

1 Comment. Leave new

Reminds me of the difficulty in communicating with one of our Elders. Each afternoon she became very agitated, stating she needed to go home to cook her father’s dinner. “Can’t someone else cook for him tonight?” “O no,” she replied. “You see, he is a very severe man.” We attempted various ways of engaging her to the meaning of that phrase, but she never would open to us. The family had no insight, but we all suspected she been abused in some way. She died with her secret. How we wished we could have helped her release those demons, whatever they may have been.

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