“Who Am I? Why Am I Here?”
The above questions were posed by James Stockdale, a retired admiral and highly decorated Vietnam War veteran, to open his introductory remarks in the 1992 Vice-Presidential debates. They were meant as a segue to a brief bio, for a TV audience largely unfamiliar with his background. Unfortunately, some difficulty he had hearing a couple of the moderator’s comments led to those opening questions being repurposed in several SNL lampoons of Stockdale as a confused old man.
Why bring up this historical tidbit? The quote came to my mind recently when thinking about Identity and Connectedness, two of the seven Eden Alternative Domains of Well-Being. When applying these Domains to people who live with different cognitive abilities, this quote nicely captures these two Domains.
“Who am I?” Who is this person for whom we care? Is his story well known to us? Do we understand his unique rhythms, his strengths, and challenges? Do we know him well enough to understand his needs, even when he cannot speak clearly?
“Why am I here?” What is this place, and do I belong here? Do I have a meaningful connection with my living environment, and meaningful relationships with the people around me?
In the culture change world, we talk about three types of transformation in the care environment: personal, organizational, and physical. When I apply these principles to the world of dementia, I divide “personal” into two categories: intrapersonal (how we see people living with dementia) and interpersonal (how we communicate with and support them).
This concept also aligns nicely with the above two Domains of Well-Being. How we see people is a central feature of Identity; how we communicate with and support them is the essence of Connectedness. But when cognition begins to change, these two important Domains can become seriously eroded. “Who am I?” and “Why am I here?” become pressing questions indeed.
The brain changes experienced by such people create many intrinsic challenges to Identity and Connectedness, certainly. But the care environment (in all three aspects) can also create challenges that lead to loss of ability. These arise from a combination of societal stigmas and a narrow biomedical view of the person and her capabilities.
If I were to draw a “Maslow’s Hierarchy” pyramid using the seven Domains of Well-Being, Identity and Connectedness would sit side-by-side on the bottom tier. To me, they are the foundation for creating well-being. The other five Domains (Security, Autonomy, Meaning, Growth, and Joy) are not attainable, if we do not have deep knowledge of and connections with Elders.
On October 8th from 3-4:00 pm ET, the second event of my six-part webinar series will focus on these two important Domains. We will examine the stigmas that lead to dysfunctional systems of care and begin to address ways to restore Identity and Connectedness, so that other aspects of well-being can be within reach, as well. I also plan to throw down a challenge for all of the providers out there on the call.
I hope you will join me! If no one does, I might be left to ask those two questions about myself!