An Introduction to CarePartners at AgeSong: Carepartnering vs Caregiving

Dr Nader Shabahangi, CEO of AgeSong talks to the incoming Pacific Institute GeroWellness interns about the CarePartnering program employed in the AgeSong communities. He discusses with the interns the difference between carepartnering they will see at AgeSong and caregiving found in more traditional models. Nader also discusses why AgeSong uses the more empowering carepartner system.

An Introduction to CarePartners at AgeSong

What does it mean to become more “psychological”? To develop a more psychological attitude?
Awareness of others and their emotions? To have that you need to be interested in the other’s awareness, and emotions, and behavior. You need to be able to have answer the question behind the others emotion and behavior, you need to know they “why?” Why is the big one. You’re talking about meaning, what happened? What is behind it?

At AgeSong t is not only about giving care but it also about partnership. We want to give the Elder the feeling that they themselves have something to offer and that they are partnering with us in their care.

Nader gives an example of the difference between caregiving and carepartnering. “One is I’m relating. I’m asking for permission. I’m asking “where is she?” Where is she in her world? Does she feel like she wants to take a walk? Does she want to get up? Leave me alone, I had a bad dream. Who knows? But, I am actually relating with her first. And I’m asking what kind of help does she need, if any? So I am partnering in the care, rather than assuming, “Ok, let’s go. And this, “Come On Let’s Go,” is what we call custodial care.

Custodial care, custody, control, means I know what is good for you. Which is basically, in many ways, kind of a mainstream care operation, eldercare operation, hospital operation. The nurse knows best. Right? We know what’s good for you. And certainly when you are in an ICU you want a doctor to tell you what’s best for you. You cant think very much about whether you want this or that medication or surgery or not. So custodial care works very well in an emergency situation. But that has been exported to everywhere. So now in a care environment that is supposedly based on psycho-social care we are also now using custodial care. And we want to change that. To create more of a respectful interaction.

Creating a more respectful interaction is something that you can help us teach our CarePartners. Because you as a therapist are all about relationships. That is your bread and butter, relationships. Relationship with a client to him or her self, relationship to others. Ninety-nine percent of the world’s problems are about relationships, all relationships.

In the system of relational care there are no problems, there are challenges. So really what’s the problem? We are the problem, we are being challenged all the time by certain behaviors. When needs are not met then what happens over time, or maybe quickly? Something happens. All behaviors, in some way or another, any kind of expression that we call aggression and that’s also a difficult word. Because what is aggression to you might not be aggression to another. So we are saying all the issues that we are facing, behaviorally speaking, and that’s really what were dealing with as counselors, are really about unmet needs. ‘

Unmet needs again bring us back to the question of “why?” Why is this person behaving in the way that they are behaving? And we have a dominant model that is saying: because there’s a chemical imbalance or we need to do a behavior mod. Our model would say no, there is a need that I am not understanding. If I understood them better I could meet their need. That is the foundation of what we want to do here.

The bias in existential work is that if I can understand your world. My goal as an existential therapist is to understand your world. It is not to fool with it, change it, make it different, I want to understand your world.

In my trying to understand your world you become more self aware of what that world actually is. Because most of us don’t really take time to understand who we are. When was the last time you sat down to understand who you are? Often it only happens actually when you are sitting with someone else, right? In the mirror of the other. You need the other its actually almost impossible to sit down yourself and figure out who you are because you are stuck in your own mindset. You’ve got your own thinking. You need the other who says hey wait a minute what are you thinking? You need conflict for crying out loud. Without conflict you do not ever grow. And you need to suffer. There’s a word I almost forgot. The foundation of consciousness is suffering. therapy or work is a little bit about being in discomfort because if you are not then why change?

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