Reflections on Eldercare Today and the Future

The Senior Care Industry at one point only saw its role as one that assisted elders with basic living needs, not to help them live in meaningful communities that provide continued integration of elders in and with society. The former approach often led to the valid criticism of senior care providers ‘warehousing’ elders. This warehousing criticism was based on an overall simplistic approach to eldercare which led to large profit margins in the industry.

Now developers and operators have a difficult time letting go of such margins. But in order to provide more sophisticated and intelligent care, more professionals in social work, psychology and other human services need to be employed, all people who cost more. The carepartners, who belong to the lowest paid people in the United States, yet are tasked with helping our elders (one time that will be you) in the most intimate and relational ways – are tired of working two and sometimes three jobs to make ends meet.

The profit margins of yesterday belong to an outdated concept of who are our elders: not useless members of society but rather highly mature, experienced as well as knowledgable people whose wisdom must be used to steer this planet and people in more sensible directions, whose experience can maintain certain ethical and rational standards of sustainability for both civil conduct and care of our planet.

Elders are a resource, not a liability. Aging allows us to mature, not to decline. This shift in attitude towards our elders and anyone being older than what is considered young (and has that not moved to a younger and younger age with teenagers now being used in marketing and on billboards everywhere?!) – this shift, indeed, is the challenge ahead of us.

Senior care providers can either help or obstruct the much needed and wanted attitudinal change towards valuing our more mature members of society. Doing so will not only be better for planet and people but, in the long run, will make sure that our present assisted living industry will not become a dinosaur because it was not able to adapt to new needs and attitudes.

~ Nader Shabahangi, PhD, CEO and CoFounder of AgeSong, Eldercare Communities

AgeSong University: From the Inside Out w/ Dr Julia Wolfson

MAY 20, 2016

AGESONG UNIVERSITY

350 UNIVERSITY STREET

SAN FRANCISCO, CA 94134

5:30 TO 7:00 PM

Refreshments Served

RSVP by May 18

415.337.1587 or email aureception@agesong.com

 

In this presentation, Julia Wolfson, PhD will share ideas on changing custodial attitudes to care, in ways that give equal emphasis to individual agency, reciprocity in relationships, and community belonging. She calls this approach to transforming our patterns of mind and feeling “Deep Power.”

For many people, care is a necessity, for others it is a job, and for many it is a calling. Too often people dependent on care and support are stigmatized and trapped in systems of control that are unsafe, and they’re robbed of basic human rights and freedoms many of us take for granted. This is as relevant for older adults as it is for people with a disability and children, in need of health, functional and social support in daily living.

Drawing on a wealth of research, stories and lessons learned, Julia will address the following three topics:

• How the care relationship changes us as care providers

• How use of in-born powers can transform care cultures from the inside-out

• How diversity is a key to communication, conflict and community building

Dr. Wolfson draws on nearly 40 years of experiences in organizational and human service communities around the world. She works directly with people, leaders, caregivers, specialists and family members, whole teams and organizations. Her experiences with people primed for helplessness led to her discovery of nine in-born powers hidden within the experiences of care practitioners, leaders and people dependent on support. Her concept of “Deep Power” is a powerful response to the central question we humans will always have to face: Who are we, really? How can care cultures facilitate friendship, purpose and contribution?

About Dr. Julia Wolfson

Julia lives in in Australia. She is a Visiting Fellow at the Australian National University in Canberra. She is founder and principal of Turning Forward, a global network organization dedicated to uplifting self-powered people, organizations and communities anywhere. Her forthcoming book Safe and Free: Transforming human service environments from the inside out will be available later in the year.

AgeSong University RCFE License Number 385600402

 

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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?

Find out More!

Read more stories about CarePartners at AgeSong.

Explore more videos in the AgeSong Video Library

An Introduction with Blanca Reyes, AgeSong CarePartner at 2015 GeroWellness Intern Training

In the video, An Introduction with Blanca Reyes, AgeSong CarePartner, we meet Blanca one of the CarePartners who specializes in Forgetfulness Care at the AgeSong Laguna Grove Community.

An Introduction with Blanca Reyes, AgeSong CareParnter

Blanca welcomes the new 2015 Pacific Institute GeroWellness participants to AgeSong Laguna. Blanca speaks about her Forgetfulness Care work on the second floor of AgeSong Laguna where residents include those with severe forgetfulness (dementia.) Blanca shares some extra care and caution that should be taken when working on the second floor. Some of the elders on the second floor with forgetfulness no longer communicate in the same ways they used to and it is important to understand each of them because each of them is different. Blanca has a special affinity for working with the elders on the second floor and encourages the interns to come to her. She can introduce the interns to the individual elders she works with. Interns are always encouraged to work with the CarePartners in getting to know the elders they will be working with. The CarePartners in each community are those with the most detailed knowledge and understanding of each of the elders residing within an AgeSong community. The CarePartners can work with the interns to show them the ways relational care works with each individual elder and help them get to know the elder, to build a relationship with the elder.

Find out More!

Read more stories about the wayEldercare is practiced at AgeSong.

Explore more videos in the AgeSong Video Library

Introduction with Betty Dominici, AgeSong COO at 2015 Intern Training

In this video, Introduction with Betty Dominici, AgeSong COO, Betty talks to the AgeSong Pacific Institute GeroWellness 2015 Interns. She speaks about a non-judgmental attitude, relational care and getting to know the residents during their internship.

Introduction with Betty Dominici, LVN, AgeSong COO

Betty Dominici expresses the wish that a goal this year at AgeSong, is to not judge the elders we work with. She speaks to how AgeSong is different in it’s approach to care. AgeSong uses relational care to get to know the elder. This emphasis on relational care is different from the mainstream. Relational care is how AgeSong works to address what is happening with the residents. She recommends that interns do not jump to conclusions about an elder, or look at an elder as their diagnosis or view them medically. At AgeSong we first try to understand the elder. By doing that we find the reason why the person is exhibiting the behaviors they are. Perhaps there is an unmet need. The only way to do that is to be accepting, to really get to know them and gain the understanding needed to meet that elder’s needs.

Betty finishes with a preview of her talk to come on assisted living operations and what it means to be an AgeSong Assisted Living Community.

In the GeroWellness training there are more talks and training on relational care at AgeSong and how it helps the CarePartners, Nurses, Engagement team and Interns meet the AgeSong residents needs.

Find out More!

Read more stories about how importantRelational Care is in the AgeSong Communities.

Explore more videos in the AgeSong Video Library

Understanding Forgetfulness – Reducing the Use of Psychotropic Drugs

At AgeSong, memory loss is not a reason for pity or despair.  Care Partners undergo rigorous training to perceive forgetfulness from a holistic, non-patholigizing viewpoint.  So-called “challenging behaviors” are approached from a place of curiosity and are considered to be full of meaning. There is a huge difference between attempting to change or control a behavior and attempting to understand its meaning. For example, someone may ask, repeatedly and in a loud, impatient voice, for a tunafish sandwich on white toast and be quite satisfied with a turkey sandwich on wheat bread. What the person really wanted was company, someone to talk with, because she became quite happy when a care partner sat and talked with her while she ate the turkey sandwich on wheat bread.

Basic Care Is an Opportunity To Interact

by Sean

Combing a woman’s hair can mean all the difference in the world to her. Just the thought of being there for someone when she needs attention.  She may be asking for something completely different from what she says, because the thought of saying what she really needs to say escapes her mind. It’s also the way you care for a person. She knows if you are just doing it as a routine. When you show that you really care, it makes the world of difference to her.

Is it a Passive “Activity” or is it Engagement?

In AgeSong’s newest publication, “What Makes AgeSong Special,” the question is posed:  “Is it a Passive “Activity” or is it Engagement?”  Research shows that social interaction is one of the most important benefits of community living.

Traditional providers offer calendars, filled with bingo or isolating activities using MP3s and headphones.  While there is nothing wrong with any of these approaches, AgeSong prefers to engage Elders, rather than predominantly to entertain them.

“Getting To Know You” is one of the most engaging activities that AgeSong offers.  Each new member of the community is invited to talk about his or her social, intellectual, physical, and spiritual preferences.  New community members also discuss their hopes, successes, favorite foods, time they like to get up in the morning, and other personal characteristics.

After new members of the community have introduced themselves, others in the group introduce themselves to the new member.  Everyone gets a chance to share.  At one such sharing, the group discovered that one elder had 12 children.  At another sharing, two elders recognized each other because they had played basketball together at a sports club. Mutual interests are discovered in this interactive group. Almost everyone loves music, all kinds of music. At some point in the conversation, someone usually starts humming the tune to “Getting To Know You,” and the group takes a break from the conversation to sing this familiar song from “The King and I” movie (Rogers and Hammerstein, 1951).

This popular and meaningful “Getting To Know You” Exercise is based on the “Person-Centered Sociogram.” (Best-Martini et al, Long Term Care, 2011). ”

Work cited:

Best-Martini, E, Weeks, M.A., Wirth, P. Long Term Care for Activity Professionals, Social Services Professionals, and Recreational Therapists, Sixth Edition. Idyll Arbor, Inc. 360.825.7797.

Encounters of the Real Kind Book 3 Available Now

Encounters of the Real Kind Book 3Elders Academy Press is excited to present the third book in the Encounters of the Real Kind series; a tome of shared stories, poems and musings from the 2013/2014 participants in the Pacific Institute Gero-Wellness Program at AgeSong.

Published by Elders Academy Press Encounters of the Real Kind Book 3 is edited by Nader Shabahangi and sponsored by Pacific Institute. The Pacific Institute would like to thank the participating interns who contributed this most recent book:  Ivy Tiegel, Sue Ann Heron, Robin Pittman, Kelly Guinea, Lily Nguyen, Kyrié Carpenter, Alyson Madigan, Dayne Menardo, Stephanie Rothman, Jessica Plumley, Jacob Engelskirger, Felix Chak, Jessica Owyoung, and Raenika Butler.

The Gero-Wellness Program interns at AgeSong come from a variety of schools and universities in the San Francisco Bay Area and beyond. The participants are interns and doctoral students with backgrounds in psychology, gerontology, counseling, grief and loss support, and human development. Through their practicum experience at AgeSong, they show an authentic interest and passion in their work with the aging population.

The Pacific Institute Gero-Wellness Program interns are part of an engaged movement that views aging with respect and awareness. All elders at AgeSong Eldercare Communities have an opportunity to connect with the interns who provide emotional and therapeutic support individually and/or in group settings.

A Note from the Editor about Encounters of the Real Kind Book 3

AgeSong programming for eldercare seeks to return meaning to aging and “Old Age.” In so doing, the hope is to return to the centrality of meaning in all of our lives.

Meaning is not to be found in either the pure philosophical contemplation of life or just the practical, everyday activities of earning a living. Rather, meaning must be grounded both in concepts and in experience. What makes the Gero-Wellness Program so unique is that students who are learning about the social sciences, such as social work and psychology, can combine these intellectual concepts with the depth of experience presented to them by elders. Residential care settings such as AgeSong provide such opportunities.

AgeSong and its partner Pacific Institute address the marginalization of the elderly in modern society; here, students and interns learn from elders, while in turn elders feel valued and respected for being the teachers they are.

In these stories and poems you can see how the AgeSong Elders are teaching the timeless qualities of being human: being in the moment, in the here and now, relating deeply with others and oneself, being kind and generous, giving and accepting, loving and caring. These ways of being are so very much needed in our modern-day societies, which are increasingly fast paced, materialistic, and cerebral.

Elders show us what our heart needs, what it yearns for. As such, elders may be the solution to many of the problems we face today. All we need to do is listen, to spend time with them. Our lives may never be the same after such encounters of the real kind.

—Nader Shabahangi, Editor, CEO AgeSong

“Days spent as an intern at AgeSong are unpredictable. Any given day may hold moments of joy, connection, challenge, affection, sadness, and delight — often in rapid succession. The experience of being there is collage-like, with many elements co-occurring simultaneously. My arts background gives me the freedom to look at things through my own lens, paralleling the creative freedom memory loss can give some of our forgetful elders. The collages reproduced in this book are visual anecdotes created to process my experience of a day’s worth of encounters with members of the AgeSong community.”

-Ivy Tiegel, MFTi Expressive Arts Therapy Intern

“So how can we come to understand and cherish, accept and love our frail and forgetful seniors? The answer: by appreciating who they are right now—not compared to days, weeks, or years ago. We need to meet and appreciate them as they are today and not worry about yesterday or what will happen tomorrow. We can deal with that as it comes. Most importantly, we need to celebrate who they are now, accept their limitations, and rejoice in what they still have—what Age Song calls “personhood.”

As the educational component of the AgeSong/Pacific Institute collaborative, Pacific Institute actively promotes the recognition of “personhood,” making the experience for residents of AgeSong-managed facilities full and enjoyable. Furthermore, Pacific Institute seeks to spread this philosophy of care to all who desire to connect more intimately with seniors. That philosophy is reflected in these stories, poems, and observations, contributed by our interns. Enjoy them!”

—Peter Szutu, President Pacific Institute

Encounters of the Real Kind: Musings, poetry, stories about elders, forgetfulness and life, Book 3Encounters_cover_front_only

 

Edited by Nader R. Shabahangi, Ph.D.

Elders Academy Press (2015)

150 pages; $16.95 Softcover, plus shipping & handling

To Order Encounters of the Real Kind Book 3 visit Elders Academy Press website. >>

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