What gives your life meaning? This important question helps to shape the tailored support we provide to people.
More than 120 people work in our Home Care Services statewide, delivering support to older people in their own homes. This includes support with personal care, general house-keeping and participation in the community. As part of recent training sessions, Home Care Services staff attended a workshop about ageism, presented by a 91 year old who last year completed a PhD thesis on the subject.
Presenter Dr Joan Webb commended our staff for choosing to work in aged care, saying they each had the opportunity to make an important, positive difference in the lives of others. But she warned that well-meaning, kindly people often inadvertently caused harm.
“If you only take are of basic, physical needs, then you may think you’ve done a good job but you haven’t seen the whole person,” said Dr Webb. “All people, including the frail aged, need to be treated as individuals and in ways that stimulate the brain by fostering creativity”.
She related her experience of facilitating creative writing at two aged care facilities. “There were excellent activities happening at these places including gardening and chicken raising, but the frail aged could only watch these things through the window,” she said. So Dr Webb held regular small group meetings with the frail aged to discuss and write poetry and prose. “If given the opportunity they can do the most magical things,” she said. These groups went on to create books of poetry.
“We must recognise that while the heart still beats, there is an inner self that can be well hidden,” she said. “...Inside is a person with powerful thoughts – happy thoughts, sad thoughts, wonderfully creative thoughts."
Dr Webb said the elderly writers had shared happy and poignant memories, but also expressed frustration, anxiety and sadness. For example, one woman told the writing group she felt angry when the staff dressed her in trousers, rather than her preferred dress. “When you’re very old and very unwell…any choice you have is tremendously important because there are hardly any left,” explained Dr Webb. “It may seem like a small thing, but it is so important to that person. That was the one choice she had and it was taken away”.
The training session highlighted ageism - discrimination against older people. Older adults can be the subject of negative stereotypes. They may also encounter patronising language including ‘elderspeak’: baby talk directed at older adults. Studies have found that when older people are exposed to patronising language, their performance on tasks decreases and their rates of depression increase. Even people with moderate to severe dementia can tell when people are talking down to them and it decreases their level of cooperation.
“It is the unconscious ageism that is so wounding,” said Dr Webb. She urged all people to see beyond frail, aged bodies. “"We must not leave people hurting inside because people are only seeing the outside. This requires an enormous amount of sensitivity”. She said all people needed to feel they had meaningful, worthwhile lives. “It’s a terrible thing, this assumption about ‘poor old dears’ being unable to contribute,” she said. “It’s not right. People have the most fantastic things inside them that need to come out, to spread to other people. They have so much to tell us”.
“The frail aged are people who are living and breathing and part of the world”.
Author Atul Gawande in his book Being Mortal wrote that modern society often treated aging as a medical concern, and focused on safety and protection. But he said all people had a deep need to identify purposes outside themselves that made life feel meaningful and worthwhile – and that this continued into old age. Gawande wrote that making lives meaningful “requires more imagination and invention than making them merely safe does”. He said older people wanted to retain the freedom to shape their lives in ways consistent with their character and loyalties.
“The battle of being mortal is the battle to maintain the integrity of one’s life – to avoid becoming so diminished or dissipated or subjugated that who you are becomes disconnected from who you were or who you want to be,” he wrote. “Sickness and old age make the struggle hard enough. The professionals and institutions we turn to should not make it worse. But we have at last entered an era in which an increasing number of them believe their job is not to confine people’s choices, in the name of safety, but to expand them, in the name of living a worthwhile life”.