service delivery. We believed that a stronger emphasis on comprehensive rehabilitation would better enable older adults to bounce back from infirmities. That idea turned out to be accurate and very important. Our experience has now shown that a great many older adults can fully thrive, age in place and avoid ending their lives in an institution that is often dehumanizing and demoralizing. We have learned what it takes to greatly increase the likelihood that injuries or illnesses are just a “bump in the road” rather than the beginning of the end. Older people can and will “bounce back” if given the resources and the encouragement to do so. This is a concept widely known as “resilience.”
There are key concepts of resilience that impact a person’s ability to recover from challenging and often life-changing situations. The same concepts also are important in industries, services, communities, and nations in handling the need to respond to circumstances and changes that have the potential to permanently alter what they look like and how they work.
These key concepts are:
•Believing that there is a meaningful purpose in life;
•Believing that one can influence one’s surroundings and the outcome of events;
•Believing that by combining current “reality” with positive possibility thinking, creative solutions emerge; and
•Believing that both positive and negative experiences lead to learning and growth.
These concepts of Resilience are the underlying principles described in this book. Current Ageist attitudes in society, institutional “one-size-fits-all” approaches to elder care and a lack of coordination in the health care delivery system, contribute to the serious challenges elders face today in not just thriving, but at times in simply surviving. Above all, there is to date a lack of commitment on the part of all those who serve elders and even elders themselves to activate the Resiliency Potential that could make a major difference in elder’s quality of life, level of independence, and overall cost of care.
We have also discovered, throughout recent years, that we were incredibly naive about all the forces that work against giving older adults the opportunity to fully live out their lives with dignity, meaning, and purpose: forces that undermine the Resiliency Potential. Society has adopted a prejudiced attitude about what it means to be old. The approaches to senior care and services that dominate the landscape are rooted in those prejudicial beliefs. Prejudice leads to people being written off when they still have important contributions to make. They too often become victims of chemically induced cognitive impairment through prescription drugs. Far too many are incarcerated against their will and have their rights taken away without due process. Some are simply admitted to long term care facilities, where they spend the rest of their lives, when they still had the potential to regain ability and remain independent. They are even being subjected to excessively strong pain medicines that in many cases ultimately cause them to die – when they had the potential to continue to live and contribute for some time to come
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The heart of the problem is often complex and may involve a number of factors. These can include:
•Inaccurate information and misunderstanding about normal aging;
•A negative, hopeless attitude about what is possible, even among elders themselves;
•Bias and prejudice against the inherent value of elders in society;
•Lack of appropriately integrated and coordinated medical care;
•The erroneous belief that most older people should naturally end their lives in a nursing home or hospice care;
•Marketing a higher level of care than a person really needs in order to sell the service, rather than to benefit the older person;
•Inadequate care provided during hospital stays that focuses narrowly on a condition and not the entire person, leaving the person much more debilitated than they should be;
•Or, the difficulty in understanding Medicare coverage particularly when deciding between a privatized Medicare Advantage Plan and regular Medicare. Inadequate coverage can prevent the opportunity for rehabilitation provided in a skilled nursing rehabilitation setting or rehabilitation hospital. That may leave the only option as a long term care bed in a nursing home, with little hope of bouncing back.
All of these concepts work directly against the principles that elders need to maximize their Resiliency Potential. They look at elders as a deteriorating physical plant – missing the bigger picture of looking at their life as something that holds meaning and purpose. They encourage elders to be powerless victims instead of helping elders and their families develop the resilient attitudes that what they do can, in fact, influence the events they are currently facing.
They tend to deliver the most negative assessment possible (often using unreliable and invalid information) instead of finding the path to positive possibilities and then acting on it. And finally, there is little or no guidance for elders and their families in either development of resilience or in making sense out of their current circumstances and growing spiritually and psychologically as a result. Too often, the focus is only on a body system that is not as good as it once was, rather than on the person as a whole being, psychologically, socially, cognitively, spiritually, and physically. This makes a major difference in developing useful and meaningful strategies for elders’ well-being.
For the last nine years our group, consisting of physicians, nurses, therapists, social workers, psychologists, chaplains, business leaders, legal experts, and others have been working together to identify ways to help elders be able to live out their lives successfully, being able to age in place with dignity, purpose and on their own terms. This booklet shares with you the insights that we have learned.
Knowledge is power. The more you understand about how elders exercise resilience and can avoid debilitation and bounce back from infirmities, the better advocate you can be for your loved one (or for yourself).
AN OVERVIEW
Elders Have Value!
The starting point is to recognize that valuing elders is worth the effort. Life, itself, has meaning and value and elders have a special role in its purpose. Sacred texts point to the elders in our society as the keepers of wisdom. They have more life experience than the rest of us and have learned many things along the way. They are making a difference and making a special contribution to society in some way. You may just have to look more closely, and with a slightly different perspective, to discover what that is.
Karen contributed by being a “prayer warrior” who diligently prayed for her family and friends every day. Paul contributed by being an encourager. He himself could no longer take the annual fall hunting trips or spring golf outings with his son; however, by supporting and encouraging his son, Paul was still able to give his son the sense of being capable of doing whatever he set his mind on accomplishing. This has helped his son be successful in life in many different ways.
Mary had serious trouble communicating after her stroke. It taught her grandson, Nathan, patience and how powerful non-verbal communication can be, simply by being with her. The list of ways people can continue to contribute, even after they’ve lost physical abilities, goes on and on.
