|
|
 |
 |
 |
|
 |
Forget how old you are and keep on planning just as
though you’re going to keep on living. The one thing that keeps you going is to
have an objective. You should have ambitions, and work to fulfill them. Then you
can forget those actuary tables and life expectancy statistics. May you live all the days of your life. Helping people live well despite chronic illness and/or the complex issues surrounding aging is the focus of procovery. How can people move forward when they no longer can move back? How can individuals live and grow and find meaning for the whole of their lives? As our organization and our work in the area of procovery grows, one of the areas we will be focusing extensively on is Procovery and Aging. In the meantime, in response to requests to expand on the Procovery and the Elderly section of the book The Power of Procovery in Healing Mental Illness, we are providing this short FAQ. As our efforts in procovery continue and this introductory work significantly expands, we invite and encourage you to visit www.procovery.com and contribute your questions and ideas and insights to agingwell@procovery.com . Contents: 3. How do the principles of procovery apply to the challenge of growing old? 4. How do the strategies of procovery apply to the challenge of growing old? 5. Do you have any procovery notes for aging persons and those who care for them? What if, instead of reaching backward to “recover” in the traditional sense, to a prior state of health, individuals reached forward to procover, to focus on life instead of illness or aging and to build new dreams and find new purpose? Procovery is defined as attaining a productive and fulfilling life regardless of the level of health assumed attainable. It is an approach to healing based on hope and grounded in practical everyday steps that individuals can take to move forward. More specifically, procovery addresses the question, “When I can’t move backward, in the traditional sense of recovery, what can I do?” with the answer that individuals can: § Move forward § Through individual actions § That are ordinary, § Regardless of the limitations of systems and symptoms, and § With faith in the possibilities, even though the path may be difficult and indirect. Procovery embodies a set of eight principles and a toolbox of strategies and ideas that focus on strengths rather than weaknesses, on personal preferences and on what is available, asking, “What can I do, with what I have, now?” The strategies and ideas of procovery can be implemented by individuals and those who support and care for them, in any increment and in any order, today. What does procovery look like for elderly individuals, particularly those with chronic diagnoses and/or diminished capacity? The answer is a life deemed worth continued living, despite illness and/or hardships that are faced. In attaining procovery—that is, “attaining a productive and fulfilling life regardless of the level of health assumed attainable”—elderly persons define for themselves the true meaning of “productive.” As a society we tend to measure whether we are externally productive, whether we create, for example, wealth or material goods. In our hearts we know the value of being internally productive, but perhaps in our society it is the role of trailblazing elders to give such productivity meaning. Erich Fromm, in referring to “inner activity” as the “productive use of our human powers,” recognized that knowledge, insight, and feelings can be among the highest results of productivity. Such results are well within the scope of most elderly individuals, whose experience and wisdom far outweigh any limitations of age and disability. So what can individuals, and those who support and care for them, do differently, today, to move toward procovery? Simply stated, they can apply the principles and strategies of procovery to their daily life. 3. How do the eight principles of procovery apply to the challenge of growing old? The eight principles of procovery are:
Applying these principles to the challenge of growing old is briefly discussed below. 1. Believe that procovery is possible Societal age discrimination is prevalent and damaging. But what is even more damaging is internal discrimination and the internal belief that life loses importance or meaning or value as we age. Procovery is possible for every individual, and learnable skills exist to move toward procovery at any age. The belief that life can be fulfilling and meaningful even in the face of, and sometimes even more as a result of, diminished capacities, is at the heart of procovery. 2. Recognize the power of the individual No matter how messy life gets, the power of the individual to be able to turn things around is amazing. One person can rekindle lost faith in another. One person can formulate a solution to a complex societal problem. One person can remind another they are not alone and they are loved. People having faced the darkest of situations often point to one person who made a critical difference, who believed in them, or their ability to take the next step, even when they felt with all their heart, they simply couldn’t. “What can I do?” it is easy to wonder, in the face of a seemingly overwhelming or hopeless situation. Do what you can, with what you have, now. And you will be simply astonished at the outcome. 3. Focus forward, not backward Aging persons often struggle with the loss of what they used to be able to do, what their life used to look like, how their mind used to react. Letting go of what was, and then exploring what is— is a critical step to moving forward. And then, rather than longing for your past, envisioning a future. What is possible? What is available? What can tomorrow look like? 4. Focus on life rather than illness and strengths rather than weaknesses Emotional and physical pain can take over all of life—if we let it. It as though a world full of experts are talking, but we only listen to the ones talking the loudest. Imagine what we miss! Procovery is a process of exploration. What brings pleasure despite “diminishing abilities”? Listening to a favorite opera? Hearing or watching small children at play? Strolling (or being wheeled!) through a local art museum? As soon as there is one thing that brings pleasure despite aging, the opportunity opens for more. Focusing on life rather than illness and strengths rather than weaknesses helps initiate new spirals of healing. Note: Focusing on life doesn’t prevent preparing for death (something that is valuable and can be done at any age); but it doesn’t presume to know death’s precise timeframe, and treats every day of life as valuable and with possibilities whether that day is at age one or age 101. 5. Recognize that big problems don't necessarily need big solutions Teilhard de Chardin wrote, "The focus is not to do remarkable things but to do ordinary things with the conviction of their immense importance." In the face of the enormous complexity of issues surrounding illness and aging, it is easy to lose sight of the fact that illness and aging are only a part of life, and that small, common-sense everyday actions can have enormous impact. It would be nice if there was one pill to take, one exercise to do, one treatment or therapy or action to heal our lives. But procovery is generally reached by an accumulation of small actions and decisions and factors. What can we do, we sometimes wonder, when the facts of our lives overwhelm us? Small steps, small actions, can have big and lasting impact 6. Just Start Anywhere The process of procovery begins by moving forward in any area in any increment. Sometimes people wait to take action and actually do nothing in the meantime, because they just don’t have the energy or interest to do the exact thing they just know they should do. Procovering individuals should go where the energy is, do what interests them. Action begets action and energy begets energy. Carol Flinders wrote, “Streams pour into creeks, creeks into rivers, and suddenly you have a Mississippi.” Don’t worry about starting at the beginning. Just start. 7. Accept backsliding There is nothing more terrifying than having your mind “fail” you. Learning to accept in a matter-of-fact fashion that sometimes your memory or your energy level isn't what it used to be, or that you can't necessarily do what you used to do, and that some days are better than others, is a critical aspect to procovery for aging individuals. My mother has said time and again, that even though she can’t do what she used to do she doesn’t HAVE to, either. Living well isn’t a linear path, neither is aging well. Taking “backsliding” in stride, is important, not just for elderly individuals but those who love and support them as well. 8. Keep hope alive An elderly individual may have years left to live or may die tomorrow. Just like all of us. Helping someone live until they die is where procovery comes into play. Birthing and aging are messy but they are also beautiful and miraculous parts of the natural process of life that we all face. Approaching the experience of aging with a hopeful attitude toward the experience is fundamental to procovery. Role models and mentors and coaches often bring out in us gifts we never knew we had. Sadly, many aging individuals have no role models or mentors for aging gracefully and with joy. (We plan to change that! But in the meantime, at the very least, being the keeper of the hope for individuals who have lost their path can be a great gift.) 4. How do the twelve strategies of procovery apply to the challenge of growing old? It would be easy to be glib and state that the twelve strategies identified for procovery from mental illness are the exact same strategies for any healing challenge of aging individuals, but we have extensive further work and research to do on procovery and aging. Nonetheless, it is clear from our work to date, and the response we have received, that these twelve strategies for implementing procovery can be enormously beneficial:
5. Do you have any procovery notes for aging persons and those who care for them? Procovery Notes are simple, practical suggestions that individuals who have procovered or helped others do so, have found to be helpful. This sampling of ideas is not by any means expansive but offers an idea of the breadth and availability of procovery to every person. For convenience, the ideas are in two sections: (1) primarily for individuals, and (2) primarily for caregivers. Some Procovery Notes for Individuals v Don’t attribute every symptom to age. Sometimes the pains we attribute to old age are in fact a specific medical (or other) problem that can be readily addressed. Michael McGarvey, M.D., tells a story about a 92 year-old man who visited his doctor complaining of pain in his right knee. “With your age,” said the doctor, “what do you expect?” “I don’t know,” said the man. “My left knee is also 92, but it feels great. So you tell me, what should I expect?” Additionally, many people have traits (losing their keys, forgetting the days of the week, getting lost driving somewhere and so on) when they are young that they just accept, but when they are older they suddenly label them a sign of age and impending weakness. Don’t attribute every quirk or weakness to age or diagnosis. v Don’t focus only on illness and symptoms; focus also on life and strengths. The process of becoming continues for all of life. We all need a reason to get out of bed, something to look forward to, and it is those reasons that generally drive our motivation and ability to heal. While the mind and memory may slow down, other strengths exist and may come more to the surface, and from these strengths there is still great energy and fulfillment. Explore ways in which you can use your strengths to still find meaning and fulfillment. As Helen Keller said, "When one door of happiness closes, another opens; but often we look so long at the closed door that we do not see the one which has opened for us." If you can no longer revel in gardening, you can still revel in a beautiful garden. And even if you can no longer captivate guests with your ability to tell a great story, you can captivate them with your ability to be a great listener. Procovery focuses on a new way of looking at life, a new way of measuring and achieving what it means to be productive and fulfilled. Sometimes age requires that we slow down to the speed of life, and we begin to find joy in everyday, ordinary things we never appreciated or noticed before. The absolute pleasure in watching a hummingbird at a feeder, or listening to a favorite opera, or eating a piece of freshly baked pie can be extraordinary. v Address sleeping and eating difficulties. Often there are simple explanations other than “age” for feelings of confusion and discomfort. Sleep quality in particular is often ignored as if it matters less for elderly individuals. Interrupted sleep or sleep deprivation can be caused by physical pain or emotional distress and lead to confusion and depression—but unfortunately is often misdiagnosed and treated as early stage dementia. The same is true for failure to eat. Often elderly individuals forget to eat, lose interest in eating for lack of a social context or don’t feel the energy to fix a meal or eat one. The resulting fatigue, weakness and/or low blood sugar can lead to confusion that, again, can be misdiagnosed and treated as dementia. Sometimes uncomplicated, overlooked reasons exist for difficulties and it is important not to over-shoot or over-diagnose the cause. v Don’t forget self-care and complementary health options. Elderly individuals have a lifetime of experience and expertise as to what works best for them, and it is important to take advantage of that personal knowledge. Are there preventive/supplemental steps to take, in line with their health care beliefs, e.g., supplementing the diet with Co-enzyme Q-10 or some other supplement, a consultation with an acupuncturist, isometric exercises, etc.? Even when no “cure’ for illness or the stresses that often accompany aging exist, all kinds of options are available for making someone more comfortable, more peaceful, more content. v Get or update a health care power of attorney and register it with your health care provider (s). This form designates someone who can speak for you at times you are unable to. It cannot be overstressed how valuable a healthcare power of attorney can be in assuring that you are treated well and in line with your beliefs and objectives, particular when a crisis hits. Who you select as your healthcare attorney/agent may be one of the most important healing decisions you make. The best heath care attorney/agent is not necessarily the person who loves you the most but rather the person who best understands and respects your beliefs and choices, and is most capable to speak up and advocate on your behalf in difficult healthcare situations—and who recognizes that even if you are not thinking clearly at times, it is only “at times” and will allow you the grace and flexibility to make decisions and choices during times that you are capable of doing so. v Manage all health care together—The hip bone’s connected to the thigh bone, and so on. Because our healthcare system is organized by specialty, and because individuals often see multiple doctors at multiple sites over time, any time spent by individuals (and those who help them) assuring their care is coordinated will be time well spent. Don’t assume, for example, that an emergency room doc will know of your allergy to sedatives even if it is “on your chart”! Or that one clinic is aware of the lab tests run last month by another doctor. Or that your cardiovascular specialist is talking to or even aware of your psychiatrist. Simply serving as a checkpoint and communicating this information to your treating nurse or doctor (again!) may save you from debilitating mistakes, and may identify opportunities to improve your care. Most important, don’t assume if you think something might be important, your doctor will ask about it. In this day and age, it is impossible for doctors to walk through a thorough checklist in the time they have available to meet with you—they need your help. v Focus on the top of the diagnosis and treatment pyramid—The flip side of the strength of our medical system at diagnosing is that individuals can receive a slew of diagnosis and treatments, end up feeling like a pin cushion. Handling the complexities and mistakes of treatment interactions can become an exercise in chaos theory. It can be helpful to address the top one or two most important areas first. v Elderly individuals and their caregivers need special attention and education focused on medication management. Fine tuning regarding medication choices, dosage, and timing is critical. Elderly individuals often have multiple doctors prescribing multiple medications for multiple physical and emotional ailments. At the same time, elderly individuals often receive medications with little explanation of their purpose, dosage, and side effects, or the possible interactions with over-the-counter drugs. Perhaps five medications properly taken can help the heart condition, ease depression, aid the prostate, and increase appetite—but will they really work without negative interaction, and will they really be able to be taken in the complex regimen prescribed? And if they are not taken as prescribed, will future lab tests take this into account, or will the provider mistakenly base diagnosis on the assumption that the meds are being taken? v Find small purchases or work-a-rounds to positively respond to the subtle changes that take place as we age. Often, subtle and cumulative effects of aging result in a hopeless feeling of passivity that can be turned around by small purchases or work-a-rounds. Ironically, elderly individuals often don’t notice it happening because it is so gradual, and younger people don’t think about it because they don’t have the same concerns. A few examples of small items that can make a large difference: § Large print books, § Large print playing cards § Bathtub grab bars § A telephone amplifier § Pillbox with timer § Laptop bed tray, § Battery operated card shuffler, § Easy-grip jar opener v Join or start a Procovery Circle™ or other discussion group, to discuss with others how to do it right, how to live while aging.
Some Procovery Notes for Caregivers v First and foremost, you need to take care of YOU. You can't help anyone if you don't take care of you. As basic and bland as that sounds, it is a critical element to being there for someone else. v Give a simple gift that communicates that you believe there is life and fun and meaning ahead, or provides something specific to look forward to. A spring purse given in the winter. A two-year magazine subscription. A cruise together planned for next year. Elderly folks often say they rarely receive long-term gifts—is it surprising that the message gets across? v Encourage and help organize the hiring of various skill sets as they may be helpful. Examples: find someone to help with bathing, or a hairdresser to come weekly and include a scalp massage, or a store that delivers (food, videos, dry cleaning, flowers, etc.), or someone to make house repairs, or read aloud to them, or someone to provide transportation or run basic errands, or someone to arrange meals. (There is a growing field of “weekly private chefs” who once a week will prepare a week’s worth of meals for the freezer, taking into account special dietary restrictions. Try entering “private chef” and your city into an Internet search engine.) Maybe find someone to go to the doctor with them, not only for transportation but to offer to take notes, in essence serving as a checkpoint and extra memory. v Join or start a Procovery Circle or other support group to vent with, and learn from, others on the same path of caregiving. v Remember that as individuals age, they don’t lose the desire to feel needed, or loved, or touched. Don’t assume what matters most to someone is in their list of symptoms. Feeling visible, needed, loved can work magic on dark, lonely days when a simple connection to others is the greatest medicine of all. Soliciting their advice, learning from their experience, hugging them, offering a back or foot rub—ordinary things we all love—are as essential to procovery as the right balance of medications or any other treatment offered. Henri Nouwen wrote, "When we honestly ask ourselves which person in our lives means the most to us, we often find that it is those who, instead of giving much advice, solutions, or cures, have chosen rather to share our pain and touch our wounds with a gentle and tender hand. The friend who can be silent with us in a moment of despair or confusion, who can stay with us in an hour of grief and bereavement, who can tolerate not-knowing, not-curing, not-healing and face with us the reality of our powerlessness, that is the friend who cares.” v Notes on transitioning and dying. Some people need help in letting go. They may need not only support but in essence, guidance, or allowance. They may need help with a sense of unfinished business, feelings not expressed, business affairs not in order, feelings that their time here didn't have meaningful impact, that they won't be remembered. Some people express the need to “die a little every day,” to let go of life just a little at a time. Some people feel a strong desire to revisit their life, before they die and need a travel companion or a friendly ear, to reminisce. Tell stories. Laugh. Cry. And then letting go of what was, more readily embrace what is, and what lies ahead. v It is valuable to recognize that aging and dying aren't always beautiful or peaceful. While dying is most certainly a part of life, it is a mistake to confuse the muddle that sometimes is surrounding someone's death with the vision and accomplishments of a long life. For instance, the birth process is hard and painful and messy … and yet a beautiful piece of the cycle of life. We need to find the beauty in someone's death, even amidst the sometimes hard, painful and messy circumstances. The fact that it is messy doesn't necessarily mean we are doing anything wrong or could have done things better. v Be the candle--approach aging with light. It is important to listen to and validate sometimes dark moods with regard to one’s experience of aging, and not to invalidate the experience in any way, but to still approach what is possible for a person in the time left with a hopeful attitude toward the experience. It is common to mirror the mood of someone who is ill or struggling with aging—to be optimistic when they are optimistic, and pessimistic when they are hopeless— but it is often more valuable to try to shine some light and a different perception and sense of energy into their life, while at the same time respecting how they are feeling. Edith Wharton wrote, “There are two ways of spreading light: to be the candle or the mirror that reflects it.” Be the candle. Last Update: 2-7-04
|
|
The ideas and suggestions on www.procovery.com are not intended as medical or psychological advice, and are for informational and educational purposes only. All rights reserved. Click here for a link permission form. Procovery, Just Start Anywhere, and Building Hope, Healing and Life are trademarks of Procovery Institute. For additional copyright and trademark information see How We Maintain Fidelity of the Procovery Model. Copyright Procovery Institute LLC 2000-2007 :: Email: support@procovery.com :: Phone: 323-934-4800 |
FAQ on Procovery and Aging