Thursday, January 10, 2013

Positive Psychology News Daily ? Exercise for Family Fitness

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Diana Boufford BSW, RSW is a psychogeriatric social worker employed in private practice and through a local hospital in Windsor Ontario Canada. She is presently working toward the completion of her BA in Psychology, with a special interest in the intersection of positive psychology and geriatrics. Diana's articles for PositivePsychologyNews.com are here.

Editor?s Note: This is the third in the series by Diana Boufford on the well-being of the elder community. She first introduced the Comprehensive Geriatric Fitness model and then discussed Spiritual Fitness. Watch this space for articles on Physical Fitness, Emotional Fitness, and Social Fitness.

Now let?s explore ways to build family fitness among elders and the people who care for them. This is part of the Comprehensive Geriatric Fitness (CGT) model I described earlier, inspired by Comprehensive Solider Fitness employed in the US Army. This aspect of CGT centers around the changes in lifestyle that elders often face. Some elders need to allow more people into their homes to assist with care. Some need to move from independent living to retirement living or into long-term care. I am sure that you would agree that this is quite a bit for one person to contend with. However the change is usually not done in isolation. Often the family must undergo these changes along with an elder parent or relative.

The focus of this article is to highlight some of the challenges that families face supporting their elders and to provide some recommendations to make the changes smoother and avoid difficulties. Building family fitness can soften the impact of changes that cannot be avoided.

We?re in This Together

Brothers and sisters and caregivers (professional and otherwise) and friends may be pulled together to help the elder manage day-to-day functioning. They may need to help orchestrate the many demands for care and help the elder make the lifestyle transitions required to stay safe while preserving as much independence as possible. This can put the family under tremendous strain. The challenge lies not only in the multiple demands, but in managing the emotional turmoil that may get stirred up in the process. These challenges can unearth sibling rivalry, parental favoritism, birth order behavioral dynamics, codependency issues, long-distance caring, and even social isolation if the caregiving falls upon the shoulders of one sibling.

For many, the strain is greater as they are caught between the demands of caring for children who still reside at home, and for their parents. People in this position are known as The Sandwich Generation.

Francine Russo is the author of They?re Your Parents, Too!. She calls this change the twilight transition. This is a time in the family?s life when siblings are brought back together, sometimes after many years of separation, to care for aging parents. Francine Russo describes this challenging transition, ?When brothers and sisters who long ago left the families in which they were raised ? and in some cases haven?t spoken in years ? are hurled back together as adults to grapple with their parents? aging, illness, and death. This is a period of time when everyone within a family unit is facing the end of their ?first family.?? If you are having difficulties of this nature or know someone who is, I highly recommend her book because Francine goes into detail about ways to overcome these difficulties and assist the various members of the family.

Be aware that these interpersonal challenges are quite common for most families. There is a history of family dynamics between siblings and between the parents and each individual child. The perceptions and experience of relationships is different for everybody in the family. Therefore the way each person responds to family stressors will also be different.

Now if we look at the individual?s response to these changes, we can see that each person copes with the losses in his or her own way, coming to recognize (or not) how their parents are no longer the strong, dominant, authority figures of the past, but instead may be becoming frail, dependent, and confused. They may seem like completely different people altogether due to medical conditions, drugs, dementia, or combination of all of these things. So grappling with the demands of caring, and one?s own personal battles of loss, grief, reconciliation, and coping (or the lack thereof) will naturally put someone under tremendous strain.

In addition to these personal challenges people need to cope with the families they created themselves, as well as the demands of working for a living. Collaborating with aging parents and with siblings with the goal of optimizing the quality of life and care for the parents can be a very daunting task. In order to make good use of the natural aptitudes of each family member, I make the following recommendations:

  • Building upon strengths: Explore the strengths, abilities, skills, and natural aptitudes that each individual possesses. People are more likely to enjoy what they are doing when they are good at it. For example, in my family, my brother very much enjoys driving, so he takes Mom to all her appointments. Here are some ideas for exploring strengths:
    • You can take the Values in Action (VIA) character strengths test to learn your top five character strengths and get ideas for applying these in your lives.
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    • StrengthsQuest is another source for identifying strengths. Additionally it provides recommendations for using identified strengths in academia, career, and relationships. While it is designed for college students, it can be very valuable to all that want to optimize the employment of their strengths in their lives.

    Optimization of strengths often involves transferring skills between different domains of life. If you structure your caregiving activities to use your strengths and encourage others to do the same, you?ll find that the strain will be lessened. You may actually enjoy meeting the demands of caregiving. This will strengthen the bonds, build family resilience and create a caregiving team that is fit and able to tackle all the challenges that may come.
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  • Communication: A strong working caregiving team needs clear communication among all care providers. A communications journal can be set up at the elder?s home in which everyone makes a note about how time with the elder went that day and what was done, along with highlights and concerns. For example if the elder is experiencing some increased confusion, a family member can make a note about what was going on. A large block calendar is great for recording appointments and anticipated visits. It can also be useful for those elders who have memory impairments. Signing the board or initialing the date on which you visited can often reassure the elder that he or she has not been abandoned and that you are visiting on a regular basis.
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  • Education: It is imperative that family members become educated about the various medical conditions that afflict their parent(s). Many tribulations can be avoided by having a keen understanding of these conditions and the resulting limitations. Ask the doctors lots of questions, seek out resources within your community, and check the Internet for support groups and information.
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  • Share the care: Be willing to allow others to help. Designate various tasks according to different strengths, availability, or preferences so that the care is shared and the onus is not put on just one or two people. Capossela and Warnock, authors of Share the Care have developed a very successful and comprehensive model of care which can be applied to eldercare. See their web site for more ideas.
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  • Self-Care: Often people do not invest in their own well-being because of the multiple demands of caring for others. However by not reserving just one hour every day for your care, your resilience, and your endurance, your ability to cope can be severely compromised. Find quiet time for reflection and peace. Take time for exercise. Moving your body relieves stress and builds up feel-good chemicals in the brain. Eat healthy and nutritionally dense foods, and sleep well. Do not compromise your sleep. These things keep you fit and strong. Do them each day so you are fully prepared to undertake whatever challenges the next day may present.
Conclusion

The changes and challenges that come with aging parents can give us one of the greatest, most meaningful, and most growth enhancing periods of our lifetimes. It can serve not only to build strong families, but also to build strong elders and other individuals within the family.

To navigate through these times, employ the available resources. The recommendations I made above are only a few of many that could be made. Many, many, more options are possible. Be sure to reach out to resources within your community, as well as to friends and neighbors. This is not a task to be undertaken in solitude. Just as it takes a village to raise a child, so it takes a village to care for elders.
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References
Russo, F. (2010). They?re Your Parents, Too!: How Siblings Can Survive Their Parents? Aging Without Driving Each Other Crazy. Bantam Books.

Capossela, C. & Warnock, S. (2004). Share The Care: How to Organize a Group to Care for Someone Who Is Seriously Ill, (Revised and Updated). Touchstone.

Power, G. A. (2010). Dementia Beyond Drugs: Changing the Culture of Care. Health Professions.

Boss, P. (2011). Loving Someone Who Has Dementia: How to Find Hope while Coping with Stress and Grief. Jossey-Bass.

Ghent-Fuller, J. (2012). Thoughtful Dementia Care: Understanding the Dementia Experience.


Images
One Last Day courtesy of Jonathan Kos-Read
Twilight courtesy of Nagesh Jayaraman
Brothers, Mother, and Cake courtesy of Martin LaBar
Smiling in the Garden courtesy of Lee J. Haywood
Leaving behing a record of your visit courtesy of Paul Downey
Grandfather courtesy of Lee J. Haywood
?The Majestic? courtesy of Alex E. Proimos

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Source: http://positivepsychologynews.com/news/diana-boufford/2013010925163

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