Transitions: Senior to Elderly - Letting Go

The aging process eventually leads to
the stage of letting go.

People often make the mistake of assuming that old is old and that the elderly are done with the bewildering life changes that the rest of us are constantly adjusting to.  In fact there are several developmental and emotional stages that those of advance age commonly pass through as they transition from being a senior to being truly elderly.  Although each individual differs in how they work through these stages, generally most progress through four psychological stages:  1) Slowing; 2) Life Review; 3) Transmission; and 4) Letting Go.  The tasks of completing the emotional work of each stage can be daunting for the elderly and their loved ones.  Since it is often in necessary for families to provide support to their elders as they transition through each stage, it is important to be able to recognize each step as they go through it.

4) Letting Go

The process of letting go is the culmination of all the previous developmental stages the elderly have pass through.  Advanced age really begins with a marked slowing of physical and cognitive actions and that is followed by life review and transmission, which are like a general tidying up of one’s unfinished business of life and passing on of their legacy of possessions and experiences.  Then the serious business of letting go begins. 

The passing through of the different stages of advanced age slowly strips away all the extras of life, leaving the elderly with the task of just being.  It is at this point the elderly deal with the task of letting go.  The mission of letting go and learning how to just BE is much more difficult than it sounds, especially in our fast paced and performance based culture.  People at this stage of life let go of all the things people prize and value.  Possessions, practicalities, behavior patterns, logic processes and even words all fall to the wayside as the elder concentrates on the simplicity of just being.  It is a vulnerable and emotional time for many. As an elderly person begins to let go, there is a concentrated clearness in their perceptions and tenderness in their hearts. The external trappings of life are stripped away and the beauty of existence is made clear. This is a time when small memories or little pleasures bring tremendous, almost childlike, joy.

Letting go is usually followed by a physical decline which leads to death.  For a smooth transition the Elderly need a loving environment which supports and facilitates the emotional process of letting go.  This is why family and friends are so important.  As the elderly become more aware of their own mortality, they attempt to hold themselves together to reduce their fears, anxieties, pain and panic.  Having loving and patient support makes this task easier to accomplish. 

The elderly need to be able to transition through each stage of advanced age without being made to feel a burden on those around them. They need to be able to slow down without being considered a nuisance and reminisce through their life’s perceptions and experiences without being thought of as a bore.  They need to be allowed to let go of all the excesses of life without being considered witless.  For an elder to pass through these stages unaccompanied by the loving support of family or friends is a tragedy, for they are left alone and isolated as they face the most difficult of life’s  transitions – death.

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two companies provide comprehensive care for the elderly in the Fox Valley of Wisconsin.

Sources:    “Emotion Regulation in Older Age” y Heather L. Urry and James J. Gross, www.aps.sagepub.com. 5/15/13

                      "The Psychological Tasks of Old Age” by Victoria Fitch, www.windhorseguild.org. 5/15/13

                      “The Old-Old Years” by Brenda Sue Black, M.S., www.wvu.edu.com. 6/1/13.



Transitions: Senior to Elderly - Transmission

It is important to the elderly to be benefactors to those they love

There are four stages people pass through as they transition from being a senior to being truly elderly.  Each individual is different in how they navigate through and experience these phases of advanced age, but generally most people go through:

1)      Slowing – a time of slowing in pace, motor functions and memory.

2)     Life Review – a time of reflection of one’s past with the goal of finding meaning in their existence.

3)      Transmission – a time of passing on the essence of one’s life to others.

4)     Letting Go – a time of stripping down the excesses of life and learning  to just be.

Being able to identify each stage as a person enters it is very helpful to both the elder and their family alike.  For those making the journey through advance age, knowing the signs of the various stages make it a little less stressful as life begins to change.  For the family of an aging loved one, it is often necessary to assist an elder as they pass through each stage and having an understanding of what to expect and how to help can make the passage much easier for everyone.

3) Transmission

Just as the first stage of physical and cognitive slowing leads to the second stage of life review, this phase of introspection leads to the third stage of Transmission.  Transmission is the passing on to others the culmination of what was gathered in the elder’s life.  This can be anything from physical possessions to small gestures of care.  Giving is what is important in this stage of advanced age.  It is the passing on of things, great and small, that mark this time.

·         Inheritance - It is common for those entering advanced age to start sorting through their physical possessions.  This taking stock of their belongings and determining who to pass them onto is usually a conscious and methodical process.  Bequeathing a life time of possessions to the next generation is one very practical way the elderly pass on important aspects of their lives to those they care about.  These gifts needn’t be of great financial value, but often have a strong sentimental significance to the giver.  People of advanced age have a deep desire to be benefactors to those they care about.

·         Experience – Elders are rich in experience, knowledge and practical skills.  In living a full life they have gained the understanding of not only how to do things, but how to think about life.  They long to pass this experience and understanding on to those who will receive it.  Their lessons of life can be imbedded in conversations about seemingly inconsequential matters and so are often missed by the busy listener. 

·         Wisdom - As the world slows for those in advanced age, there is a great awareness of detail that is gained. This understanding of the intricate details of life is what elders wish to pass on to those around them.  Detailed direction on how to arrange flowers or set the table can be full of the essence of wisdom to those who take the time to receive it. 

·         Grace -   In many cases it is not the gift itself that is important to the elderly.  What shines in their eyes is the exchange that is made between themselves and those they care about.  In the act of giving and receiving, the elderly are able to bring their loved ones into their slowed world and show them a perspective of life in its simplest form.  Those who truly take the time to receive all the elderly want to give come away with a sense of grace and a deeper understanding of humanity.  The elderly at this point are able to teach us by example what it means to be human.

Advanced age brings with it many challenges.  Frailty, failing health, cognitive concerns, physical pain and emotional anxieties all burden the aging to one degree or another.  These challenges make the time of transmission all the more urgent to those in that stage.  Facing mortality prompts the aging to go through the process of sorting out and tidying up their life.  The stage of transmission is an important step in preparation for the final stage of letting go.

www.homeaidhealthcare.com

 

www.prairiehomeassistedliving.com

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two family owned companies provide comprehensive care for the elderly in the Fox Valley of Wisconsin.

Sources:    "Emotion Regulation in Older Age" by Heather L. Urry and James J. Gross, www.sagepub.com. 7/15/13

                  “The Old-Old Years” by Brenda Sue Black, M.S., www.wvu.edu.com. 6/1/13.

                   “The Psychological Tasks of Old Age” by Victoria Fitch, www.windhorseguild.org. 5/15/13.

                



Transitions: Senior to Elderly - Life Review

A natural part of the slowing of advanced age
is spending time in reflection



Ever try to help an elder cross the street or reach out to steady a senior descending the stairs. Most likely you won’t be thanked for your trouble.  Many seniors will show a bit of temper when treated as frail or in need of help.  Today’s seniors are enjoying life to the fullest and don’t wish to be reminded that old age is encroaching on them.  So when a person reaches advanced years and transitions into being truly elderly, there are often some difficulties with adapting to the next stage of life.

There are four psychological phases that the aging naturally go through as they make the transition from being a senior to being elderly.  These stages are 1) Slowing; 2) Life Review; 3) Transmission; and 4) Letting Go.  Working through each stage is important for the emotional well-being of the aging.  Even though it can be difficult to go through each phase, avoiding or denying the process may result in anxiety, anger and bitterness at end of life.

Being aware of the common characteristics of each stage is very helpful for the aging and their families.  For those facing advanced age, it is helpful to recognize the signs of transition rather than be thrown for an emotional loop as life begins to change.  For families, knowing what to expect is important as it is often those closest to the aging that must help their loved ones go through each stage.

2) Life Review

A natural response to the slowing down of advanced age is spending time in reflection of one’s life.  This review covers everything from a lifetime of memories and experiences to re-evaluating past and present relationships to re-assessing conflicts that remain unresolved.  For most elderly, it is the understanding that time is now limited that prompts them to shift through their life story and come to terms with its impact and value.   

For many of advanced age there is a sense of urgency to work through this review process.   They may feel alarmed that time is passing and they have not yet made sense of what their life has meant.  As they take stock of their past, many elderly also look to the future to consider what they will do with the time that remains.  This is a time of introspection which needs to be aided by family and friends.

The telling of stories from an elder’s past is one way the aging sort through their memories and pass on their perceptions and experiences.  The passing on of their stories and the knowledge and wisdom they have gained, is how the elderly work out the meaning and value of their lives.  For people of advanced age, the sharing of their history helps in finding the grand meaning in their existence and aids in accepting their mortality.  These stories and pearls of wisdom are considered valuable and so family and friends need to really listen and respect the gift their elder is giving with them.  They need to recognize that they are not just listening to old stories, but receiving the legacy of a life as well as assisting their loved one in his work of life review.

It is often difficult for elders with memory issues to complete this stage of the aging transition.  They become stuck in the task of evaluating life and grow distressed at not being able to make sense of their existence.  Yet even for those with cognitive limitations a life review is possible with patient assistance and an accepting environment.

Being able to face mortality and move on without anxiety is the goal of life review.  Many elderly need help in focusing on the positive aspects of life as they go through the life review transition. Family and friends play an important role in providing the encouragement and support necessary to move through this transition.  Yet ultimately it is the work of the elderly to go through this review and move on to the next phase of their life.  It takes great courage to come to terms one’s life and learn to accept it without regrets.

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two companies provide comprehensive care for the elderly in the Fox Valley.

Sources:  “The Psychological Tasks of Old Age” by Victoria Fitch, www.windhorseguild.org. 5/15/13.

                 “The Old-Old Years” by Brenda Sue Black, M.S., www.wvu.edu.com. 6/1/13.

Transitions: Senior to Elderly - Slowing




Slowing is a natural part of aging.

Most seniors don’t usually categorize themselves as "elderly".  Many will bristle at being treated as frail or dependent and will actively work at remaining as young as possible. Seniors look forward to retirement age with plans of finally having time to enjoy family, the opportunity to travel or pursue personal interests. They are encouraged with opportunities to do things, go places and experience life like no aging generation has been in the past.  So when today’s senior reaches advanced years and frailty begins to be an issue, the transition into being truly elderly can be very difficult.

There are four psychological phases that the aging pass through as they transition from senior to elderly. These stages are 1) Slowing; 2) Life Review; 3) Transmission; and 4) Letting Go.  Recognizing and understanding the characteristic behavior of being elderly of each stage is helpful for families and the aging alike.  For the aging themselves, recognizing the transition into advance age can be difficult, frailty often just sneaks up on a person before they are really ready for it.  Knowing the signs of that transition can help with acceptance of the next stage in life.  For family it is often necessary to assist their loved one through each stage of advancing age and knowing what to expect can make it easier on all involved.

 Slowing

 

One of the most visible indicators of the transition from senior to elderly is the process of slowing down.  Except in the cases of illness, slowing is a very gradual process.  For most healthy individuals, advanced age is noticeable by the lack of speed in all functions.  This is the time of slowing in pace, motor skills and biological processes.  There is also a reduction in speed in certain intellectual and memory functions.  The physical slowing of advanced age takes over all aspects of life and brings with it formidable physical and psychological implications.

·         Focus on bodily maintenance - For the advanced elderly, a trip to the bathroom may take a half an hour and buttoning up a sweater or finding one’s socks may take another 20 minutes.  The basics of living occupies the bulk of the day, leaving the elderly essentially only time to focus on the routine tasks of daily care.

·         Focus on details - Rather than quickly completing multiple tasks as one does in youth, the elderly pay attention to the details of the one task at hand.  Their focus on minute details may be frustrating when it comes across as being particular or difficult, yet taking the time to listen and help with those details is an act of love.

·         Focus on routines – For the advanced in aged life is simplified into daily routines and schedules.  These routines, which are followed strictly, provide stability as the elderly is face with an ever increasing fast paced world they can no longer keep up with.  Asking an elder to interrupt or change his routine can be met with resistance and needs to be approached gently and with advanced notice.

·         Focus on the negative - The advanced in age are often traumatized by personal losses of health and loved ones. They may feel of isolated from family and harbor resentment of being relegated to institutions for the old.  The elderly face many challenges in keeping a positive outlook on life and not succumbing to hopelessness and it is often interaction with family and friends that help put problems in perspective.

·         Focus on fears – Many elderly people grow confused and tend to panic when confronted with the fast pace of life.  These moments of forgetfulness and disorientation create great anxiety.   Humiliation at loss of memory, loss of physical competence and occasional states of confusion all create paralyzing fears of being incapacitated and being unable to care for one self.  This cycle of fear can cause the aging to shut down emotionally, psychologically and physically.  

·         Focus on being rather than doing – The challenge for the elderly lies in making a healthy relationship with slowing.  It requires abandoning the pace of life from the past.  There is no longer the future to consider, but a focus on the present.  To be able to relax and accept just being rather than doing is a great challenge for the elderly, who have clung to remaining active and productive all through their senior years.

Today’s aging often faces the transition of slowing without the support of a safe and loving environment.  It used to be that the elderly remained centered in the family life, helping with the raising of children and acting as the living history of a family.  The youth were taught to slow down to a pace acceptable to their elders and to wait on them respectfully.  Without that loving and patient support an the elderly can perceive their natural process of slowing as being a nuisance.

Natural aging for the elderly unfolds best  in a caring atmosphere; one enriched with life and love, communication and relationships.  It is in such an environment the aging are accommodated as they go through the first transition stage of becoming elderly. 

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living, which has served the physical, spiritual, mental and health needs of their Residents since 1999.  Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.

 

Sources:  “The Psychological Tasks of Old Age” by Victoria Fitch, www.windhorseguild.org. 5/15/13.

                   “The Old-Old Years” by Brenda Sue Black, M.S., www.wvu.edu.com. 6/1/13.

Proper Nutrition for Elderly: Quiz

Learn about the link between nutrition and health among the aging.

We all know about the correlation between diet and health. For the elderly, a nutritious diet is essential to maintaining health and promoting longevity.  A proper diet keeps aging muscles, bones, organs and other body parts in good working order for the long haul. Getting the necessary vitamins and minerals from healthy food boosts immunity and fights off illness-causing toxins.  Beyond reducing the risk of heart disease, stroke and high blood pressure, eating a proper diet also fights against type -2 diabetes, bone loss, anemia, cancer and Alzheimer’s disease. Yet studies show most elderly don’t eat a nutritious diet.  Test your understanding of diet and nutrition for the aging by taking this quiz and see if you know the essentials of a healthy diet for a healthy senior.

1)  The average person puts on 10 to 20 pounds from 45 to 65.  This is_____?

A.    quite normal.  We need to expect body changes as we age.

B.     to be avoided.  A person’s recommended weight should remain the  
  same throughout the adult years. 

C.    caused by aging, not by inactivity or overeating.

D.    not that common.  Most people don’t put on weight as they age.

ANSWER:  B   In fact, dramatic changes in weight can lead to negative health issues. Maintaining a proper weight through a lifestyle of health diet and exercise, even if started later in life, contributes to longevity and a better quality of life.

 2)  Being notably underweight _____.

A.    is a sign of possible health problems.

B.     is wonderful!  Don’t we all want to shed a few pounds?

C.    can lead to fatigue, cognitive confusion and depression.

D.    both A and C.

ANSWER: D Significant lose of weight is a red flag to many health concerns.  Many of today’s elderly suffer from malnutrition from not eating enough food or getting the proper nutrients from the food they consume. Poor diet increases risk of falls, mental confusion and osteoporosis.

3)  Elderly get all their nutrients or vitamins and minerals from the food they eat.

A.    true

B.     false

ANSWER: B In fact, the aging are less able to absorb some nutrients from their diet and may need to take vitamin supplements.   For example, after 50, the stomach produces less gastric acid making it difficult to absorb vitamin B-12 from food, which is necessary to keep blood and nerves vital.  Another important nutrient combination is calcium and vitamin D.  Calcium is needed for maintaining bone strength, but cannot be absorbed without vitamin D. With age, the body is less able to synthesize vitamin D on its own and so supplements become necessary. 

4)  Elderly with urinary incontinence should _____.

A.    cut back on the amount of water they drink each day.  We don’t want 

to risk any embarrassing accidents.

B.    supplement with coffee or soft drinks.

C.    drink eight 8 oz. glasses of water daily.

D.    not worry about drinking water unless they feel thirsty.

ANSWER: C  Incontinence can be embarrassing, but should not stop an elder from drinking enough water.  Getting enough fluids can be an issue for the aging because they do not always realize when their body is thirsty.  Usually drinking eight eight-ounce glasses of fluids per day is enough but if in doubt, check the urine color.  Pale yellow urine is best.  Bright or dark yellow means you need to drink more liquids.

5)  Elderly are less active and so should consume fewer calories to avoid
     putting on weight.

A.    True

B.     False

ANSWER:  B   For the majority of elderly, diet isn’t about losing weight anymore; it’s about eating healthy meals.  Eating a balanced diet is more important than counting calories, but for those who count this is a good guideline.

Women over 50:  not physically active = 1,600 calories a day

                               some physical activity = 1,800 calories a day

                               very physically active = 2,000 calories a day

Men over 50:        not physically active = 2,000 calories a day

                               some physical activity = 2,400 calories a day

                               very physically active = 2,800 calories a day

 

6)  Elderly often lose interest in food due to _____.

A.    changes in sense of taste and smell.

B.     poor fitting dentures make eating painful.

C.     medications affecting their appetite.

D.    eating alone.

E.     All of the above.

ANSWER:  E   All of the above can affect the eating habits of the elderly causing them to lose interest in eating properly.  Not maintaining proper meals is a leading cause of malnutrition among this age group.

7)  Food choice has nothing to do with Alzheimer’s disease.

A.    True

B.     False

ANSWER: B  Key nutrients are very important for the brain to function at its best.  Eating a selection of brightly colored fruit, leafy veggies, fish and nuts packed with omega-3 fatty acids can improve focus and decrease the risk of Alzheimer’s disease.

8)  The best diet for the elderly to follow is _______.

A.    Vegan Diet

B.     Atkins Diet

C.     Mediterranean Diet

D.    Western Diet

ANSWER: C  Known for increasing lifespan by 8-14%, the Mediterranean Diet is also credited with lowering the risk of heart disease.  A veggie loaded diet with legumes, fruits, fish and unsaturated fats like olive oil, the Mediterranean Diet is ideal for the elderly.

9)  Seniors and the Elderly need 1,200 mg. of calcium daily to maintain good bone health.  A common source for calcium is milk, yogurt and cheese.  Non-dairy sources include ______.

A.    tofu, broccoli, almonds and kale

B.     mushrooms, molasses and salmon

C.     basil, soybeans and sardines

D.    All the of the above

ANSWER:  D There are a lot of great sources for calcium even for those who don’t tolerate dairy easily.  Getting enough calcium prevents osteoporosis and bone fractures, which to the aging, is a major issue. 

10)  Being carb smart for the aging means limiting consumption to about 6-7 ounces of grains daily.  An ounce of grain is equal to _______?

A.    a crouton

B.     a croissant

C.     a slice of bread

D.    a loaf of bread

ANSWER:  C   A couple of slices of bread a day sounds fine, but most people don’t realize that pasta, cereals, beans and many vegetables all are considered carbs.  Filling up on carbohydrates is a problem for everyone, but for the elderly it means missing out on getting the proper nourishment from their diets.  Eating carbs labeled “whole” is better option, as they have more nutrients and fiber.

As people age, eating well can be an important element of maintaining a positive mental outlook and remaining emotionally well balanced.  Eating a healthy diet is no longer about sacrificing and watching one’s weight.  It is about enjoying fresh, colorful foods and being creative in the kitchen.  Enjoy a healthy meal with friends today and you will feel vibrant and healthy, inside and out.



 

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com



HomeAid Health Care which provides non-medical home services for the elderly who wish to remain safe and independent at home.  HomeAid is a sister company to Prairie Home Assisted Living which has served the  physical, spiritual, mental and health needs of their residents since 1999.  Together the two companies provide comprehensive care that meets the needs of the elderly in the Fox Valley of Wisconsin.