Golden years not a happy time for all seniors
Many of the requests for information that I receive as a result of people reading this column come from those over the age of 65. Many are quite positive and optimistic, but others contain elements of loneliness, financial distress, health concerns, and depression.
Feelings of being neglected, abandoned, manipulated and even physically abused add to the expressed concerns, thus prompting me to address the issue of counseling for elder citizens.
The aging process obviously produces a great deal of change, often resulting in undesired alterations in lifestyle. Sensory impairment, such as vision and hearing, organic impairment in thinking and memory, or changes in ambulatory capability due to strokes or orthopedic problems are examples of medical problems that may arise and result in a potential decrease in independence and freedom for the aging person. Not being able to drive a car, read a book, or take care of one's personal finances can give a person the feeling of the world closing in.
Counseling objectives for older individuals often involve such themes as:
• Grief over losses, fear and worry about physical illness
• Concerns regarding dealing with a disability which may occur with aging, facing issues of mortality
• Dealing with issues of perceived failures earlier in life and the guilt/depression that may relate to these issues
• Concerns over relationships with adult children (especially those dealing with independence/dependence)
• Despair and frustration over unresolved conflicts dating back many years.
Various therapeutic techniques are utilized with older individuals, including both individual and group counseling.
• More traditional psychotherapeutic approaches including supportive psychotherapy aimed at helping the individual adjust to the environment, and cope with the environment surrounding them, and cognitive/behavioral therapy--modification of dysfunctional beliefs and assistance with the development of new behavior patterns that enables the individual to receive more positive reinforcement from their environment.
• Life-review intervention strategy--this technique was developed to help individuals deal with their past, and, in particular, unresolved conflicts. They are encouraged to deal with "unfinished business," which for many older adults with significant depression, anxiety, or other psychological difficulties, often means working through a process of self-forgiveness or forgiving others for real or perceived past transgressions. An important aspect of life-review therapies is that they seem to help many people realize that they are worthwhile because they have really done something significant in their lives and have had an impact on other people. Life-review therapies have been shown to be effective methods for increasing self-esteem and renewing interest in areas that once held meaning and satisfaction for them.
• Reminiscence therapy--this approach, often pursued in groups, encourages the individual to reminisce and reflect on various aspects of their life and during the process to receive positive feedback from those in the group, as well as encouraging the development of insight into positive areas of one's past which may have been overlooked or temporarily forgotten.
These and other counseling techniques are not designed to help extend life, but instead to improve the quality of life.
