Saturday, February 04, 2012

Posts Tagged ‘depression’

Boomer Community: Aging with the Right People

Without friends no one would choose to live, though he had all other goods.
Aristotle

Stress is an isolator. As its intensity increases, it promotes distrust of others and that distrust leads to greater isolation from the essential social networks of family, friends, and colleagues. The inherent loneliness of this isolation also comes with a significant quality of life burden. House, Landis, and Umberson (1988) published a classic review of five prospective studies showing that social isolation is a risk factor for broad-based morbidity and mortality. This is especially troubling news for baby boomers. The polyphasic stress of middle age puts them at increased risk for social isolation and poor outcomes. Finding remedies to address the problem exceeds the scope and resources of clinical medicine. No amount of antidepressant or anti-anxiety medication can overcome the fundamental need of middle age adults to learn how to band together in diverse social networks to reduce this threat to quality of life. Simply put, middle age should not be attempted alone.

Social networks serve a critical role in fulfilling the developmental tasks of middle age. They provide emotional scaffolding for the fifty-something growth phase by reducing instability and buffering volatility. Echoing Shakespeare’s adage that “a sorrow shared is a sorrow halved,” social networks have the enormous capacity to provide support, comfort, and relief. In addition, they are collaborative “dream teams” for baby boomers providing fresh input, new perspectives, and valuable feedback in the pursuit of second half goals. Once goals are clarified, social networks become a prime resource for human capital. Specialized “swat teams” of friends, peers, or other contacts can be mobilized to foster new business opportunities, address a health crisis, or pursue altruistic callings. Their success is the end product of collaboration, a strategy that can prove difficult for middle age men.

As noted previously, men’s individualistic approach to pursuing goals becomes a deficit in the second half of life. In the United States, suicide rates are highest among men aged 65 years and older, and within this group, the highest for men who are divorced or widowed. Winding up alone either physically or emotionally can be catastrophic to quality of life. Confronting a broad-spectrum upheaval with insufficient social networks can simply be too much leading to irreversible damage to men and their family systems. Offering men reframing strategies to reconsider the benefits of utilizing social networks is vital for preserving quality of life for themselves and those who are counting on them.

Social networks serve another crucial function by providing the architecture for a goal unique to middle age: generativity. Eric Erikson, a pioneer in developmental psychology field, defines generativity as an adult’s ability to look outside him or herself and care for others, an individual’s concern for the generations to come. In the middle-adult years, Erikson wrote, a person may come to realize that “I am what survives me.” Social networks allow individuals to begin to discover what they want to survive them. Many times the simple experience of interacting in network communities reveals for the first time the magnitude of reaching beyond self-interest. The well being of society depends on middle age adults’ contributions to those who will follow them.

Boomers need to remember that the search for generativity is impacting their entire generation, a psychological call to arms to make the second half to matter. Social networks provide a critical forum to help accomplish this and other goals. The developmental disruption of middle age may not be pleasant but it does shed new light on the role and potential of social networks. For baby boomers it is deja vu to what occurred to their generation in the 1960s, finding themselves once again between an old system that is no longer working and the new system that is still in development. The challenge is how to assess the current inventory of social networks and then use the analysis to improve their quality and quantity. One resource is The Network Cultivator™.

The Network Cultivator™ assesses the quality and diversity of social networks from a historical, integral, and functional perspective. It is an effective tool for middle age adults to better understand the dynamics of their social networks and how they change in quality and purpose over time. The Network Cultivator™ is in part a historical tally of which communities have proven beneficial over time and why. It also identifies which ones have either failed or seemed trapped in chronic dysfunction. The Network Cultivator™ assesses, organizes, and prioritizes the entire social network system. The results are captured in a global summary that is used to rebalance the social network sector of The Quality of Life Portfolio™. Rebalancing includes addressing the human ecology issues that are undermining the developmental mission.

A primary benefit of The Network Cultivator™ is its capacity to reframe dysfunctional networks. This is a critical step for family systems, which are complex, slow to change, and impact the quality of life for middle age adults. There is also an understandable tendency to see dysfunctional family sectors as predestined, a perspective that assumes individual members are simply “stuck” with the way things are. The Network Cultivator™ can alter this bias by providing a protocol to test assumptions that individuals have about their family system. It effectively identifies strategies that make them incapable of moving beyond chronic conflict and pessimism. It then provides a way to recast these strategies into a more effective format. The reframing of dysfunctional sectors alone can reduce the volatility of this essential sector by helping middle age adults modify their perspective and expectations. This creates a more realistic view of the family system and what individual members can or cannot control. It also highlights the inherent pitfalls and limitations of family systems reinforcing the fundamental need to seek outside communities to insure a more balanced inventory of network resources.

The Network Cultivator™ is an ideal tool to define the theme and structure of new social networks. The global summary maps out quality sectors that are at high risk for instability due to poor relationship ecology. It also uses historical success to emphasize the community structure that has been beneficial in the past. With this information, middle age adults can begin to seek out or create highly individualized affinity groups. Whether to shore up exhaustion from working with aging parents or creating an ad hoc support group for coping with a devastating diagnosis, The Network Cultivator™ provides baby boomers tools for distributive decision making that intensely involves social networks in filtering choices, vetting decisions, and monitoring progress.

New network communities are a source of great hope for middle age adults. They represent a new beginning, a chance to join forces with kindred spirits who have similar needs, issues, or interests. As important, their form and content are not bound by what has occurred in the first half of life. The second half world operates with a unique intensity and content that only the experience of being middle age can comprehend. The scope and depth of the upheaval argues for a more open-minded approach to reinvention, to risk moving into uncharted waters to find or create new networks that could to be the deciding factor in preserving quality of life.

Reinvention for middle age adults involves the past as much as it does the future. It is not surprising that desires and dreams from youth resurface amid the crisis of middle age. Passions that have been put on the shelf for years suddenly surface and insist on reconsideration. This renaissance of unfulfilled dreams carries enormous emotional sway for reframing middle age goals. In the same manner it provides a focal point for discovering or creating new social networks. It is a transformational insight that turns a perceived setback of being older into an opportunity to finally pursue what you really wanted in the first place. Learning Greek while studying ancient history on location in Athens with a group of like-mind peers is no longer out of the question. So is a scratch start to learn golf, piano, salsa dancing, or a foreign language. It also includes forays into new business venture, going back to college, joining humanitarian missions, remodeling a house, or upgrading a marriage. Once freed up to leverage middle age as a cause for reinvention, baby boomers can mobilize a vast array of skills, choices, and technologies to self-organize in dramatic new and exciting ways.

Boomer Perspective: Moment of Truth

One sees great things from the valley, only small things from the peak.
—Chesterton

While aging is inevitable, arriving at a healthy perspective about its meaning and potential is not. In our youth-oriented culture, middle age more often than not is portrayed as embarrassing stage of life that is in desperate need of enhancements to stave off the signs of being older. But Botox® and hair transplants can not hold the line forever and at some point thoughts and feelings about aging have to be sorted out at a deeper level, a realty check on what it really means to be older. The outcome of this “aging moment of truth” will have a profound influence on the quality of life for middle age adults. It will either reframe the journey as a continuation of growth and learning filled with unique potential, or see a darker landscape riddled with loss, regret, and limitations. This vantage point from which baby boomers will judge the aging process is called perspective.

Perspective provides a “filter” through which life experiences are assessed, organized, and ultimately judged. Youth has its own filter typified by an optimism found in the first half of life that keeps the metaphoric glass half full. It is a perspective that always sees another opportunity, another deal, or a fresh start that is not limited by health, family, or time. The first half perspective quickly converts setbacks into opportunities based on an unshakeable faith in the magnitude of possibilities that lie ahead. Middle age changes the filter.

Ushering in an era of external and internal upheavals, middle age introduces a different reality that undermines the sustainability of earlier optimism. What appeared unlimited now has restrictions and complications. The unspoken and yet pervasive cultural shame that sees aging as pathology leaves middle age adults holding a glass that is suddenly half empty. In this new environment, the first half perspective can undergo a rapid deterioration leading baby boomers to buy into a more cynical future. Without reframing, this is the anticipatory reality they are stuck with to manage being older. Ironically, this cultural anxiety about aging has no basis in biology or psychology. Growth and learning do not wane in middle age, and creative capacity is at an all time high. But the media’s slight of hand trick that obsesses over youth as the ultimate consumer class delivers a convincing message about the downhill trajectory of the second half of life. This dysfunctional perspective is a trap for middle age adults pointing them developmentally backwards to a phase that is over while distracting and devaluing the rich and immediate next phase on which so much is riding. Avoiding this unhealthy entrapment requires a different type of inquiry into being older. We call this inquiry The Perspective Inventory™.

As a reframing tool, The Perspective Inventory™ allows middle age adults to “test” the critical questions that ask themselves and others about the aging process. As Dr. Marilee Adams succinctly argues in her book Change Your Questions, Change Your Life, questions are the raw material of how individuals size up themselves and their world. They are the building blocks of perspective, the framing tools that either discover hope and opportunity or perpetuate endless cycles of conflict and despair. From a developmental perspective, questions are an ideal vehicle to examine and change concepts. They have the right linguistic packaging to emotionally override long-standing beliefs. They are receptive to the right brain, which has proven to be the informational gatekeeper for middle age and beyond. They are also emotionally generative and as such quickly alter cognition and change behavior. But the benefit of The Perspective Inventory™ is not simply to arrive at a better set of questions about being older, as valuable as they may be. The Perspective Inventory™ offers baby boomers a way to build a new filtering ritual so they can habitually reframe the experiences of aging to facilitate their developmental journey.

First and foremost The Perspective Inventory™ is an inquiry tool. It is allows middle age adults to organize and evaluate the quality of the questions they ask about the aging. It is based Dr. Adams’ premise that most people simply adopt a “questions style” without giving much thought to the impact it has on quality of their lives. Once internalized, these core questions become the ingrained filter for looking at people and experiences. With middle age, the impact question style intensifies in either a positive or negative way. Negative questions such as “Who’s to blame?” and “How can I prove I am right?” extract a heavy price on individuals and family systems. They negate prior success, shut down communication, and close off avenues of collaboration and growth. Even more concerning, they have the lethal potential to undermine confidence at a time in life where confidence is already in jeopardy. In contrast, aging friendly questions such as “What’s useful about this?” and “What’s possible?” lighten the emotional load on everyone. Not only do they facilitate communication but open up new channels of creativity, possibility, and growth. They help restore confidence and optimism to individuals and family systems.

The Perspective Inventory™ is also valuable resource for baby boomers as they engage the predictable dilemmas of their aging parents, experiences and situations that can leave both parties feeling frustrated, guilty, and anxious. Reframing questions surrounding the monumental family tasks of determining the right health care, sorting out living options, coping with the death of a spouse, untangling financial decisions, and coming to grips with the final goodbye can create a more effective and nurturing perspective. Developmentally tuned questions such as “what are the control issues here?” and “what other ways to look at this situation?” can help middle age adults keep their bearings in the midst of an emotional family landscape.

Finally, The Perspective Inventory™ reminds middle age adults that they can make positive alterations in the second half of life; they can opt for a radically different approach from the one they used in the first half. Moving into the upheaval of middle age asks two primary developmental questions:

1. How am I going to manage all this?
2. What is it I really want?

Successfully addressing these questions requires a perspective that is both personal and collective, is about self-fulfillment that is wrapped in a nurturing community of meaningful relationships. This is the heart of the need for authenticity. It is about finding personal clarity and not simply searching for another twenty years of approval or more of the same. For baby boomers that understand this potential, it comes as a welcome relief and an extraordinary opportunity to leverage their experience and education into an unlimited universe of choices and possibilities.

When Am I Going Home From The Nursing Home?

This is one of the predictable dilemmas of aging we all wish we could avoid. We can’t. At some point we run out of aging-in-place options and a parent winds up in a place they never wanted to be, a nursing home. It is a painful transition that in most cases is irreversible. But they continue to ask us when they can go home. So how do we respond? How do we help them come to terms with this new reality?

Start with the truth. Tell them the painful truth. Tell that you have run out of options. Their health and care issues requires a new level of support. It’s not what either of you wanted, but it is the new starting point that both of you are going to have to use going forward. You wish it wasn’t so, but it is.

Start with control. Make a working list of all of the choices your parent still retains despite being in a nursing home. Can they choose their own food and when they eat? Can they choose their activities and when they leave the facility on outings? Can they choose pictures to hang, a special chair, music, blankets, and when family and friends can visit? The more ares of control you identify and orchestrate for them to manage, the easier it will be for them to come to terms with the transition.

Start with legacy. Make a working list of the people connected to your parent’s life who can “rise to the occasion” and help with the transition. This could include neighbors, co-workers, friends, clergy, and of course family members. Tell them to come ready with a story, pictures, food, and news. We all want to know our lives make a difference, but when we wind up in a nursing home, it doesn’t seem that way anymore. The more connections you mobilize to interact your parent, the easier it will be for them to come to terms with the transition.

Make ample room for tears. The losses of aging break our hearts and all of us need room to grieve openly. It helps us come to terms with the things we cannot change; it makes room for courage and compassion. Let your parent have his or her feelings and let them see yours. It will provide both of you comfort and deepen your partnership for what lies ahead.

Caregiver Stress? Try Inspirational Walking

Caregiver stress is well documented and extracts a heavy toll on both caregivers and their families. In the heat of trying to keep everything together, it is hard for caregivers to find effective strategies that offer some respite from the natural tendency to obsess and feel overwhelmed. Caregivers need a way to take their brains “offline,” to momentarily disengage for anxious, closed-loop thinking, catch their emotional breath, and come back renewed. But how?

Here is my solution: Inspirational Walking. This is a simple, effective strategy that combines walking with a personalized soundtrack. It combines two powerful strategies that change thought patterns: exercise and music.

Exercise clears the mind. Even when we start out feeling overwhelmed, a simple thirty minute walk makes our thoughts clearer, gives us new ideas that help us cope, and leaves us feeling physically and mentally energized.

Music inspires the heart. Music has been a part of lives from early childhood, and we all have personal sound tracks of our lives. We mark people, events and the passing of time with certain songs. In the end, music helps us give meaning to our experiences and, as important, helps us cope.

Inspirational Walking integrates both of these strategies into one simple strategy. Here’s how it works:

1. Using iTunes, create a playlist that is thirty minutes long. Begin with a song that captures the reality, mood, or irony of being in a difficult caregiver situation. I personally like Van Morrison’s song “Stranded” with the lyrics “everyday is puzzle time again.” I can’t explain it, but hearing these kinds of songs makes me feel better. Then add songs that that offer courage, inspiration, and motivation. I personally like Jack Johnson’s “Upside Down,” Indigo Girls’ “Love of Our Lives, and Coldplay’s “Yellow.” The key is to find songs that speak to your heart, that pick up your mood and step, and that remind you that you are not alone with your life struggles. Don’t obsess about the order or the exact length of the first playlist. As they say at Nike, just create it.

2. Give your playlist a test run. Put on your most comfortable walking clothes and shoes and take an thirty minute Inspirational Walk. This is your thirty minutes off line. If you can, walk outside; it will have the deepest impact on your thoughts and mood. If not, use a treadmill or an indoor mall. Put the world on pause; it will have to make due without you for thirty minutes. Find your own starting pace and just go with the music.

Remember:

Everyone is stiff and tight the first ten minutes and wonders if this is a good idea.

Everyone feels remarkably better at twenty minutes and are glad they took a walk.

Everyone feels better as they bring it home at end of thirty minutes and are sure it was good for their body, brain, and heart.

3. Modify your playlist and build new ones. Maybe you want to change the order of songs, or delete some songs and add new ones. Maybe you thought of a theme for another Inspirational Walk playlist. Create playlists for those days when nothing goes right. Create playlists for those days you are grateful for the lessons. Create playlists for those days you are on point and things are falling into place.

Our minds don’t do well sitting and stewing. We need movement and music to break us out of our mental quicksand. Try Inspirational Walking for thirty days, three to four times a week. See where the music takes you. See how your body feels with some new, consistent motion. See how your brain reacts to new input. Lastly, share your success and playlists with other caregivers who, like you, need a little time off line to regain their balance.

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Communicate

No Money: No Comment

I was recently asked what to do about aging parents who had little or no savings but refused to discuss any aspect of their “money issue.” It reminded me that our role as adult children is not necessarily about problem solving; it is about compassionate containment. So many of the issues we feel compelled to “fix” have no clear answers. The best we can do is sort out what to accept from what we can actually change. Here was the advice I offered:

The issue of money, like so many other issues in the last phase of life, is about control. The best way to approach it is to reframe money as means of maintaining control. Lack of money takes away control. This link http://www.dsolie.com/articles/reframing.html will take you to an article I authored on “communicating touch choices” that offers a practical strategy for how to do this.

You may also want to consider three strategies that will help you “hedge” your parent’s financial risk:

1. Buy a long term care policy with a two years home care/two years nursing home benefit. This assumes they will cooperative with the process (i.e. signing the applications and answering questions).

2. Start funding a dedicated “side fund” for expenses that a long term care policy will not cover.

3. If you parents own their home, become familiar with how “reverse mortgages work and when they make sense.

Lastly, you need to began discussions with local area agencies on aging to determine what, if any, community resources can assist your parents if they run out of money.

This is a tough end-game, especially if you parents don’t want to talk about. The article will help you frame your conversations. Be patient but persistent in your discussions about control and your desire to help them maintain it.