Importance of empowering older adults
Bachelor of Social Work (Honours)
Clinical Social Worker, Gerontological Psychotherapist & Sessional Lecturer
We all get older. It’s a natural part of life. Yet, particularly in Western cultures, ageism is clearly evident. Popular culture is focused on youth; through the concept of beauty, the power of physical ability and strength, and the perception of usefulness in the workplace.
But when society discriminates against older adults in this way, aren’t we also discriminating against our future selves?
UniSA alumna Felicity Chapman is a clinical social worker, sessional lecturer and educator who works closely with advanced seniors in Australia, and knows the importance of valuing the old as much as the young.
“Many older adults confess to me that they feel over looked or treated like a child. And some have even said to me that they feel ‘thrown-away’,” says Felicity.
“They can fall into a social trap of being one of many older people, not as an individual anymore, especially if they are in care or have a lot of health problems.
“We need to be savvy about how easily ageism can affect our attitudes so that we can protect ourselves against it. And we need to realize how easy it is for older adults themselves to feel invisible and unworthy.
“I want older adults to feel like they’ve got a voice, that they matter as an individual and are valued members of our community.”
Felicity recently launched her new book, ‘Counselling and Psychotherapy with Older People in Care: A Support Guide,’ on World Social Work Day, which concentrates on tackling ageism and advocates for a new model of psychological care that places a premium on relevancy and dignity. The book is written in a warm conversational style and has stories woven throughout based on her experience in this area.
“There are three things happening in our world at the moment. We’ve got a high incidence of depression and general distress amongst older adults - especially in care facility settings. We’ve got an ageing population and people are living longer. And on-top of all that, we’ve got a shortage of practitioners specializing in psychotherapeutic work with an advanced senior population. It’s a perfect storm!
“It’s a matter of great urgency that these issues be addressed, not only for today’s advanced senior group – but also for our future selves.”
People currently aged eighty years and over are often not familiar with psychotherapy, nor seek it, however psychological distress for this group can be high. Men over eighty five in Australia have the highest rate of suicide, and a report by the Australian Institute of Health and Welfare in 2013 revealed that more than half of facility residents in the study had depressive symptoms.
“Depression is not a normal part of the ageing experience. Older adults deserve quality of life – right to the end – in all aspects of their wellbeing, which includes the psychological.
“What can compound the problem of depression even more is internalized ageism, which negatively affects how older adults perceive themselves. Internalized ageism can have people feeling like a burden which actually increases their risk of suicide.”
Felicity suggests a unique model of psychological engagement which she believes makes psychotherapy more accessible to an advanced senior group and offers the best chance of success in improving their emotional and psychological health.
“It’s called the ‘Flexicare Model.’ It combines evidence based interventions adapted for an older adult clientele and offers an alternative view. It challenges a number of elements common in traditional geropsychology like a focus on pathology, set processes and strong assumptions about the helper-as-expert. The centre piece of the model relates to the concept of ‘pre-therapy, therapy’.
“Most of the older adults I speak to in their eighties and nineties have no idea what counselling is. When I mention the word ‘counselling’ they often look at me like a budgie has done its business on my head! And the current group of advanced seniors often pride themselves as being resilient, and don’t want to see themselves as having problems.
“‘Pre-therapy, therapy’ is a way of using life story techniques common in Reminisce Therapy and Narrative Therapy to develop trust and motivation for the psychotherapeutic process. It looks like an informal chat but, really, it’s as therapeutic as any more formal intervention is.
“By intervening like this, I also give them an experience of therapy that creates permission for them to talk about themselves and doesn’t focus on the practitioner being the helper.
“It changes the dynamic so they feel as though they are helping me by sharing their story, which automatically promotes dignity and has them defining their situation in a way which is empowering.
“It also connects them to strengths or things about themselves that their change and loss might have overshadowed.
“Once I have earned their interest and trust, they can see the relevance of what I am doing and that it’s not ‘whacky.’
“The model is all about creating comfort and dignity which, ultimately, leads to engagement and healing. We need to be ‘senior friendly’ in how we package psychotherapy: it needs to be relevant and respectful and not a ‘one size fits all’ approach.”
Felicity has found that creating open conversations with older adults about their life story helps to segue into more formal therapy where she continues to help them re-establish their unique identity, which can often be ‘buried’ underneath definitions of deficit and decline and be linked to feelings of failure.
“They can still feel taller and feel relief even though they are also experiencing loss. It’s about providing a bridge between their past achievements with how they see themselves now.
“I find a dignity based approach, exploring what their values are and how they can see themselves, can sit outside of all of their physical changes and help to find something they can feel proud of.
“My book aims to motivate and encourage practitioners, and arm them with practical skills. The reviews on Amazon so far are very positive. My book is particularly relevant for psychologists, clinical social workers and nurses who want to be ‘aged care ready’.”
While many aspects of Felicity’s book relate to a global audience, she suspects that the anti-ageist element is more relevant for practitioners in Western countries as opposed to Eastern cultures where ageism appears less apparent.
“Eastern cultures tend to elevate their elderly in a way that they are seen as having more wisdom which is really lovely to see. The older they get, the more value or status they tend to have. They are less cut off from society and there is often a strong role that they play in the family irrespective of declining health. What can compound depression in people is when they feel like they have no purpose – that they have no role in society. It all relates to value.”
“We need to value the old as much as we do the young so that older adults feel important and feel empowered to age with dignity no matter what situations they are faced with.”