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Strategies for Therapy with the Elderly|Newly revised and updated! In this second Living With Hope and Meaning, 2nd Edition. Author: Claire.
Table of contents

Therapeutic factors in group support from the perspective of the coordinators and group members. Erdman SA.

Therapeutic factors in group counseling: implications for audiologic rehabilitation. Use of therapeutic factors for the evaluation of results in support groups. Therapeutic factors in a group of people with diabetes. Therapeutic factors of cognitive behavioral group treatment for social phobia. J Korean Med Sci. Rev APS. Efecto de un programa educativo para cuidadores de personas ancianas: una perspectiva cultural.

Rev Salud Publica Bogota. Rev Panam Salud Publica. Gatti BA. Bardin L. Effects of gerotranscendence support group on gerotranscendence perspective, depression, and life satisfaction of institutionalized elders. Aging Ment Health. Correspondence addressed to : Denize Bouttelet Munari. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Services on Demand Journal. Therapeutic factor Group members Group coordinator Cohesion Attraction of members among themselves and within the group … I really like to be part of the group, I like the environment..

So, the group is something very good, very satisfying. It is friendships that we create. I think it really is just like a family. Come rain or come shine, people are respectful, very friendly, lovely, and very dedicated. Even on days that you are not feeling well, when you get there you feel better. Introduction to hope Belief and trust in group efficacy … All the stress and nervousness had just gone. The problems with our joints that are due to lack of movement, all of that is resolved. I am very happy with the benefits I achieved with the meetings. People who participated in the group had depression and many were in pain.

Now, they have a totally different life So, the group is different, and the members will tell you how good it is to be part of the group. Socialization Development of basic social skills Because you just stay at home, you feel as if your life has come to an end, and you notice that. So, you begin to think about sad and bad things, all the things just get you down. But here with coordinators you play, laugh, shout, sing, and talk.

They really make you feel good. This group is a blessing of the Lord. There is a place for gathering together, where people meet each other, gossip, talk, talk about others life, fight [LOL], and play. People who have knowledge teach things to us, and the health agencies help us with physical activity because without them we could not do anything. We do many things, but we want to learn more and more things. We talk about smoking, about their civil rights. We talk about dengue, we educate them on health and nutrition. Existence factors Help to deal with facts of the human condition To be with this team is purely positive.

They teach us how to live, how to love; they teach me to be more patient with my life and job. We see the group members helping each other. Altruism Satisfaction in helping others … We help to animate things, give people support. For example, a friend of mine in the group wanted to go on our trip, but she did not have cash, so I helped her I paid for her trip ticket, and I ended up buying her a swimsuit We feel happy when we can help someone to become part of the group.

Interpesonal learning Learn by interaction with other people … I learned to be happy, to be more dedicated, and I left that sadness. I use to say that if my job were only the group, everything would be great. There, you learn with them. You teach things and you learn things as well. That life lessons you learn from the group are astonishing. Universality Other persons sharing the same dilemmas in life I thought I was the only one who suffered in the world. I believed that nobody suffered more than me. In the group I learned that there are people in very bad situations, and I could help them, so I became more comforted about with own situation.

Received: August 07, ; Accepted: August 25, How to cite this article. Cohesion Attraction of members among themselves and within the group. Introduction to hope Belief and trust in group efficacy. Socialization Development of basic social skills. Because you just stay at home, you feel as if your life has come to an end, and you notice that. Information sharing Didactic instruction or direct counseling.

Existence factors Help to deal with facts of the human condition. To be with this team is purely positive. Currently, the average age at which Nobel Prize—winning physicists make their discovery—not get the prize—is Theoretical chemists and physicists make their major contribution slightly earlier than empirical researchers do.

Similarly, poets tend to peak earlier than novelists do. All the composers studied were male. This age-creativity relationship is a statistical association, the product of averages; individuals vary from this trajectory. Indeed, everyone in a creative profession thinks they will be, like my collaborator, in the long tail of the curve.

There are late bloomers. As my friends who enumerate them do, we hold on to them for hope. It is true, people can continue to be productive past 75—to write and publish, to draw, carve, and sculpt, to compose. But there is no getting around the data. By definition, few of us can be exceptions. Lehman called them in his Age and Achievement , produce is novel rather than reiterative and repetitive of previous ideas. The age-creativity curve—especially the decline—endures across cultures and throughout history, suggesting some deep underlying biological determinism probably related to brain plasticity.

We can only speculate about the biology. The connections between neurons are subject to an intense process of natural selection. The neural connections that are most heavily used are reinforced and retained, while those that are rarely, if ever, used atrophy and disappear over time. Although brain plasticity persists throughout life, we do not get totally rewired.

(PDF) Handbook on Animal Assisted Therapy | Joselo Martinez - egidirisykol.tk

As we age, we forge a very extensive network of connections established through a lifetime of experiences, thoughts, feelings, actions, and memories. We are subject to who we have been. It is much more difficult for older people to learn new languages. All of those mental puzzles are an effort to slow the erosion of the neural connections we have.

Once you squeeze the creativity out of the neural networks established over your initial career, they are not likely to develop strong new brain connections to generate innovative ideas—except maybe in those Old Thinkers like my outlier colleague, who happen to be in the minority endowed with superior plasticity. Maybe mental functions —processing, memory, problem-solving—slow at Maybe creating something novel is very rare after that age.

One university professor told me that as he has aged he is 70 he has published less frequently, but he now contributes in other ways. He mentors students, helping them translate their passions into research projects and advising them on the balance of career and family. And people in other fields can do the same: mentor the next generation. Mentorship is hugely important. It lets us transmit our collective memory and draw on the wisdom of elders.

It is too often undervalued, dismissed as a way to occupy seniors who refuse to retire and who keep repeating the same stories. But it also illuminates a key issue with aging: the constricting of our ambitions and expectations. We accommodate our physical and mental limitations. Our expectations shrink. Aware of our diminishing capacities, we choose ever more restricted activities and projects, to ensure we can fulfill them.

Indeed, this constriction happens almost imperceptibly. Over time, and without our conscious choice, we transform our lives. And so we remain content, but the canvas is now tiny. The American immortal, once a vital figure in his or her profession and community, is happy to cultivate avocational interests, to take up bird watching, bicycle riding, pottery, and the like. And then …. Maybe this is too dismissive. There is more to life than youthful passions focused on career and creating.

There is posterity: children and grandchildren and great-grandchildren. I will leave aside the very real and oppressive financial and caregiving burdens that many, if not most, adults in the so-called sandwich generation are now experiencing, caught between the care of children and parents.

Taking Good Care of Yourself

Our living too long places real emotional weights on our progeny. Unless there has been terrible abuse, no child wants his or her parents to die.

Potential Power of Meaning-Centered Group Psychotherapy in Patients With Advanced Cancer

It is a huge loss at any age. It creates a tremendous, unfillable hole. But parents also cast a big shadow for most children. Whether estranged, disengaged, or deeply loving, they set expectations, render judgments, impose their opinions, interfere, and are generally a looming presence for even adult children. This can be wonderful. It can be annoying.

It can be destructive. But it is inescapable as long as the parent is alive. Examples abound in life and literature: Lear, the quintessential Jewish mother, the Tiger Mom. And while children can never fully escape this weight even after a parent dies, there is much less pressure to conform to parental expectations and demands after they are gone.

Living parents also occupy the role of head of the family. They make it hard for grown children to become the patriarch or matriarch. When parents routinely live to 95, children must caretake into their own retirement. But there is something even more important than parental shadowing: memories. How do we want to be remembered by our children and grandchildren?

We wish our children to remember us in our prime. Active, vigorous, engaged, animated, astute, enthusiastic, funny, warm, loving.

MORE IN LIFE

At age 75 we reach that unique, albeit somewhat arbitrarily chosen, moment when we have lived a rich and complete life, and have hopefully imparted the right memories to our children. Yes, with effort our children will be able to recall that great family vacation, that funny scene at Thanksgiving, that embarrassing faux pas at a wedding.

But the most-recent years—the years with progressing disabilities and the need to make caregiving arrangements—will inevitably become the predominant and salient memories. The old joys have to be actively conjured up. They love us and fear the loss that will be created by our death. And a loss it will be. A huge loss. But even if we manage not to become burdens to them, our shadowing them until their old age is also a loss. And leaving them—and our grandchildren—with memories framed not by our vivacity but by our frailty is the ultimate tragedy. That is all I want to live.


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Once I have lived to 75, my approach to my health care will completely change. The momentum of medicine and family means we will almost invariably get it. My attitude flips this default on its head.

My Osler-inspired philosophy is this: At 75 and beyond, I will need a good reason to even visit the doctor and take any medical test or treatment, no matter how routine and painless. I will accept only palliative—not curative—treatments if I am suffering pain or other disability. This means colonoscopies and other cancer-screening tests are out—and before If I were diagnosed with cancer now, at 57, I would probably be treated, unless the prognosis was very poor.

But 65 will be my last colonoscopy. No screening for prostate cancer at any age. He ordered the test for himself, I told him, not for me.


  1. Flow-Induced Vibrations: An Engineering Guide (Dover Civil and Mechanical Engineering).
  2. Why I Hope to Die at 75;
  3. Whinny From the Heart;
  4. Garys Guide to Getting Somewhere at a Nowhere Kind of Place;
  5. Vidi Angelum - Score.
  6. After 75, if I develop cancer, I will refuse treatment. Similarly, no cardiac stress test. No pacemaker and certainly no implantable defibrillator. No heart-valve replacement or bypass surgery. If I develop emphysema or some similar disease that involves frequent exacerbations that would, normally, land me in the hospital, I will accept treatment to ameliorate the discomfort caused by the feeling of suffocation, but will refuse to be hauled off.

    What about simple stuff? Flu shots are out.

    Strategies For Therapy With The Elderly: Living With Hope And Meaning, 2nd Edition:

    Certainly if there were to be a flu pandemic, a younger person who has yet to live a complete life ought to get the vaccine or any antiviral drugs. A big challenge is antibiotics for pneumonia or skin and urinary infections. Antibiotics are cheap and largely effective in curing infections. It is really hard for us to say no. But, as Osler reminds us, unlike the decays associated with chronic conditions, death from these infections is quick and relatively painless. So, no to antibiotics. Obviously, a do-not-resuscitate order and a complete advance directive indicating no ventilators, dialysis, surgery, antibiotics, or any other medication—nothing except palliative care even if I am conscious but not mentally competent—have been written and recorded.

    In short, no life-sustaining interventions. I will die when whatever comes first takes me. As for the two policy implications, one relates to using life expectancy as a measure of the quality of health care. Japan has the third-highest life expectancy, at But we should not care about catching up with—or measure ourselves against—Japan. Once a country has a life expectancy past 75 for both men and women, this measure should be ignored. The one exception is increasing the life expectancy of some subgroups, such as black males, who have a life expectancy of just That is dreadful, and should be a major focus of attention.

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