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Posted: November 03, 2004

Professional Caregiving

Facilitating Legacies of Our Seniors

I recently returned from a five-day family vacation celebrating my mother's 80th birthday. It was a big one, so my sister and I, our kids and significant others met in a rental home on the beach in North Carolina and celebrated.

Something serious happens to all of us, our parents, our loved ones, when we reach the octogenarian plateau in our lives. We clearly take inventory and reassign value to the many gifts, lessons, hardships and wonders collected over the years.

Coincidental to the planning of our family trip, I was sent a review copy of a newly published book that addresses some of these very same issues. Reading it has helped me step back from thinking one of my jobs is to "manage" my mother's aging and instead, listen more, encourage life review and help support her process in this final chapter of her life.

How To Say It to Seniors, written by David Solie, a healthcare professional-turned-entrepreneur is a very interesting read, especially when the topics covered build toward the skills needed to help our family members and clients work through the last developmental stages in their lives.

Solie's medical healthcare experience gave him the insight into geriatric psychological developmental health, which plays a significant role in how an older adult handles their own aging, the losses associated with it and plans for their last years. He folds his understanding of the last developmental stages of aging into a flourishing practice which helps frail, and or disabled adults process the important life issues they have faced so that they can begin to examine how to identify a legacy, a way to leave part of themselves to their families and/or communities, after their death.

I found the reading very intriguing because he takes situations we see every day, especially those related to an older person's resistance, obstinance and refusal to take well-intentioned family suggestions to the next level. He helps us learn new ways to connect with seniors that bridge some generational gaps. He argues that before any developmental work on legacy planning can take place, control issues must be dealt with. Indira Ghandi is quoted in one chapter, "You cannot shake hands with a clenched fist."

Too often, well meaning spouses, adult children or designated caregivers try to convince an older adult to make changes that will offer the senior more safety, more security, and so forth -- but upon closer examination, really are driven more by self-motivation.

How often do we see adult children finding the perfect "place" for mom or dad, making the arrangements, handling the details, and then lo and behold the parent refuses to leave their home of 56 years, a home that is too large to manage and not designed for their physical needs? What is happening here is that the control has been usurped (again, with the best of intentions, we hope) and the senior bucks the recommendations and logic.

Control, if wrested from an aging adult, will only create more resistance. When the adult child consults with the parent, leaving the decisions in the parent's corner, the opposite occurs. The parent now is more likely to seek input where before they rejected it. Solie is clear that we might not all agree. But it does mean we have returned choice and control to their rightful owner.

Of course, it's not so simple, but the gist of the discussion on control is very enlightening, because we often cloud the issue with good intentions, then find they are discarded using illogical, but psychologically understandable, explanations. The losses incurred during the later years -- disability, loss of loved ones, loneliness, illness and decline -- create either a passive, older adult who gives away all control, or a mega-resistant and angry person, showing everyone that they still control something.

Once control issues are realigned and the older adult is more open to asking for assistance or seeking input, they are freed developmentally to focus on the biggie -- that of leaving a legacy to future generations.

Legacy, preserving how one will be remembered, is the final developmental life stage aging adults can achieve. This may be thwarted due to the struggle around control issues with family members. A diminished self worth forces the senior to "prove" their strength through resistance, even to ideas that make a lot of sense.

Legacy planning is an empowering process for one who is prepared to face their mortality, yet wants to develop a way to live beyond death, for the greater good. This can be anything from collecting the recipes or stories their family cherished to establishing a foundation for autistic children -- anything that is a way to express the values, the missed opportunities, and the life lessons they want to leave with the next generations. This is the ultimate gift we can give our clients and loved ones.

Solie takes us through numerous scenarios and demonstrates how interviewing techniques families or professionals use can be the pivotal acts that aid the person to explore the essence of their existence from which they develop a legacy and a plan to communicate it.

Control issues must be managed first, before legacy issues can be resolved. This understanding has certainly clarified family mediation issues for me, both professional and personal, and explains why the locus of control should stay with the older adult thus freeing them to do important legacy work, which when accomplished, enrich us and our communities' lives.

This is a gift I will use in my lifetime, with my loved ones and clients, as I hope my children will encourage me to step into the last years of my life with a sense of control, freeing me to work on plans for my own legacy.


Sylvia Nissenboim is a licensed clinical social worker and who has been working in the field of adult day services in the St. Louis area. She is the director of four adult care and enrichment centers for the American Red Cross and also operates a personal and professional coaching firm, LifeWork Transitions, specializing in caregiving concerns, adult day care management and other aging services, such as virtual coaching and family care giving support groups. She co-authored The Positive Interactions Program, is a national speaker, and has served as president of the Missouri Adult Day Care Association and as a member of the Missouri Governor's Advisory Council on Aging..

© 2004 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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