In 2014 Atul Gwande published his seminal book, Being Mortal, exploring end of life values and perspectives by the medical establishment. He says, “As people become aware of the finitude of their life, they do not ask for much. They do not seek more riches. They do not seek more power. They ask only to be permitted, insofar as possible, to keep shaping the story of their life in the world– to make choices and sustain connections to others according to their own priorities.”
Dr. Gwande is making a case for offering opportunities for older adults to sustain a sense of self-determination and purpose. How in the world can we do this? Following are a couple of examples that begin to meet this challenge.
In Canada, nurses are trained to assess older adults from a mental health and wellness perspective and provide interventions to improve social and emotional wellness. In rehabilitation and long-term care settings, forming small groups for adults offers social opportunities and good interpersonal dynamics to encourage self-reflection. This is a specific, small group practice and is dependent on building in best practices for healthy groups such as group norms, structure and having the same ways of doing things each time a group meets. In other words, the way a group operates should be intentional, predictable and consistent so that group members feel comfortable sharing and reflecting. This kind of group practice can be exceptionally important for people to feel valued, relevant and seen as a unique individual in a congregate setting. What does this look like? You will see things like ground rules that support everybody having a chance to speak, guidelines for respectful listening, and focused themes and topics that inspire participation from everyone in the group. That this psycho-social approach is being integrated into nursing training is impressive and makes a statement! Healthy groups bring out the best in all of us.
Another important study found a consistent relationship between structured social and recreational programs and increased social engagement among older adults. It’s that simple. Form a small community with prepared structure, and people will engage with each other in healthy ways!
These kinds of structured engagement programs are very well received by residents in long-term care and suggest their value for reducing loneliness and promoting satisfying relationships.
The bottom line is we need to help a healthy group form. We can intentionally enable people to come together and share who they are through their personal stories and feelings. What a gift to offer; to again feel connected and purposeful in one’s world.
In these times when we can become so distracted by the threat of Covid-19 and a mandate to “separate” from each other to stay healthy, let’s not forget that we must continue to also explore ways to stitch us together in our shared humanity.