The Immense Value of Community

Being part of community improves the mental health of aging people.

Community is a truly beautiful treasure. Last week I was at my local grocery store. I noticed the young supervisor and the bagger were chatting and no customers were around. I placed my two items on the belt and said, “You two look bored so here I am!” We all began to joke. I don’t really know them but I know them from seeing them frequently. At the local Mexican restaurant, I am always greeted with, “Kim! How are you?” when I walk in. When my neighbor goes out of town, she asks me to collect her mail. These are examples of the benefits of community. There is a feeling of belonging, and importance, of not being anonymous in a large setting.

There are different roles in the community. There are the leaders, both political and commercial. We depend upon them to get things done that benefit us all. The grocer, the pharmacist, the coffee shop, the music store, and the fish market. The doctor, the realtor, the mayor, the teacher, and the police chief. All of these people organize the community and give it structure. The rest of us support the community and create the network necessary to make it thrive. We all matter to one another in a community.When one truly feels a part of a community one feels a certain ownership of it. The grocery store, mail person, park, and schools are ours. The people, the landmarks, the weather, and the very leaves of the trees belong to us. There is security and peace from the familiarity of all the things that make up our sense of community.When one moves to a new home, especially a long-term care home, there is an end to being part of a former community and the need to start fresh in a new community. Think about how long it has ever taken you to get used to a new community whether it was a city, a neighborhood, or a company.  When an aging person has to take on the challenge of adapting to a new community, especially a long-term care residence it is harder. There are often health worries, uncertainties about the future and the requirement to become dependent upon strangers for help. There may be dementia that adds a dimension of confusion to the relocation. This level of adaptation takes time; it may be months before the person says with ownership, “These are my aides and nurses; this is my dining room, these aremy neighbors and friends.” Or better yet states, “I’m in charge of this committee, or I helped plant those flowers, or this is where I take my weekly class.”A question that might arise in response to the adjustment period would be, “Should I take mom to visit her old home?” That depends upon the individual and how tough the adjustment is. For someone with advanced dementia, returning to a familiar setting for a brief visit might cause confusion and aggravation when it is time to return to the new community. For someone who is mentally healthy and played a big part in the choice to move to a long-term care community, it might be an excellent idea to go back to the old home to see familiar faces and sights on a regular basis. However, as a mother who has just seen her second child off to college, I think there is an advantage in immersion in the new community before going back to the old. Allowing someone a few weeks or months to develop ties to their new surroundings may then make it easier to travel back and forth between the old and new communities with ease.Community is so valuable to our mental well-being. It is more than just a physical home; it is a home for our hearts and minds. Helping someone to feel part of their community is a gift no matter how long it takes to achieve it.

Mental Health and Your Loved One

Mental health changes can occur in a skilled nursing home. Therapy can help improve quality of life.

What are poor mental health symptoms?  Depression, self-isolation, excessive crying, anger, verbally or physically lashing out at others, loss of appetite, trouble sleeping, thoughts or talk of suicide.  Why do our loved ones in long-term care have mental health issues?  Moving into a long-term care home, even the finest home, is an adjustment. There is often a sense of loss: loss of independence, loss of the former residence, loss of pets who could not move to the new home, loss of familiar faces, loss of personal furniture and belongings that could not fit in the new home, loss of choices about how the day proceeds. There is a change and it is stressful. The stress from the move can be confusing and may bring up other emotions such as anger at life in general, resentment toward family members who brought them to the new home, fear that life as they know it is over or coming to an end.  My loved one has been in a long-term care facility for a long time. Why are there suddenly mental health problems?  Even if a person has been living happily in long-term care, changes in their mental and physical health, admission to hospice, changes in their surrounding, or frustration with the ongoing need for long-term care can cause mental health to decline.  


 What can be done to help with a loved one’s mental health?  There are a number of things you can do to help.  1. Visit when you can. When you visit, bring a treat such as a food item they do not receive in their new home (check with nursing staff to make sure it is compatible with their new diet), a new item of clothing, a new photo of grandchildren, or flowers. Give them your full attention and ask them how they are doing. If possible, accompany them to a meal or activity and get to know the other residents and their families. This will create a sense of community for you and your loved one, and help them get to know the activities offered.  2. Take your loved one out of the long-term care home for occasional meals out, shopping, or family gatherings, if it is possible for you to safely transport them.  3. Ask your social services director if mental health counseling can be arranged. A licensed social worker or clinical psychologist can meet with your loved one once per week, if needed. During the session, your loved one will be able to talk to a professional for 30-45 minutes and they will receive coaching on how to deal with the issues that are bothering them.  4. Ask your social services director if you and your family can meet with a mental health counselor to help you all deal with issues involving your loved one. The move to a long-term care home is an adjustment for the family, too, and a session with the counselor can help you to better help your loved one. You can choose to involve your loved one in the meeting or you can meet privately.  In many cases mental health counseling is covered 100% by health insurance. For some people, there is a small co-pay for each session. GCSI will investigate the co-pay ahead of time to help you decide if you want to proceed with counseling.  Together, you and a GCSI counselor can help to make life easier for your loved one. Please talk to your social services director today.  


Plan for Aging. Focus on Living.

Staying engaged in life helps the aging improve quality of life.

Inviting children to visit residents in nursing homes is not a new concept. When I worked in a nursing home, babies came to visit with their moms every month. The residents loved to watch the wide-eyed children crawl and toddle around the room. For many residents, the scene probably brought back their own memories of parenthood. For most of them, it was also a reminder that life continues to flourish despite what it might feel like inside the nursing home.

Because it is difficult not to focus on illness, aging, and disease when you’re in the thick of it, it’s wonderfully healthy to be reminded that there is a world outside of yours.

This week in my social media newsfeed, two items popped up about kids brightening the days of older people when they visit. One post was a promotion for a British television experiment with older people engaged in a six-week experiment living with four-year olds.  This clip was especially enjoyable because it featured a man who stated he had little interest in the children. He wasn’t particularly excited about their visits but the impact that the kids had on him was endearing. His energy picked up; he stopped using his cane for one morning; and he went so far as to sit down on the floor in spite of his own physical limitations to interact with them and make them laugh. A link to the program is below.You might expect to see a negative aging attitude in a grumpy older person but negative feelings about aging often start much younger. Some middle-age people decide it is a topic that needs to be thought about and talked about frequently. They plan their retirement and their housing well in advance for aging in place. They read studies and alter their exercise and diet to reduce their chances of dementia or heart disease. They start scoping out 55+ communities so they will be safe when the time comes. They accept it as a fact that they won’t be able to climb stairs, that they will have dementia, that they will face a long slow decline. So, they make decisions while they are still young to accommodate a frail body and mind. They approach aging with practicality and a mixture of dread and fear.Others prefer to focus on their vitality while refusing to acknowledge aging. They don’t want to think about getting older and would rather take steps to alter their appearance and their lifestyle in an attempt to stay young forever. They don’t want to plan or research for the future and they don’t want to talk about what should be done for them if they need help in their old aging. If they don’t allow old age to have purchase in their thoughts, it won’t happen to them.For those who have already reached the age they consider “old” life can be challenging and it’s hard to think about anything beyond their pain, discomfort, decline, and imminent death. For other elders, life is still wonderful. They look back on their lives with satisfaction and are grateful to have had a “good ride.” They have planned the rest of their time here as well as their dying. Their advocates know what to do and what not do on their behalf, giving peace of mind to the elder person.Ideally, you want to be in the latter group at the end of your life. You want to have taken some time to think things through so that you are prepared. But you don’t want to have obsessed over aging and you should not assume that you will be disabled or have dementia.

Most people have every possibility of having a healthy and fulfilling life to the end or pretty darn close to it.

From the time we are young we should be a bit like the first group of people I mentioned and give an occasional thought toward the future. Where would you like to live? Do you want to age in place in your own home or would you like a retirement community? Do you have family who will take care of you no matter what, or will you need to hire some help? Plan your finances accordingly. Save more than you think you will need! Very few people say, “I’m 85 and I have too much money to meet my needs!” But once your savings plans are in order, you don’t need to think about it anymore.While you are planning ahead, be like the second group of people I wrote about and focus on your youth and good health, if you are lucky enough to have it. Is there a disease that runs in your family that you want to work on now? Good to know! Make adjustments, see a specialist once in a while, and then do your best to focus on the positive area areas of your life. Or you can work on the disease metaphysically. Either way, stay in the positive zone. Do you have opinions about life-saving treatments you wouldn’t want if you were unable to speak for yourself someday? Make sure someone reliable knows how you feel and will represent you. Then don’t give it anymore thought.

The important thing is to live now while maintaining a little balance with thoughts toward your future.

We want to be mindful of what is happening in our lives right now. Right now you are alive! Few of us at this moment are actively dying. By actively dying, I mean lying in a bed, spending most of our hours asleep, barely cognizant of the world around us. Until that point, we are still living, and we need to be savoring our precious gift. Spending time with friends and loved ones, interacting with children who are just beginning their journeys, caring for animals, and observing nature all help us to be in the now. Aging is a part of life and an adventure that only lucky people get to face, but it should not be an obsession that prevents us from enjoying that we are living and that beautiful life is going on all around us. Like the man in the nursing home who left his cane behind, stay engaged in life.