Thursday, September 29, 2016

Navigational Thinking & Being Older

We see things not as they are, but as we are.
-H.M. Tomlinson

Navigational Thinking is an effective strategy for recalibrating perspective. It
offers aging adults a process to create a more useful attitude about being older.
Navigational thinking mimics the strategy that pilots use during an in-flight
emergency. Pilots resist the natural response to panic by focusing their attention
on a set of predetermined questions that lead them to useful thinking about the
best course of action to save not only their lives, but also the lives of the
passengers who are counting on them.

Although Navigational Thinking acknowledges a decline in outlook is a normal
response to upheaval of being older, it insists that a course correction is not only
possible but is necessary to preserve quality of life.

Navigational Thinking is designed to capitalize on the unique opportunity aging
adults have to orchestrate a different outcome. To accomplish this, it provides
them with a new thinking ritual they can use to change the internal discussion
they are having about their experiences. It taps into the cognition-emotion
connection in the brain and redirects the emotional intensity of being older into a
more useful, positive perspective.

Navigational Thinking is comprised of three reframing questions that increase
control and facilitate legacy. They can be used at any time and in any situation.
This is not a quick fix that will magically transform a negative attitude back into
first half optimism. Rather, Navigational Thinking is a rebalancing tool for the
distorted thinking that being older creates, a cognitive reframing system that
slowly begins to restore a more sustainable and nurturing perspective.

Navigational Thinking questions can be asked in any order. All three questions
begin to reverse the myopia of “problem fixation” that a negative attitude imposes
on aging adults by redirecting their focus to new insights, choices, and solutions.
The questions have no right or wrong answers; they are not a test. They offer a
starting point for a new internal conversation. Like all cognitive strategies, they
are most effective when written down, reconsidered, annotated, and shared on a
regular basis.

1. What is the big picture of being older?
The years forever fashion new dreams when old ones go. God help the one
dream man…Robert Goddard
Aging brings with it losses and recovery. This is not a new experience for aging
adults who are veterans of life’s give and take. Yes, being older has painful
setbacks, but at the same time it mobilizes new channels of courage and
resiliency in a world where time is no longer vague or intangible. It also fosters a
deeper gratitude for family and friends who anchor love and support. Aging
adults are free to savor both the past and an amplified present with just enough
time to make a difference.

2. What are my choices in being older?
Ever tired. Ever failed. No matter. Try again. Fail again. Fail better…Samuel
Becket
Aging takes its toll. It is easy to become defeated by losses and setbacks.
Withdrawal and isolation are common is a society that venerates youth and sees
aging as pathology. Despite these emotional and cultural headwinds, being older
still offers the opportunity to dance with circumstances. Aging adults are free to
set the agenda and see what happens. They are equally free to change their
minds, be out of character or reclaim a dream. The same is true for
disengagements and amends. It is also possible to do nothing and dance with
the gift of each day. Aging changes many things but choice survives it all.

3. What can I learn from being older?
The wiser mind mourns less for what age takes away than what it leaves
behind…William Wordsworth
Aging leaves in its wake lessons about being older. First and foremost, aging
adults come to understand that life is hard for everyone. This transformative
insight paves the way for an inclusive empathy through patience and kindness.
Second, aging adults have come far enough to see that life always works out of
its own volition, an insight that marks the limits of their control over life’s drama.
Aging adults are called to adopt a new perseverance that is less apologetic about
being older and more accepting of the opportunity life presents without fanfare or
limits each day.
Contributed by David Solie, Adjunct Faculty, Saint Joseph's College

Tuesday, September 13, 2016

Happy National Assisted Living Week!

The week of September 11-17, beginning with Grandparents’ Day, is designated as the week to honor assisted living.  This year’s theme is Keep Connected.  In 2005, 2% of older adults used social media; today, 35% do.  It seems Granny is keeping up with the times!

Social media plays a great role in the lives of many seniors, including residents of assisted living.  By staying connected with family members who live far away, they don’t feel as disconnected and lonely.  Family members at a distance also appreciate staying “in the loop” with their loved one’s care and lifestyle.  One of my residents was reassured to Skype with her grandson while he was deployed in Afghanistan. 

The field of assisted living continues to evolve, primarily in response to market demands.  There is no standard definition of assisted living due to this ambiguity.  For this reason, those potential residents and their families should determine what services they require now, and are likely to require in the next few years.  Costs will vary greatly depending upon the services offered.  If the loved one can still be independent with many household tasks, can he/she perform them?  If the person loses that ability, then can staff supplement and provide assistance? 

A valuable guide to help in evaluating needs and making decisions can be found at http://www.helpguide.org/articles/senior-housing/assisted-living-facilities.htm

During this special week of recognition, let’s express appreciation to the caregivers in assisted living, and recognize the valuable accomplishments that our assisted living residents have made.  May our understanding and provision of assisted living services continue to evolve to meet the needs of our beloved seniors!



Contributed by Philip C. DuBois, CNHA, FACHCA

Program Manager, Long Term Care Administration, Saint Joseph's College

Thursday, September 01, 2016

Gender Issues?

On May 13th, President Obama issued a directive to public schools requiring them to allow transgender students to use the bathrooms and lockers of the gender to which they associate.  If a school did not cooperate, the President threatened to take away their federal funding.  Last week, U.S. District Judge Reed O’Connor heard arguments against this directive and put a temporary stop on the order.  Several other states are suing the President on this issue.

The arguments surround two issues.  First is federal overreach – opponents of the directive claim that the directive came without time for input and that the President did not follow the appropriate rule-making process.  The second issue is terminology.  Title IX prohibits discrimination based on sex, but the word “gender” is not utilized.

Likely, this decision will be appealed and we will hear more about it in the coming months.  In the meantime, healthcare facilities can be proactive about future transgender issues.   Here are a few suggestions from the American Medical Student Association:

1.  Have a gender-neutral bathroom at your facility.  Many facilities already have bathrooms designated for family use – these could also be used as gender-neutral bathrooms. 

2.  When asking for gender on a health history form, leave a blank so that people can fill in their choice, rather than only offering two choices.

3.  Use gender-neutral language when discussing a patient’s partner.

4.  Be aware of health disparities and inequalities that occur in the transgender population. 

For more information, please see: 



References:




Contributed by Valerie Connor, MA, CCC-SLP, CHES Adjunct Faculty, Saint Joseph's College