A beautiful retirement village I first visited over a decade ago is going through a significant change. The site is being redeveloped, with the existing single storey villas being knocked down and replaced with high rise apartments.

Change is inevitable, nothing is forever. And when change occurs, we all have different coping styles that we may turn to in difficult times.

So what does being uprooted mean to the residents and workers?

I initially thought everyone would be devastated, but found we all cope differently. The village is very scenic, and many of the residents chose to live her specifically due to the proximity to hospitals, public transport and the city. It also has its own gardens, a pond where ducks visit, and the accommodation is made up of single-storey villas, which suited those who wanted to be on the ground floor. While change is inevitable, it was a huge bombshell that this site was not immune to the mass growth happening in Australia, and around the world. It drove home the fact that you really can’t keep living where you are anymore without something around you changing.

For the residents of this village, many never thought they would have to move away from the site, or their neighbours, at this stage of their life.

Not everyone is completely devastated though. Some residents have implemented an adaptive coping style and have already put their name on the list for an alternative village, or have even moved out. Others have adopted a passive approach, deciding they will not be dealing with it this year, but will wait until next year to act. However, for those who decided to stay and have chosen a passive approach, the change is impacting them now anyway. Some of their neighbours have already left, so on their daily walk they no longer see the same faces. They didn’t know they would be facing those changes so rapidly. So, even those who decided not to do anything now, are still being forced to face the issue.

I received a Government grant to run a group program at the village to support those who have stayed, and have been delivering an 8-week preventative psychoeducational program on site. The Wellness Adventure program is exactly the same program my licensees deliver to residents and it has been amazing to see it in action and witness the results firsthand.

I have seen some really positive outcomes in the participants. They have turned up to the session each week and I can see the benefits in terms of resilience building, problem-solving, coping strategies and self-care. While all are dealing with the same challenge of needing to find a new home in their 80s or 90s, all are processing it quite differently. They are all on different journeys.

Spending time with them, being able to hear their stories and learn more about their coping strategies has been wonderful. Not only can I help them, it also helps me to create new programs for other elders and those who support them who are going through similar challenges.

The elders from the village who have been coming to the Wellness Adventure program are actually doing okay, despite the significant change they are experiencing. They are coping well. The group has given them an opportunity to debrief and share their experience in a non-judgemental environment. It’s not group psychotherapy, it’s education. The result has been that attendees are not necessarily needing a referral toa  psychologist, as they are finding ways to adapt and cope without that level of support. This can work for others too. If you are able to bring people together in a room where they can share their experience, address their concerns, hear stories, listen without judgement and hear what others are going through, it is really beneficial.

It’s clear from this example that it’s not all doom and gloom. Residents from this village are demonstrating resilience, and leaving the program with newly acquired skills. It shows that you can build resilience in late life, and that we can help and support the elders in our care to improve their outcomes.

What you do matters. Look for ways to create opportunities for your clients to discuss concerns, where you can hear them out and show them they are a valuable member of society, and that their voice is being heard. Recognising the individual differences between people is really important to help us understand how to support them best.

Beyond the Reluctant Move book

5 Facts About Me Worksheet

Wise Care workshops

We all have different coping styles, and we’ve all been exposed to different types of stress in our lives. So how do we understand the coping styles used in late life and what we can do about it?

Stress is a normal part of life, and coping is what people do to try and minimise stress. We all find different ways of coping with stress, and managing it, often through trial and error. Even when we are dealing with the same stress (e.g. lockdowns during the pandemic) we all find different ways of coping that we feel will work for us at that time.

To understand coping better, it’s helpful to break the three styles of coping down in more detail.  

Active coping involves actively trying to solve the problem to reduce stress. It is where we take action, problem-solve and be proactive, so that we are taking responsibility and taking action to solve the problem straight away.

Passive coping is where we feel helpless to deal with stress on our own and rely on others to resolve the situation for us. We feel we can’t do it alone and need help. In late life it can often be due to a loss of confidence to address issues, where we rely on someone else to share that mental load.

Avoidance in coping is when we are in denial. We may tell ourselves this is not happening, or try and forget it. This is common in late life, for example when changes need to be made, but those steps are not taken, until the problem is much bigger.

The most effective form of coping will depend on the nature of the issue presented. For example, does it need to be tackled right now? We can’t be actively coping with everything life throws at us, so we do need to pick our battles.

In addition to the three types of coping listed above, coping more broadly falls into two categories: adaptive and maladaptive. Both include five main characteristics as outlined below:

With so many changes in late life, it can be really difficult for an older person, to use coping styles effectively. They can often get really muddled up, and the road ahead can at times seem quite dark and narrow.

We can support them through changes, by reminding them they are not alone. Supporting them should not be the sole responsibility of one person, so think about inclusion and involvement, so that others can play an active role.

At a recent event in Sydney, a presenter, a renowned psychiatrist, said something that struck a chord with me: It’s not about the tools, it’s about who will take us through them.

In other words, it’s not about resources – it’s about who will use them, how they will use them, and importantly, what happens to the information the resources provide?

For example, the ‘5 Facts about Me’ resource available on my website is a really powerful tool that allows you to get to know the elders in your care. But once you’ve used the tool, what do you do with the information? Pop it on their file? What is the process in dealing with the information?

The big question is, how will you use what you have learned in your day to day interactions?

It’s great to have information about how to improve the quality of experience for the elders in your care, however, having the resources and information alone won’t enable you to be a mental health champion. It’s what you do with the information that really counts.

Mental health champions work collaboratively, involving others in the process as needed to help older people identify and achieve their goals.

We are never too old to achieve goals, and many of my workshops and resources are centred around helping elders realise what their goals are so they can identify steps to achieving them.

When I think about tools for enhancing wellbeing in elders, it’s about uncovering the process of taking them from A to B. How do we help them get what they want in their life? How do we help them achieve those goals?

The people who help them this process are mental health champions. So, who are they?

It’s not necessarily someone with a degree or someone specifically employed in a lifestyle or health professional role. A mental health champion can be anyone who is dedicated and committed to improving mental health outcomes in an older person.

It could be a carer, nurse, lifestyle personnel, a chaplain, physio, or anyone who uses the information they have gathered from interactions and tools to improve their engagement.

So, how can you become a mental health champion?

If you are able to use your knowledge and personal attributes to enhance the lifestyle factors of the elders in your life, you are suitable to be a mental health champion, whether you are a family member, friend, allied health professional or any other person in their life.

In my experience, some people might do a 2-hour workshop (like my ‘Grief and Loss in Late Life’ program) and that might provide them with all they need to be able to recognise what’s going on for the older person, and understand when they need to escalate concerns further or access additional support.

For others, they might choose to do my 6-hour ‘Enhancing Emotional Wellbeing in Late Life’ workshop, to further expand their learning and mental health champion toolkit.

In recent times, the pandemic and natural disasters have affected access to many aged care settings. Global events such as wars and climate change have also caused triggers in some. In these times, we also need to understand how we can best support residents when so much is happening.

This is not about being unrealistic, or trying to make them happy. Instead, as mental health champions we are looking for ways to improve social connections and minimise the risk of disengagement.

Mental health champion moments happen in your day to day interactions with elders. Even if you feel like you have no more time and capacity available, if you are already communicating with clients, you have an opportunity to lead by example in your approach and interactions. You don’t need a badge, you just need a commitment to promote the wellbeing of our precious elders.

In this episode you will learn:

Links:

Enhancing Emotional Wellbeing in Late Life Practical Strategies Workshop

5 Facts About Me Worksheet

Grief and Loss in Late Life Workshop

Beyond the Reluctant Move book

What are the signs and steps to psychological support in late life

I get a lot of emails from people asking about the signs and steps to psychological support in late life. For example, maybe you’ve identified that a client or family member needs help, but are unsure of the next step. Or perhaps you’re not sure whether support is even necessary.

An older person may say they don’t need help, even if they do. This age group is the least likely to engage support, often because they don’t understand the benefits.

So firstly, it’s really important to identify the signs that indicate psychological support might be needed.

It could be that you notice they are having difficulty adjusting to their environment or are struggling with grief. Changes in their life or in their roles can also play a part. For example, they may have recently gone from living independently to needing care and support. Accepting these big changes in what they are able to do in their daily life is a huge adjustment.

Many of these circumstances are unavoidable. What we are looking for is the older person’s ability to adapt, both internally and externally.

Remember to look for signs in a range of areas, such as emotions, thoughts, behaviours and physical changes. They may feel anger, guilt or sadness, or think life is overwhelming. They may behave differently, avoid activities and want to stay home. A lack of motivation, weight loss or gain and changes in sleep may also be observed.

If you do notice signs, how much are they impacting the quality of their life? And where is the line that you draw when you say, okay, we need to do something about this? The rule of thumb is, if the signs have persisted for more than a couple of weeks, we should seek support.

The first step is generally to speak to a GP to seek advice and arrange a referral for psychological services. I recommend you do this sooner rather than later. However, if you think there is an imminent risk of harm to themselves, it’s essential you act immediately.

Things have changed and mental health professionals now realise that it’s important to make psychological services accessible, easy and affordable to those in late life, so a lot more travel to visit residents in their home. Telehealth is now accepted as a normal way of delivering services and support, so if an older person has concerns about leaving their home and home visits are not available, it is still possible to get help. There is also a range of supports available that don’t require a GP referral such as Swinburne University Wellbeing Clinic for Older Adults.

We need to let older people know that it is normal to seek help when it is needed. Support is there and sometimes it’s just a phone call away.

In this episode you will learn:

Links:

Lifeline

Swinburne University Wellbeing Clinic for Older Adults

Australian Centre for Grief and Bereavement

Learn more strategies for delivering positive care in my book Beyond the Reluctant Move  

Sadness vs. depression

What is the difference between sadness and depression? And how do we know if an older person is experiencing one or the other?

Firstly, sadness is an emotion, and we all can get sad at times, while depression is a mental health condition.

The difference can be seen in terms of persistence of symptoms (how long they have been there) and the level they are affecting the person and their functioning in day to day activities and engagement.

There is an overlap between sadness and depression, but it’s really important to avoid giving labels to what is going on unless you know the person, and have the qualifications to assess them.

It’s not uncommon for an older person to deny they are depressed, even when they are displaying symptoms such as feeling low, crying a lot, lacking energy or are struggling to concentrate.

In this case, we need to consider, what is the benefit of having that label of depression? Is it helping that person?

There is much in modern life that might make people sad – floods, fires, rising costs of living to name a few. No-one is happy about any of this, including older people. We need to remember that sadness is a normal response and emotion to external events that make us upset.

However, depression is not just about emotions, there’s much more to it than that.

We know that for depression and anxiety, the best outcomes are achieved when we take a combined approach of talking to a psychologist, taking medication (if needed) and making changes to lifestyle factors. When it comes to lifestyle, we can all support an older person in this area. You don’t need to have a degree or be a health professional. Small acts like taking the older person outside, helping them to engage with others or playing their favourite songs. These acts all make a difference.

In general, if symptoms persist constantly for at least two weeks, it is an indicator that depression may be the cause. This includes emotions, thoughts, behaviours and physical symptoms.

Emotions may include sadness, irritability and anger. They may feel helpless and hopeless. Thoughts can be frequently self-critical. An older person experiencing depression might also have impaired memory and concentration. We can often jump to the conclusion that this means the person has dementia, but these symptoms exist in depression as well. Depression and memory issues can be reversed if the person gets the support and treatment they need for their depression.

Often, a combination of behaviours, emotions, thoughts and physical conditions they have can make them question if they want to keep going.

So, how can we help people before they get to that stage? What can we do?

We know that lifestyle changes is something we can all help with, and this must happen sooner rather than later. Because otherwise, there comes a point where their physical health declines, and they may never want to get out of bed. It’s then really hard to re-engage them after this point.

You don’t need to be a psychologist to encourage an older person to engage with others and enjoy nature. Avoid jumping to conclusions and labelling if you are not qualified, instead focus on giving them hope that things can improve, even though their health and care needs are changing.

In this episode you will learn:

Links:

Enhancing Emotional Wellbeing in Late Life Practical Strategies Workshop

5 Facts About Me Worksheet

Beyond the Reluctant Move book

Loneliness and isolation are common in late life and two terms used interchangeably, yet there are not the same. Sometimes loneliness and isolation are normalised as part of ageing, and more recently with the pandemic and restrictions associated with COVID-19, isolation is attributed to minimising the risk of infection and spread of the virus.  So, how do we define them?

Broadly, the difference between the two terms sits in subjectiveness versus objectiveness. What do we mean but that? 

Loneliness is subjective and can be social and emotional. It is about how the person perceives their relationships with others and if their emotional needs are met. What type of relationship does the person have with their children, neighbours and friends? 

Isolation on the other hand is objective. The relationships with others may be there but the individual may not be reaching out and connecting with others. Perhaps the family lives in another town, state or overseas, perhaps they have friends but can no longer visit them since they stopped driving or the older person has moved into a new environment and can no longer organise social activities independently. 

- How we define isolation, particularly during a pandemic

- How we define loneliness and why it is a feature in late life

- Strategies to boost engagement for older adults

- The impact of COVID-19 on engagement and wellbeing in late life

Buy my book "Beyond the Reluctant Move"

Find out about my Courses

Download my popular Resources

Working in aged care is rewarding but can also be challenging. The last two years have been particularly difficult with increased work demands. In this episode we discuss the importance of examining this topic, organisational support and involving the workforce in the quality and improvement process.

Buy my book "Beyond the Reluctant Move"

Find out about my Courses

Download my popular Resources

In this episode we discuss the challenges of experiencing client turnover in aged care. We will cover communication styles, resilience building activities and the importance of self-care strategies.

Buy my book "Beyond the Reluctant Move"

Find out about my Courses

Download my popular Resources

If you are supporting an older person chances are they have experienced a loss. It may be necessarily be the loss of a loved one, it could the loss of independence, value, role and meaning. In this episode we discuss strategies how to support clients with multiple losses.

Buy my book "Beyond the Reluctant Move"

Find out about my Courses

Download my popular Resources