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Emotional & Intellectual Wellbeing

Interactions.

Each human being is a unique combination of body, mind, and spirit and we should be aware how all these interact. For example, some people can have powerful emotional responses while facing the many challenges which life presents. So some may often appear cheerful and optimistic while others are anxious and unhappy. In later years, we usually continue our basic moods, but the ways we express our feelings can become more obvious.

Depression:

Signs and Causes
In the midst of losses, such as physical deterioration, the death of friends or loved ones and reduction of income, some older people can show signs of depression. Some things to look for are:

- inability to concentrate or make decisions,
- lack of feelings of enjoyment, or enthusiasm even for doing those things that were favourites,
- little interest in eating (causing weight loss) or changes in eating habits (overeating causing weight gain),
- lack of interest in being with other people,
- feeling unwanted and worthless, sometimes leading to the thought that life is not worth living,
- sadness or crying spells for no apparent reason,
- problems with sleeping (sleeplessness during the night or excessive sleep during most of the day),
- feeling tired most of the time, regardless of adequate rest.

If people brood about their unhappiness, most of their energy is drained by worry. Some of this worry may be an unlikely fear that they will become forgetful and unable to manage their affairs. This worry can lead down the path to more depression, which may cause physical problems.

In exploring the cause of depression, the following questions should be asked:

  1. Is there an underlying physical or medical problem causing the depression?
  2. Have there been changes in hearing, seeing, moving, or other bodily abilities?
  3. What social contact does the care receiver have?
  4. What are the opportunities for feeling wanted and needed?
  5. Have any friends, relatives, or pets died recently?
  6. Is the lack of a good diet a problem?
  7. What kind of mental stimulation is the person getting?
  8. Has there been a difficult adjustment following retirement?
  9. Is the focus entirely on the past or is there some enthusiasm about future events?
  10. Is there any possibility of a bad reaction to medications?
  11. Is there any dependency on alcohol or drugs?

Once these problems have been resolved, steps can be taken to relieve the depression. It will take some work from both the carer and the care receiver to change habits and routines. Prolonged depression causes biochemical changes in the brain, usually requiring short term treatment with antidepressant medicines. The doctor is a good first contact to find help for treatment of depression. But ensure that any medicine is not taken for an extended period.

Suicide Prevention

Suicide is a significant and ever increasing problem. Statistics show that increasing age is a factor. Unlike other segments of the population, the elderly do not often make threats or mention suicidal thoughts to others. Therefore, it is important that carers also know other warning signs:

Successful suicide can often be prevented.

If the person you care for shows any of these danger signs, you can:

Death and Dying

Any terminally ill person experiences anxiety and fear about death:
fear of the process of dying - will there be pain?
fear of losing control - will I be at another's mercy?
fear of letting go - I can't leave family and friends to an uncertain future.
fear of seeing how others will avoid me.
fear of losing my carer - will he/she be turned off emotionally to me?
fear of the unknown after death.
fear that my whole life has been meaningless, unfulfilled, a waste.

You might wish to ease these fears through open discussion.

Religious faith is important to many and the subject of death and the hereafter is is well covered.
It can help to assist the person to get his or her "house in order."
This could involve updating a will, and making funeral arrangements. Also attempt to have the person and family involved discuss the situation.

If there is any feeling about the meaninglessness of life, go over all the good things done for others, and achievements, etc. Then reassure the person that had he/she not been there to do what he/she did at that time, no one else would have, and society would have been the worse for it. So he/she did truly make a difference.

Promoting Emotional Well being

It is important to help everyone remain involved in decision making as long as possible. You must stress that needing help with everyday activities does not mean that they cannot make decisions for themselves. Also, granting others the right to decide does not mean you are ignoring or abandoning them. Carers need to be sensitive to the right combination of giving just the right amount of assistance and no more or less.

Ways to promote good mental health:

encourage socializing with friends and relatives through visits, phone calls or letters
- arrange fun times such as parties or outings
- help start new hobbies or revive old ones
- listen, talk, and share feelings
- assure privacy
- treat with respect, not as beings unable to think for themselves
- encourage movement and exercise
- help them find ways to be as useful as possible
- strive to keep the lines of communication open

The Importance of Lifetime Learning

Research shows that reaction time tends to be slower in older people but they can still learn. Families and friends may need to be patient in waiting for responses. Short term memory may not be as good as it was but long term memory seems to go back to the dawn of time.

The brain helps link people to the world. If we are able to process and understand what we see, hear and absorb from our senses, our experiences will become more meaningful.

Sometimes an older person is incorrectly labelled as "senile"; the misconception being that they no longer have the ability to think for themselves. However, for the most part, older people continue to make good use of their creative powers, and as is true for all parts of the body, the brain usually will function better if it is used regularly.

Lifetime learning means exploring new ideas, whether this is from reading, listening to radio or television, trying a new hobby, or trying a new recipe. It can include lively conversation with friends and family. What it boils down to is a willingness to keep exploring the many adventures that life has to offer. The benefits of lifetime learning include more enthusiasm for life, less boredom and depression, increased feeling of self esteem and self respect, more interest in the surrounding world, and new ideas to share with family and friends.

Memory Problems

Memory loss can be one of the hardest problems for both the care receiver and the carer. Some memory problems are treatable, some are not. Therefore, it is important for the doctor to determine the causes of memory loss in the individual. Forgetfulness, even inability to recognize familiar faces and places, might result from such treatable causes such as malnutrition related to improper eating habits, alcohol, side effects of medications, loneliness, isolation, few chances to socialize with others, sensory impairment (decreased vision, decreased hearing), surgery or accident resulting in injury to body, viral infections or other illness, or depression or other mental illness.

Sensory Problems

People who have losses in hearing and vision may have trouble understanding things consequently negatively affecting their emotional well being. Basic aids to hear and see are vital. At times people are cut off from the world because of wax in the ears or worn out hearing aid batteries. Glasses may need to be adjusted or perhaps just cleaned. Good lighting, without glare, is important. Magnifying glasses or large print can make reading easier.

Confusion

For people who are confused, the following tips may be useful:

- make changes in routines gradually,
- be clear about reminders for appointments or meetings,
- write simple directions in large, clear print,
- use large labels (words or pictures) on drawers and shelves to identify contents,
- have clocks and calendars clearly visible and mark off passing days,
- make certain that medicine is being taken regularly,
- remind or dispense medicines,
- encourage healthy eating,
- encourage movement to improve blood circulation.

Challenging behaviour

It is usually best to not antagonize or confront but to temporarily remove yourself and give the unspoken message that "I love/care for you but not this behaviour."

Here are some suggestions to minimize undesirable behaviour.

1. Avoid confrontation. If this involves undressing offer alternative clothes which make the person feel good.

2. Don't argue. If the person becomes too agitated, change the subject to something completely different.

3. Reduce stimulation. Lower lighting, reduce noise (radio, TV) to soothing music, minimize items in the area to a few possessions known to the person, and avoid clutter.

4. Promote familiar objects, pictures.

5. Walk slowly with the person to reduce anxiety and stress in the muscles.

Mental Stimulation

Because many people enjoy recalling events from past years, families and friends should encourage the sharing of stories. Activities which stimulate the brain such as going visiting can add to the goal of continued lifetime learning.

Often people can become happier and more productive individuals when they are encouraged to perform useful or brain stimulating activities. The following activities are especially good for the housebound:

sew or knit,
be a friendly telephone caller,
be a foster grandparent,
be a pen pal,
save stamps for collectors,
write favourite recipes on cards and share them with others,
read books, magazines, newspapers,
do crosswords
try painting or drawing
write or record memoirs, poetry, thoughts,
keep a joke book,
care for pets or plants,
listen to music, soothing or totally headbanging!!
take correspondence courses,
play musical instruments,
start or re-arrange a family photo album,
do volunteer work,
bake for self and others,
type for self and others,
participate in radio talk shows,
or even learn to use a computer.

Anyone who is physically able should be encouraged to participate in swimming, bowling, gardening, dancing, miniature golf, nature walks, shopping, jogging and other activities outside the home.

Drawing, writing, reading, arts and crafts, taking classes, and other hobbies encourage creativity. Indoor games including chess or billiards give relief from boredom as well.

Last updated 25-02-2013