In a recent article in Geriatric Nursing (Vol. 29, No.6, 2008), Andrea Sherman and Ethel Mitty described how elements of ritual could be used to transform lives.
Dr. Andrea Sherman is co-founder and president of Transitional Keys, a non-profit New York-based educational, research and training organization. A gerontologist and choreographer, Sherman is a Fellow of the New York Academy of Medicine and the Gerontology Society of America. She and Marsha Weiner co-authored A Guidebook: Rituals to Improve Quality of Life for Older Adults.
AHB reached Dr. Sherman in Dobbs Ferry, New York.
Ruth Dempsey: Are there different kinds of rituals? What do you mean by ritual?
Andrea Sherman: YES, there are many different kinds of rituals.
A ritual or ritualized behavior is different from a habit because a ritual is done with intention, with awareness. In a nutshell, rituals provide a framework to symbolically mark changes that occur in life, knitting us into the greater fabric of our selves, our family and community.
RD: What sparked your interest in rituals for older adults?
AS: My interest in ritual was inspired by the anthropologist Barbara Myerhoff who identified the need and value of ritual in the second half of life. She made the point:
Retirements and funerals are crude markers for the stark beginning and end of old age. In between, there is a universe of differentiation that remains a cultural wasteland for each to calculate and navigate alone without the aid of ritual, ceremony or symbol.
Also, earlier in my career, I taught dance to older adults in many senior centers in San Francisco, Los Angeles and in New York City. I was acutely aware of the desire of many elders to share their life stories and engage in meaningful activities. Putting together dance, story and meaning led naturally to ritual and to the development of Transitional Keys.
RD: So how do you see ritual benefiting older people?
AS: Ritual provides:
RD: This reminds me of my friend, Vivian, who gave up driving last year. She drove members of her church to medical appointments for 50 years. In the article, you have a wonderful ritual to mark this important transition.
AS: Yes, this is the Driver’s License Ritual Party. The ritual helps prepare the older person for their new status as a non-driver, as well as the transition from independence to interdependence. The transition ritual is enacted through participants giving "IOU" gifts that state how they will assist the elder with their new transportation needs. An IOU might include an offer to become a "bus buddy", a certificate for a taxi ride or an agreement to provide a monthly ride to a favourite outing.
RD: What are some other rituals?
AS: Transitional Keys provides opportunities for rituals that mark major transitions in the second half of life such as launching an encore career, celebrating a landmark birthday, the birth of a grand or great-grandchild. Accepting an empty nest, rethinking one’s attitudes towards aging or caring for an aging parent.
Rituals can also mark a turning point like completing a divorce or moving to an assisted residence.
We provide opportunities for rituals during times of loss. This may include death of a family member, spouse or friend. Rituals are used to acknowledge the loss of cognitive abilities, loss of mobility or hearing. As well as motor abilities, such as speech or swallowing. Rituals of loss acknowledge and respect what is gone. They honor grief and provide comfort and support. Indeed, these in-between times can become springboards to personal meaning and growth.
RD: You champion a ritual toolkit. What’s in the kit?
AS: The objects in the kit appeal to the senses. Items change, depending on the ritual. Some staple items include: candle, bowl, stones, incense and flowers. Symbolic objects can be culturally specific such as flags, emblems or logos; specific religious objects such as skullcaps and candelabra; and personal objects, including photographs, jewelry, household items or a ticket stub from a first date.
RD: Cultural sensitivity is important . . .
AS: If you are going to "bring ritual" to a group of people, you should be sensitive to the opinions and biases that they might hold. For example, in some cultures, it is inappropriate to look strangers directly in the eye. In others, certain foods are forbidden. In most instances, simply asking what people are comfortable or not comfortable with is enough to engender trust. When in doubt: ask. Don’t assume.
RD: The research reports on a program implemented in a number of long-term care facilities. Is that right?
AS: That’s right. The program: Transforming Long Term Care Through Ritual was developed by Dr. Ethel Mitty and myself in the New York City area. We have implemented the program in nursing homes and home care settings in Manhattan, Bronx and Queens. We have also presented it at conferences nationwide.
RD: Ritual can also improve the lives of nurses and other care staff?
AS: Absolutely. Ritual is a form of creative expression that uses a variety of arts – music, poetry, dance, drama and art. It changes the environmental dynamic, fostering communication and conversation between and among residents and staff. It is vital for all those involved in the care of older adults, whether they are professional caregivers or family caregivers.
We have trained many nurses in the program. Right now, plans are underway to train the evening shift in two nursing homes.
RD: There is a host of practical ideas in the guidebook. It contains rituals, such as relinquishing a driver’s license, downsizing from a home to smaller living quarters, blessing a room and creating a Memory Jug. How can I get a copy?
AS: Just send a check for $30.00 US, payable to Transitional Keys (includes shipping to Canada), to PO Box 465, Dobbs Ferry, NY USA 10522.