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Interview: Scientist Says the Older We Get, the More Different We Become

 

Dr. Bo G Eriksson


"Lumping all older people into catch-all categories like "seniors" can lead to discrimination," says Dr. Bo G Eriksson from the University of Gothenburg in Sweden.

In his recent thesis, Eriksson drew on research from longitudinal studies of aging among 70-year olds in Gothenburg and his work with 1000 home helpers and 500 officials in the Swedish Home Help Service for the Elderly. The study focused on individuals from 70 to 90 years of age.

"Attempting to paint the old with the same brush can lead to perceptions older adults have similar interests and values and that they are frail and dependent," says Eriksson. "I found as individuals age, these stereotypes become more and more untrue."

The new research highlights the effects of everyday conversation on health and longevity. Specifically, Eriksson shows how conversation can be used to honour the individuality of the person.

To learn more, AHB caught up with Dr. Eriksson in Gothenburg, Sweden.

Ruth Dempsey: Why did you do this study now?

Bo G. Eriksson: I retired in 2009. My research is the basis for a book on how to provide good care for older adults.

RD: You have worked with the Swedish Home Help Service for many years. How does it work? Who pays?

BGE: Home help is provided to those in need of assistance. The local community pays for the services, but individuals also pay a fee depending on their financial circumstances. Home help officers make decisions about specific services to be delivered.

RD: You tell the story of Anna and her client Ulla. As a rule, Ulla managed her daily life fairly well, but on one occasion she came down with severe influenza and was unable to manage her incontinence. The next time Anna visited, she found Ulla distraught and crying that she had to move into a nursing home. Anna assessed the situation and quickly helped Ulla to get things back on track.

Another helper may not have provided Ulla the same opportunity. What qualities do you look for in a home helper?

BGE: I look for four qualities:

1. language skills (Swedish speaking in my case);

2. the ability to understand the needs of clients, which may include:

i) assistance with daily living such as cooking or personal hygiene;
ii) assisting clients to pursue meaningful activities; and
iii) helping clients maintain their social networks;

3. the ability to help clients compensate for their losses; and

4. the ability to refrain from doing tasks for clients they can still do for themselves.

These four points are drawn from Swedish social security law, governing services to older people. However, I am sad to admit that in most cases home help officers do not comply with the law in its entirety. They neglect to help clients maintain their social networks and pursue meaningful activities.

RD: You say the older we get, the more different we become. How so?

BGE: Maybe I can give you an example. Newborns are very similar to each other. They share similar behaviours. You have to put markers on them in maternity wards in order to get your baby home. At seven, most children can get out of bed themselves but none compete in the marathon run. At 70, some adults are unable to get out of bed by themselves, and some are competing in marathons.

In other words, we are all shaped by our life experiences. We receive diverse educations and have different work experiences. We have different family experiences and form different relationships. These experiences shape our lifestyles. They give rise to different expectations and different preferences. So, as we age, we differ more and more from our contemporaries.

RD: The study uses conversation to honour the individuality of the person.

BGE: Yes. It’s so easy in my culture to see old people as dependant, lonely and incompetent. We are talking about ageism. Sadly, ageism has a second effect: some old people buy into the stereotype and become lonely, sad and incompetent.

When we engage in conversation with an older person, this can change. Gradually, we are drawn into their story. Nobody else sees the world as they do. We tune in to that particularity, that unique voice. And we begin to know their preferences, desires and the things in life that give them pleasure.

RD: And conversation can help people who are inactive or bored to tap into their dreams and regain interest in life.

BGE: That’s right. For example, there are some individuals who are frequently bored and complain there’s nothing to do. These people lack a certain trait of consciousness.

Let me explain: in ordinary life, we are often present in one situation and at the same time we are wishing to be somewhere else or doing something else.

An example: you may be working on a team project and at the same time planning a barbeque for the following Saturday. Or, maybe you are participating in a staff meeting and at the same time, thinking about your upcoming holiday in Majorca. I call the content of these wishes "dreams." It is these dreams that motivate many of our actions.

These bored older people lack dreams about what they would like to do in the future.

So, I encourage home helpers to use everyday conversation to helps their clients. I teach them the following strategy:

  • Begin by asking the client what they would like to do or whom they would like to see.
  • Probe into their earlier experiences and social networks.
  • When the client expresses a wish, welcome it, and then push them to take responsibility for its fulfillment.
  • So the home helper asks the client, "How are you going to fulfill your dream? You know that you can rely on my help to make it happen."
  • The client typically starts to give reasons why the dream is impossible to fulfill.
  • For each obstacle, the home helper asks, "How are you going to solve this problem? You know that you can count on my help?"
  • In this way, clients gradually come to the point where they want to fulfill their dream.

Most clients just want to do ordinary things like getting outside to enjoy the summer sun, but some set more challenging tasks. For example, one woman – an amputee who had lost both legs – wanted to ride a horse one more time. Wonderfully, she accomplished her dream with assistance from the home helper and employees of a riding school for disabled people.

In this way, clients learn to take risks to accomplish the things that are important to them and so elevate their mood. And home helpers learn to use everyday conversation to boost their client’s identity and nurture their well being.

RD: Everyday conversation can also boost memory . . .

BGE: Here I am talking about normal aging. So, let’s take the example of people living in nursing homes. They often complain they do not remember anything nowadays. In my experience, the main cause of this complaint is that nothing worth remembering has happened. If today is just like yesterday and the day before that, what is there to remember?

Usually, when something comforting or troubling happens to us, we share it with our friends. We tell them what has happened and get their response. It is easier to remember events that we have expressed in conversation or in writing. That is why some students make notes during classes. Talking with friends about what has happened to us consolidates the memory and helps to make it stick.

That’s one reason why it is important to develop events in nursing homes and talk about them. These conversations boost everyday memories.