"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.

They are not dead who live in lives they leave behind – in those whom they have blessed, they live again. – Maya Angelou

Sons are motivated to care for their ailing parents by strong emotional bonds and the desire to give back, a new study has found.

Researchers interviewed 48 sons providing care to an aging parent and 24 of their spouses. The men lived in and around Hamilton and London in Ontario, Canada. The first group was made up of 38 married sons. Most were working full-time or retired.

The second group consisted of 10 bachelors, who were generally younger than their married counterparts. Most were working part-time or retired. Members of this group were far more likely to be living with the ailing parent.

The research was conducted by Dr. Lori Campbell from the department of sociology and health, aging and society at McMaster University in Hamilton, Ontario. Campbell’s study was published in the Canadian Journal on Aging (Vol. 29, No. 1, 2010).

Because it’s in the family

When study participants were asked why they provided filial care, most sons replied out of a sense of commitment to the family, particularly to a parent.

For example, many sons recalled how a parent had supported them through good and bad times when they were growing up. As one son put it:

I owe her because she spent a lot of years bringing me up, but I wasn’t all that great as a kid. She did a lot for me and I just figure, at this time in her life, that she needs me there and I am dedicated. I owe her and it’s time to pay her back.

As well, most sons said they cared for their parent out of an emotional bond that made them want to offer to help, rather than a sense of obligation.

One unmarried son explained:

I make a lot of sacrifices on my own. I put him first before anything else. I believe he’s my responsibility. The way I look at it is that my time will come later, when he passes away. Then, that’s for me. Then, I can do what I want.

Surprisingly perhaps, the study revealed some single men had always felt they would put aside their lives to care for their parent when the time came.

However, neither single nor married sons felt siblings should be "obligated" to care for a parent. They felt children should want to provide care.

Closer to the heart

The study found that many participants shared close emotional ties with their parent from their earliest years. In fact, this closeness was an influential factor in the men’s decision to offer assistance.

One participant, an only child, described his feelings this way:

We’ve always been very close. My mom passed away in 1982 and it was just him and [me] left. I’m looking after him 24 hours a day, seven days a week, and it gets a little stressful sometimes. But, our relationship is so close. That’s why I do it.

However, for some men, caregiving helped warm up previously distant relationships.

As one son explained:

I was never really close to my dad in the early years. I’ve become closer to him now in the last little while just because we spend more time together. He enjoys the relationship [we] have as much as I do.

Most significantly, the study revealed all the sons maintained or increased closeness with their parent throughout the caregiving experience.

Mixture of emotions

According to the study, the men experienced a jumble of emotions – love, compassion, responsibility, frustration and guilt – in carrying out their caregiving role.

One son described how he coped this way:

Everything is all mixed together. You feel everything. You just put one foot in front of the other and whatever hits you hits you. If you want to sit down and cry then you sit down and cry, and then you kind of carry on.

Not surprisingly, the men found the experience particularly bleak when they had to help move their parent into a care facility: "In some ways, it sort of eases the pressure, but again, there’s still a great deal of guilt," one son said. "You always have the feeling, am I doing enough. It’s such a difficult thing. It’s almost like grieving."

Most of the sons felt it was important to visit their parent in the home frequently – at least three times a week – to provide emotional support and monitor their care.

Gradual process

The study found most participants had time to "grow" into their caregiving role. In the early stages, they did yard work, home maintenance and provided transportation or financial advice.

Over time, the men took on increasing care for their parent, including personal care tasks.

As one son explained:

I guess part of this is you grow into the care. Initially, it was more mechanical things that I was doing, but in more recent months, the type of care has changed and I’m doing more personal care. I initially found it very difficult. I think I am much more comfortable with them now. I really had to sort of kick myself to get my mind in gear to do it.

Growing through caregiving

When asked whether they felt they had changed as a person because of their involvement in care, all the men replied the experience had changed them.

Many sons said they had become more caring and compassionate. Some said they had become more patient, more resilient or more resourceful.

When the men were asked to describe other ways they had changed, some sons said the experience helped them prioritize what was important in their own lives. One son replied it helped him understand what other people go through. Another son said that looking after his father helped him appreciate the caring dimension of his own being:

I always thought of myself as being a caring person, but helping people in less personal ways. So when things start to get personal and intimate, I tend to get cold feet. But I haven’t been able to that with Dad. I have had to jump right in. This has helped me get some new appreciation for that part of me.

However, the changes were not all positive.

As one bachelor explained:

I used to be very outgoing, very happy go lucky, you know. Not a lot of things used to bother me. Now I find myself, some days, if I have a bad day, sort of short with people, sort of sad, and you know, sort of edgy, that’s in a negative way. But in a positive light, it’s opened my eyes that there are people that need help.

Spousal support

The study found wives played a supporting role:

• they assisted their husbands by helping with the shopping, laundry, meal preparation or by accompanying their husbands during visits to parents; and
• they provided emotional support. For example, one woman spoke about "picking up the slack" at home so her husband could assist his father.

Sons as caregivers

Unmarried sons tended to make caregiving the central element in their lives, according to the study. Many of the men found the experience emotional and stressful. Yet some unmarried sons reported they got more satisfaction from being a caregiver than did from their previous jobs: care giving gave their lives "purpose".

Caregiving was more limited for married sons. The men had to balance their involvement with their work and family responsibilities. Even so, these sons felt providing care for their parent was important and the right thing to do.

In June, the rising rate of late-life divorce was highlighted by the breakup of Al and Tipper Gore’s 40-year marriage.

Acclaimed biographer Deirdre Bair has mapped the surprising landscape of late-life divorce in Calling it Quits: Late-Life Divorce and Starting Over (Random House). Bair, whose own marriage ended in divorce after 43 years, conducted nearly 400 interviews with ex-wives, ex-husbands and their adult children.

All had been married at least 20 years. Most were in their 50s; the oldest was 85. They answered questions about the roles played by each partner, how they had come to believe divorce was their only option and whether or not life after divorce had been what they had hoped for.

Here are some highlights from the study:

• Many men and women saw their divorce as an opportunity to launch a new life chapter.
• Breakups were more about intangibles such as "freedom", "identity" and "having control" and less about secret love affairs and trading in older for younger models.
• Women initiated the splits more often than men did. Many men didn’t know what hit them.
• Many individuals were just plain unhappy. "Patricia," 63, had grown tired of juggling work as a senior administrator for a law firm, entertaining clients for her husband, a manufacturing company executive, and listening to her adult children complain about the ups and downs of their marriages. Similarly, "David," in his mid 60s, was tired of propping up his wife and kids with scant thanks.
• Mindful of the clock ticking down, some wanted a chance to live life on their own terms, even when it meant less financial security. "Anne" a British war bride living in the Australian outback, was in her 70s, when she decided she "just wanted out." Another woman, married for 53 years woke up after a kidney transplant and told her husband, "I don’t know how many years I have left, I just know I don’t want to spend them with you."
• Marriage breakdowns hit adult children hard. Many were devastated, some were angry and a few wondered, "What took them so long?"
• Men and women who wanted companionship after divorce found it. Some women took the dining and dancing and then went home to their own beds and their own houses. They had cooked their share of suppers and picked up enough socks.

Pedometer use has spiked over the past few years with the popularity of health programs like 10,000 Steps. And while fitness educators tout the pedometer as a motivational tool, a new study has found older adults fear counting steps and walking longer distances may spur competition and dampen group camaraderie.

Dr. Denise Copelton of the College at Brockport, State University of New York examined why older adults participated in a hospital-sponsored walking program. Copelton joined the walking club for a five-month period. She interviewed key members of the group and the walking-club coordinator. She also interviewed the wellness center director about the club and its history.

The study findings appeared in the Sociology of Health & Illness (Vol. 32, No. 2, 2010).

Meet the Walkie Talkies

The research is based on a walking program launched in 1998. The program was part of a local hospital’s efforts to engage older adults in physical activity, following their stay at the hospital. Members of the club, dubbed the "Walkie Talkies," received a free pedometer, t-shirt, walking club manual, activity log and resistance band (that can be stretched with the legs or arms for strength training). They met three days a week. Hospital organizers encouraged the walkers to set personal fitness goals and chart their progress with pedometers.

Since its inception, the program has undergone significant changes. Today, the walking club is open to adults 50 years and older. There are about 30 members with 8 to 15 walkers participating in any given week. They range in age from 50 to 79 years – the majority women. The Walkie Talkies meet each Thursday morning in front of the hospital entrance. They walk around the perimeter of the buildings for 60 minutes and do stretching exercise for another 30 minutes. The coordinator winds up the session with a story. Today’s club members do not set goals or monitor their progress. And nobody except the walking club coordinator uses a pedometer.

Four reasons to join the club

The author identified four benefits of joining the Walkie Talkies.

1. Health benefits

Most participants said they joined the club for health reasons. "I should be doing exercise at my age. It’s good for me," Ruth said.

And Helen remarked, "I just thought if I joined a group I’d be more apt to do it more often, more regularly."

2. Camaraderie

Over and above health benefits, the researchers said members were drawn to the club for the social aspects, especially the conversation and camaraderie.

Spontaneous pairings in the group ensured a variety of walking partners. As Gary said, "I’ve walked with just about everyone in the group at one time or another and it’s always good. It always turns out to be a positive experience."

Topics of conversation ranged from cooking, knitting and vacations to television, sporting and community events. The walkers developed social ties over time, cementing their links to the group and fostering a sense of community.

Ruth summed it up this way:

As you meet people, walk with them especially, you find out more about them. Rather than just doing your exercises and going home, you walk with them, you find out more about them, so you want to know what’s happening with them. I think sometimes I come just to see what’s going on.

3. Non-competitive

The members also appreciated the club’s easy-going atmosphere. As Doris put it, "There are no demands or restrictions or pressures to do anything, and no one says walk faster . . ."

In contrast, the women perceived aerobics and other classes at local gyms to be inherently competitive. In such settings, participants felt they would be judged negatively in terms of their physical abilities, age and physique.

4. Non-hierarchical

Finally, the study found that walkers considered the use of pedometers to be incompatible with the "come as you are" ethos of the club. Simply put, they saw pedometers as symbolizing competition and the potential for hierarchy. As Helen explained: "I’ve never been competitive . . . if I’m doing something, I will do it well, but I don’t need to outdo somebody."

Give talk a chance

According to the study, health and fitness promoters see pedometers as a handy low-cost tool for measuring walking activity and monitoring fitness goals. But for walkers, talking and social enjoyment trumped health goals and physical activity. In other words, participants were attracted to the Walkie Talkies for health reasons, but a sense of camaraderie kept them coming back week after week.

Copelton concluded, "Health campaigns that structure walking as a social activity may find a more receptive audience among older adults, especially older women."

NEW FRENCH SUBSIDY FOR THE DYING: Last February, the French government passed legislation to ensure that individuals caring for a dying relative or partner received payment. The unanimous vote entitles individuals, who take time off to look after a relative close to death, to a payment of 50 euros (about $65 Canadian) a day for 21 days. As Andrew Brown of The Guardian wrote: "What the payment does is to register the state’s belief that to tend a dying friend or relative is a worthwhile activity, which should be honoured and not needlessly impeded."

 

BLAZING NEW TRAILS: After retiring from the nursing profession, Barbara Hillary looked around for something interesting to do. The native of Queens County, New York City, was soon dog sledding in Quebec and photographing polar bears in Manitoba, Canada. Then, at the age of 75, the spunky lung cancer survivor became the first African American woman on record to ski to the North Pole. Hillary has told AHB she plans to ski to the South Pole and break another record in January 2011.

 

DANISH GOVERNMENT GREENLIGHTS BABY SEAL ROBOTS: Why has the Danish government purchased 1000 baby seal robots? To find out, watch the video at the International Federation on Ageing website. For news about Canadian researchers investigating baby seal robots, see Interview: Robot Companions for Older Adults.

 

MOBILE MALL MAGIC: Every other month, the Seniors’ Mobile Mall arrives at East York Acres community housing in Toronto, Ontario, creating a buzz and lifting spirits. Launched in 2005, the mobile mall is a traveling clothing bank that provides quality clothing and stylish accessories free of charge to people with low-incomes. Individuals can also pick up sheets, blankets, tablecloths and towels.

"I was lucky or else I would have been out of pants this year," smiling resident Glen Maloney told OpenFile.

The Mobile Mall is the brainchild of Cindy Blakely, co-founder of New Circles Community Services, a Toronto charity.