Doris Bersing, PhD
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Ageism and Sexism

Fighting Sexism and Ageism: We Need A New Paradigm for Old-er Women.
Ageism

I was stunned, when Debbie—my 67-yer-old client, who has one PhD in American history and a JD—told me that her contract as full-time faculty at a local law school had not been renewed. She is vivacious, energetic, intelligent, and adored by her students. I asked  immediately, why? She has always told me she was on the “retire-at-85” plan and as far as I knew, Academia is supposed to be a world of respect and knowledge; a place where attaining knowledge and wisdom are regarded as the ultimate achievements. Nonetheless, Debbie told me she was forced into retirement! Debbie had spent 25 years of her life as a professor for several graduate and law schools, during which time she had received many awards for research and groundbreaking work. Now, she said “retirement has been forced on me, and my courses have been assigned to young-er faculty members, who are less expensive. For the first time, I have faced ageism as never before, and it is not a theoretical concept, anymore. It is real.” She, too, was shocked.

Yes indeed, ageism –although an old paradigm—is still in full force, current and pervasive permeating all layers of our society. Perhaps it is time to kick this new old paradigm with its ill-fated consequences for our society’s well-being to the curb and embrace a different more optimistic, engaging, and active paradigm of aging: one that does not fear aging but embrace it as a very meaningful and with great potential phase of life.

Sexism

Like we did not have enough  with the ageism in our culture, we also need to face Sexism.  The prejudice, stereotyping, or discrimination, against women, on the basis of sex is a fact very well known in all fronts of society and affects women of all walks of life. Instances of sexism are experienced by our mothers, sisters, daughters, granddaughters, and all women and girls around the world. It is one of those phenomena would like to have the exclusivity of it but it is not like that. It is pervasive and perverse all around the world.

Sexism is based in the prejudice and extensive generalization that there is something faulty in women and  it continues to impede women from their rights to grow and thrive in our society. Perhaps we are not as pretty and firm as we were when young-er but seasoned –or spicy, hot women—had fought for equality, diversity, had raised their self-esteem, run for public office. They have shaved off their internalized ageism and are ready to venture in new characters, created new connections, and created a new wave of accomplished women who give us the inspiration we need to live as first-class citizens and make our golden years shine and count, and do what needs to be done.

Not all of us get to that place and nevertheless, it is worth trying. A place where we can branch out, revolt, or go quietly happily ever after about life. Whatever works for you do it with gusto! Let’s this new woman be at the top of the hill and not over the hill. She can change her image of a raggedy crone to the one of mentor. to be proud and loud.

As many of us who are undertaking the journey through the uncharted land, we become pioneers with no maps but following our moral compass to be the best we can be. Being the eternal optimistic and positive thinker, she is, at 80 Ms. Steinem finds herself more productive and at peace than ever.  “…A dwindling libido, she theorized, can be a terrific advantage: “The brain cells that used to be obsessed are now free for all kinds of great things…” 


Preparing Your Home for Alzheimer’s: Tips and Advice for Caregivers

When caring for a loved one with Alzheimer’s disease or other type of dementia, the safety around the home is a very important issue. Caregivers, here you can find some tips and advice in regards to keeping your home safe.

Some Facts About Alzheimer's Disease

Today,  about 5.4 million Americans suffer from Alzheimer’s disease, with the majority of them being aged 65 or older. Safety at home is a very critical issue when caregiving for somebody with Alzheimer’s disease. Safe at Home is the key. Progressive Alzheimer’s disease makes it impossible for people with it to take care of themselves. Many of them require care 24 hours a day, seven days a week. In order to make that possible, many people with Alzheimer’s move into a loved one’s home for caregiving.

Alzheimer’s disease is a severe form of dementia associated with memory loss as well as the loss of other cognitive abilities. The symptoms can be serious enough to eventually interfere with daily life. If a person is experiencing Alzheimer’s, you may start to notice:

  • Changes in personality and interests.
  • Difficulty making decisions.
  • Problems concentrating and general cognitive struggles.
  • Long-term and short-term memory loss.
  • Confusion with places, people, and timing.
  • The inability to complete tasks that require sequential steps, such as getting dressed or making a meal.

Caregiving for a person with Alzheimer’s disease is not easy. It’s difficult to watch people you love deteriorate and grow unable to do even the simplest things they used to enjoy. However, taking in people with Alzheimer’s gives them the opportunity to spend the rest of their lives surrounded by the people who love them while enjoying comfort and care. In order to make your home as safe as possible for a loved one with Alzheimer’s disease, you’ll want to make a few preparations around the house.

Their Private Room: A Place to Escape

One of the utmost important things about caregiving for people with Alzheimer’s is preserving their dignity and showing them respect. Loved ones need a room of their own where they can have privacy and a place where they can escape the noise and confusion of outside. Their room should be safe, comfortable, and easy for them to move around in. Provide them with all the things they love whether it is a stereo for music, books, blankets, or a television. Remove hazardous decorations that can break or shatter upon impact. It’s also helpful to give them a room on the first floor near a bathroom for accessibility.

Bathroom & Kitchen Safety

The bathroom and kitchen are the most dangerous rooms in the house. If you are taking in Alzheimer’s patients for the long term, it may behoove you to accommodate these rooms for them with a remodel. To do this, you have to take cost into consideration. For instance, the average cost to remodel a kitchen is $19,589. There are several ways to modify your kitchen for safety. Considering the amount of dangerous tools and materials in the kitchen, locks on drawers and cabinets containing these things can prevent loved ones from hurting themselves. Some people also put locks on the refrigerator as the disease progresses. If the room contains steps or stairs, a safety ramp with rails to hold on to can help your loved one navigate the area safely.

When changing your bathroom, it’s important to make it accessible for loved ones while reducing hazards that can lead to a fall. Grab bars or side bars near the toilet and tub can help them get up and down safely and with ease. Label all water faucets clearly so they know which one controls hot and which controls cold. A scalding burn can be a devastating injury. Finally, make liberal use of non-slip mats, stools or chairs, and lighting.

If you are one of the millions of Americans who takes in loved ones suffering from Alzheimer’s disease, you’ll need to prepare your home to make a safe, comfortable environment. Providing them their own room is paramount; it’s important to respect their privacy and preserve their dignity. You may also want to consider making renovations or modifications in the kitchen and bathroom. These rooms are important but contain plenty of hazards you want to avoid.


Older’s American Month: Age Out Loud

Each May, the Administration for Community Living (ACL) leads our nation’s celebration of Older Americans Month (OAM). ACL designed the 2017 OAM theme, Age Out Loud, to give aging a new voice—one that reflects what today’s older adults have to say.

This theme shines a light on many important trends. More than ever before, older Americans are working longer, trying new things, and engaging in their communities. They’re taking charge, striving for wellness, focusing on independence, and advocating for themselves and others. What it means to age has changed, and OAM 2017 is a perfect opportunity to recognize and celebrate what getting older looks like today.

Marianne Gontarz York, portraits one of our older Americans who live and age out loud. She says on the Newsletter of the Marin County Commission on Aging “…There is no one I can think of who exemplifies this more than Barbara Borden… a 71 year old drummer [who] has lived her life out loud” Read More

Forbes published that according to the Administration on Aging (AoA), to Age Out Loud means “having the freedom to live with dignity, choice, and opportunities.” … and they comment on 10 Ways All Ages Can celebrate Older Americans.

    1. Talk to older people everywhere. Find out what they have to say. Learn about their experiences. Interview people in your community who exemplify what it means to Age Out Loud. Gather a mix of individuals, such as older public servants, elder rights advocates, back-to-schoolers, moms and grandmas, athletes, authors, retired professional people who broke barriers or people trying new careers. Everyone has a story. Share your interviews through written pieces or videos.
    2. Arrange for older adults to share or read stories in a workshop or for a “Senior Day” at a local school. Find out about older adults reading books to children at a local library.
    3. Teachers and others, help local school students set up interviews with residents of a retirement community, assisted living community or nursing home, and write short biographies for a school assignment. Plan a program for wherein the students would read aloud their stories. Invite families of students and seniors and even the media to attend.
    4. Ask your older followers and friends on social media to share their wisdom, tips and stories online. You can use a unique hashtag or post to a page or forum you create or manage.
    5. Arrange a celebratory event with a community leader or keynote speaker from your community. Invite community members to a special event celebrating older Americans. It could be a sit-down meal, a networking gathering or a special program like a storytelling or talent show. Plan activities that will result in proceeds like those from a raffle, and donate the funds to a local charity or program or agency that supports older adults.
    6. Plan a volunteer event for older adults who want to give back. The purpose could be anything from picking up litter or gardening in public areas to collecting clothing and food donations for those in need. If you need ideas visit Serve.gov.  If resources are available, create matching volunteer t-shirts that say “Age Out Loud!” This creates a sense of unity and raises awareness among those who see your group volunteering.
    7. Coordinate an education event like a resource fair, class, workshop or lecture a topic covered by this year’s theme. The gathering could hone in on self-expression with activities like painting, acting and singing or focus on maintaining health and independence with a yoga or strength training class. Nutrition tips can be added to any wellness event. Consider teaching a group about self-advocacy, technology or starting a new career.
    8. Help an older person gather family photos and make an album or scrapbook about their life and the legacy they will leave.
    9. Consider participating in a life review project such as The UMSL Life Review Project at the University of Missouri – at St. Louis, where Dr. Tom Meuser, Ph.D., clinical psychologist, applied gerontologist, and director of the University of Missouri-St. Louis’s Gerontology Graduate Program is recruiting older adults and their adult children in pairs to either be interviewed or complete questionnaires in support of his research. He will be recruiting through July 2017 and welcomes participants to contact him by email at meusert@umsl.edu to volunteer or learn more. The project flyer can be found at here. https://sites.google.com/a/umsl.edu/legacy-project/home.
    10. And finally, simply spend time with an older person, no matter what age you are. Chances are you can learn a lot from them and vice versa. Read the article


Thinking of Dementia and Identity

DB smTime goes by and I realized, I am getting old-er …although it is not a discovery, it is for sure, a daily fact. One that shows on the mirror more often than before. Always when thinking about getting older, given my line of work (gerontology, among others), I think: what if…what if I get dementia?

Most of us spend a big part of our life searching for meaning, trying to find our identity, and although Thomas Szasz said in The Second Sin (1973) said “…the self is not something one finds, it is something one creates…” we set ourselves for the pursuit of that elusive identity and our meaning as human beings. What is life all about and overall what is our role in life? What do we really live for? Who are we?

We pass many of our prime years looking for our identity, fighting for one, trying to assert one if we are ever given a glimpse of it, wrestling to have our needs met and to have our dreams come true. That search for identity comes sometimes in a puzzle of circumstances, challenges and exploits, and like the overprotected Nemo, we need to swim the oceans of uncertainty and grow until finding ourselves

Through the journey in search of our identity, we attempt to unfold our potential, our desires, and to adjust at the best of our abilities to the challenges of daily life. We build our life upon joys, shadows, and sorrows and fill that life with the mementos and the facts we carve in our memory, those we gathered throughout our journey but one-day, zas! You are diagnosed with dementia. There you are, all of the sudden lost, confused and soon to be stripped, if not of your identity, at least, officially, of your mind.

I know, hopefully, we all have been lost in our minds out of excitement, passion, or love and yet, after the diagnoses you will not be lost in your mind, anymore, since now, your are losing yours. Of course, we could discuss what really mind is, there is so much more to the mind than the cognitive aspect of it and yet for any purpose is THAT mind the one holding your memories, mementos, treasures, pains, and joys that is ready to go with the wind. Well in reality, with the plaques and tangles created in your brain, in a certain time you will not even remember the time of diagnosis. Just as Clark Gable stated while playing Rhett Butler in Gone with the Wind, stated, you may well say: Frankly, my dear, I don’t give a damn….” But he clock is ticking.

Professionals will offer all what they have. They talk and teach how to calm you down, how to deal with your mood swings and your challenging behaviors but do they really know what we are going through, what you are going through? Do they know that you are going through the tunnel, in and out of the darkness, the uncertainty with the challenge of living an existential tale of the here and now, for which, you did not sign up and for which, effectively you have never practiced. Then come the drugs, the optimism, the clinical trials, the walking to fund more research, hopefully before it is too late for you. Looking now for a different meaning. There is so much that is done, said, so much still to do and yet nobody really knows what you are going through.

We try and theorize about the phenomenon, the neurological, psychological, emotional, and practical side of it, even the spiritual side of it. Needless to say, we appreciate all the nice legitimate attempts people make writing new books about breakthrough treatments and findings; they present lectures, write articles about you but what if you could really explain how it is to know that your life is slipping away, fading away? What if you had a voice? What if they found a cure?

I wish I could be more helpful, but I really do not know how it is, all is in my best efforts to explain a phenomenon, I can only observe and witness with powerlessness, compassion and horror. I do not have dementia and I wonder if I had it how I would feel? What would it be like? Again, I do not know but if I could, if I were you, I would not like to go there. That said, I hope I would react calmly and with patience for myself, although I doubt it but let the journey continue and keep on swimming.

For now, I find some solace and motivation to keep ‘on swimming in Thoreau’s wisdom:

“…I went to the woods because I wished to live deliberately… only the essential facts of life, and see if I could not learn what it had to teach, and not, when I came to die, discover that I had not lived. ~Henry David Thoreau, 1854


Resilience: The Client as an Active Agent of Change

Copyright : johan2011
Copyright : johan2011

Accepting we clinicians are not as mighty power as we , sometimes, want to believe, and as much of a blow to our egos, it can be, there is a fact we need to recognize as such: human resilience and people’s self-healing powers count for positive outcomes after traumas and strenuous circumstances, equally effectively or more than proven therapeutic approaches.

A very respected and renowned colleague of mine, Dr. Arthur Bohart always reminded me and anybody who wanted to listen to his revolutionary opinions in regards to the effectiveness of some therapeutic approaches or the best personality traits for a successful clinician, that human beings are more resilient that what we want to account for and that the theory of some approaches being more effective than others are more of a myth than a fact since for Dr. Bohart” the “client acts as a self-healer” and human resilience counts for more of the positive outcomes in therapy. So, what is the clinician’s role? In a way, we therapists are a catalyst or better said a witness to the self-healing process. A guide to educate and share the process with the client. In an article published in the Journal of Psychotherapy Integration, Vol. 10, No. 2, 2000, he describes the dominant “medical” or “treatment” model of psychotherapy and how it puts the client in the position of a “dependent variable” who is operated on by supposedly potent therapeutic techniques. Next I argue that the data do not fit with this model. An alternative model is that the client is the most important common factor and that it is clients’ self-healing capacities which make therapy work…” Read his article

The same concept works with the forgotten population, the older adults and elders. Resilience and aging: it’s a favorite theme of gero-psychiatrist Helen Lavretsy, MD, MS. It’s the subject of her new book, Resilience and Aging: Research and Practice and the theme of a symposium at the APA Annual Meeting in New York City. In a recent podcast, she talks briefly about interventions that can help bolster resilience and help older people recover quickly from adversity. Listen to her podcast

 

Resilience and aging: it’s a favorite theme of geropsychiatrist Helen Lavretsy, MD, MS. It’s the subject of her new book, Resilience and Aging: Research and Practice and the theme of a symposium at the APA Annual Meeting in New York City.Here, she talks briefly about interventions that can help bolster resilience and help older people recover quickly from adversity. – See more at: http://www.psychiatrictimes.com/apa2014/strategies-bolstering-resilience-older-adults#sthash.LuOVSHfT.dpuf
Resilience and aging: it’s a favorite theme of geropsychiatrist Helen Lavretsy, MD, MS. It’s the subject of her new book, Resilience and Aging: Research and Practice and the theme of a symposium at the APA Annual Meeting in New York City.Here, she talks briefly about interventions that can help bolster resilience and help older people recover quickly from adversity. – See more at: http://www.psychiatrictimes.com/apa2014/strategies-bolstering-resilience-older-adults#sthash.IleQ1IGr.dpuf


Elders, Mental Illness, and the Expertise Gap

Copyright : fotoluminate
Copyright : fotoluminate

The US population is aging rapidly. Advances in medicine have led to the expectation that the US population of seniors will grow from12.4 Million in 2000 to 19.7 million in 2030 (US Census data). As the oldest baby boomers become senior citizens in 2011, the population 65 and older is projected to grow faster than the total population in every state. Twenty-six states are projected to double their 65-and-older population between 2000 and 2030. The impact of this anticipated population increase, which has been described by some as an “age wave” and by others as an “aging tsunami,” would be felt in every aspect of society. This “tsunami” predicts that humane healthcare will soon be financially out of reach or simply unavailable for tens of thousands of elderly Americans. There is an urgent need to expand training opportunities for geriatric care providers to meet the growing demand for psychological, medical, and social services. Older adults are commonly represented in the current literature as presenting co-morbidity of many conditions and illnesses about what we will talk a little more further along but we need to  say that meaningful and engaging aging happens as well but it is often underscored. A great number of older adults lead a meaningful life, a healthy one where they take advantage of  exercising, changing dietary patterns, seeking information, relying on spirituality and/or religion, and engaging in life, I would also like to stress the positive coping skills of many other older adults.

However, mental health issues among the elderly have reached epidemic proportions and are expected to worsen in the next few decades.  Elders with mental illness find more difficult dealing with adjustment in lifestyle, such as isolation or loss of independence, and this is complicated by medical conditions or physical diseases. The most common diagnoses in gero-psychiatric patients include depression, dementia, psychosis and anxiety.

Elderly suicide currently accounts for 20% of suicides in the U.S. – the highest suicide rate in the country compared to other age categories.[1] One in four elderly over 85 years old is diagnosed with dementia and one in two with Alzheimer’s Disease.[2] A landmark report estimated that by 2030 the number of elderly who suffer from a mental illness will grow to approximately 15 million;[3] and in California alone the projected number of elderly persons diagnosed with depression will reach 1.2 million by 2025.[4] A lack of access, education, and awareness lead many older individuals and their doctors to accept depression and mental illness as a normal part of aging when it is not. Among the elderly, mental health conditions are frequently untreated or inappropriately treated; more than one in five older persons with mental disorders are given an inappropriate prescription and are at increased risk for inappropriate medication treatment.[5] As a result, many older persons with mental disorders have a lower quality of general health care and associated increased mortality.[6]

However, researchers expect there will not be enough gero-psychologists trained to handle the increasing demand for psychological services from this age group. The National Institute on Aging estimates that 5,000 full-time, doctoral-level gero-psychologists will be needed by 2020 to accommodate the increasing demands of aging baby boomers. In 1991, slightly more than 700 psychologists who spent at least half of their time working with older adults were listed in the National Register of Health Service Providers. Along with the need for more gero-psychologists, the number of adults with mental disorders and behavioral health problems in 2030 is expected to reach 15 million–four times the prior census. In addition, older adults have the highest rates of suicide of any age group.

Experts agree that adequate staff is the most important factor in good patient care. However in spite of the growing demand for elder care, the education system and the pool of medical and mental health care providers with appropriate geriatric training are extremely inadequate.[7] A lack of training and institutional support has resulted in the 27% decline in certified geriatricians since 1998.[8] In 2005, there was one geriatrician for every 5,000 Americans 65 and older.[9] Nationally, geriatric mental health specialists comprise one of the smallest groups of health care professionals. By 2010, an estimated 5,000 psychiatrists, 19,000 gerontological nursing specialists, and over 50,000 social workers will be needed to provide mental health care for elderly patients.[10]

The “expertise gap” is among the greatest challenges to mental healthcare for the elderly,[11] and the effects are already apparent in many regions of the country where two out of three skilled nursing facilities failed to meet the state’s minimum nursing staff requirements[12] and a majority of surveyed primary care physicians considered themselves only “somewhat” (66%) or “not very” (20%) knowledgeable about geriatric mental health issues.[13] Even many specialists, internists and emergency room doctors said they felt “unprepared” to deal with depression and other mental health and end-of-life issues of elderly patients.[14] Of the 145 medical schools in the United States, only 9 have departments of geriatrics; most teaching hospitals graduate internists with as little as six hours of geriatric training. Only about 10% of U.S. medical schools require course work or rotations in geriatric medicine. While many more offer geriatric courses as electives, fewer than 3% of medical school graduates choose to take those courses. In nursing there is no gero-psychiatric certification and only one-third of masters level programs offered a course in aging.[15]

The integration of mental health services in the system of care for the elderly has proven to raise the quality of care to patients and support the larger network of care facilities to increase access to, and build capacity in mental health services. Research demonstrates that the integrated mental and medical health service arrangement achieve a higher level of access to mental health care[16] and is associated with better health and treatment outcomes at a lower cost.[17] Traditional models of service and professional training programs are frequently costly, disjointed and ineffective due to their inability to incorporate contemporary research findings and evidence-based practices into usual care.[18]

There is an undeniable need for professionals who would develop a humanistic and comprehensive approach to care for elders and to see the aging process as a fulfilling part of life as well as to offer a different, humanistic approach to approach aging and to treat those older people afflicted with Alzheimer’s and other dementias, and mental challenges, while implementing the best practices with seniors diagnosed with these phenomena. These professionals will challenge their attitudes towards aging and their attitudes for working with older adults. They will attempt to develop a humanistic-existential perspective to the creative and meaningful phases of aging and the possibilities of growth and development in later life. In particular, they will be able to articulate the relationship of the humanistic tradition to this specific subject and the importance for a new paradigm that encourages unfolding wellness versus the Cartesian dichotomy of mind-body separation.

Wellness is an alternative to the split between health and illness because people move along the continuum toward optimal wellness at each stage of life by way of their own efforts. As Dr. Judah Ronch says in his book Mental Wellness in Aging: “… People have more options than to be sick or healthy; they do not have to be sick in order to take advantage of the means to improve wellness. …this is an especially important outlook for aging as a process — people can have an array of illnesses as they age and yet enjoy wellness and a good quality of life.”

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References

[1] Mentally Healthy Aging: A Report on Overcoming Stigma for Older Americans. US Department of Health and Human Services & SAMHSA, 2005

[2] The Mental Health Workforce: Who’s Meeting California’s Needs? California Workforce Initiative, February 2003

[3]Consensus Statement on the Upcoming Crisis in Geriatric Mental Health: Research Agenda for the Next 2 Decades, Archives of General Psychiatry, 1999

[4] The Mental Health Workforce: Who’s Meeting California’s Needs? California Workforce Initiative, February 2003

[5] Mentally Healthy Aging: A Report on Overcoming Stigma for Older Americans. US Department of Health and Human Services & SAMHSA, 2005

[6] Ibid.

[7] Consensus Statement on the Upcoming Crisis in Geriatric Mental Health: Research Agenda for the Next 2 Decades, Archives of General Psychiatry, 1999

[8] Wanted: Geriatricians. Dani Dodge. Ventura County Star, September 5, 2004

[9] Geriatrics Lags in an Age of High-Tech Medicine. Jane Gross. The New York Times, October 18, 2006

[10] The Mental Health Workforce: Who’s Meeting California’s Needs? California Workforce Initiative, February 2003

[11] Bartels, Stephen, et al. Evidence-Based Practices in Geriatric Mental Health Care. Psychiatric Services, Vol. 53, No. 11, November 2002

[12] Nursing homes: Stronger Complaint and Enforcement Practices Needed to Better Ensure Adequate Care. U.S. General Accounting Office (Testimony before Senate Special Committee on Aging), 1999

[13] Halpain, Maureen, et al. Training in Geriatric Mental Health: Needs and Strategies. Psychiatric Services, Vol. 50, No. 9, September 1999

[14] Decision Making at a Time of Crisis Near the End of Life. David E. Weissman. The Journal of the American Medical Association, October 13, 2004; 292: 1738 – 1743.

[15] The Mental Health Workforce: Who’s Meeting California’s Needs? California Workforce Initiative, February 2003

[16] Bartels, Stephen, et al. Improving Access to Geriatric Mental Health Services: A randomized trial comparing treatment engagement with integrated verses enhanced referral care for depression, anxiety, and at risk alcohol use. American Journal of Psychiatry, Vol. 161, No. 8, August 2004

[17] Bartels, Stephen, et al. Evidence-Based Practices in Geriatric Mental Health Care. Psychiatric Services, Vol. 53, No. 11, November 2002

[18] Ibid.

[19] Ronch, Judah L. &Goldfield, Joseph A. (2003). Mental Wellness in Aging: Strengths-Based Approaches. Baltimore, MD. Health Professions Press, 2003


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