Navigating the Territory

of Older Age

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“Old age ain’t for sissies.”

- Bette Davis

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We may say this with a poignant chuckle or a wincing grimace, but most of us would agree with Bette! The “Another Country“of growing older, as renowned psychologist Mary Pipher calls it, can loom before us like what ancient map makers once called “Terra Incognita” or land unknown.

 

We visit it at first as non-natives, through the stories of our older loved ones, and, later, experience it first hand. The territory is unfamiliar, complex, sometimes frustrating and sometimes exhilarating. It is certainly an ever-shifting terrain.

 

While it is may be the “Land Unknown”, it does not have to be anticipated or experienced as a land only of fear and dread or what more frightened cartographers of yore labelled: “Here Be Dragons”. Rather, despite our American fear, lack of respect for and denial of aging, more and more of us are recognizing that growing older and maturing is a realm full of daunting challenges, yes, but also of blessings and rich opportunities. It may not be for sissies, but it is for pioneers and adventurers. And there often even is humor in Terra Incognita.

 

How can we learn to effectively navigate our way?

1. One way to prepare for the journey is to talk with some natives (our elders) and learn from them! Talk to cherished older parents, aunts, uncles, cousins, siblings and friends. Ask them what they enjoy about being their ages and what concerns them. Ask them what surprises them about being their ages. Those conversations will be a win-win – a win for the elders who have so much to share, and a win for those not as old who will learn from their role models.

Renowned psychologists Erik and Joan Erikson created groundbreaking theories about the stages of human development when they were in their middle age.  Here is what Joan had to say about their work regarding older people when she herself became 90 years old:

“I feel as if we owe an apology to all of them saying “That wasn’t it, we hadn’t been there and so we didn’t know the difference. And we shouldn’t have made it up. We should have gone and talked to a lot of wise old people. Maybe we would have learned.”

 

 2. We can also read guidebooks – there are so many books on the second half of life that are superb and helpful. I mentioned Mary Pipher’s book Another Country above.

 

The Longevity Revolution is another – written by one of the heroes of American gerontology, Dr Robert Butler. Dr Butler was one of our country’s first geriatricians, coined the term “ageism” and wrote the Pulitzer prize winning exposé about ageism in our country entitled Why Survive? Being Old in America. 

 

From Age-ing to Sage-ing by Zalman Schachter-Shalomi is also wonderful, also Losses in Later Life by Scott Sullender, and Aging as a Spiritual Practice by Lewis Richmond. Many more, too many to mention, are available online and at your libraries.

In our isolated society that seems to have such a negative stereotype about older people, it can be very common to feel overwhelmed at times as we approach the shores of this new land. But, “white knuckling it” through overwhelm all alone is probably not the wisest plan. Many studies have shown that isolation, stress and loneliness are not good for overall physical and emotional health including this one recently published by the University of California, San Francisco called: “Loneliness linked to serious health risks for problems and death among elderly“.

3. Fortunately, we can also learn from guides who can meet with us in person - people who are knowledgeable about the major landmarks in territory of midlife and older age. Psychotherapists who are trained in gerontology – the study of aging – can be invaluable in helping you, or your loved ones, navigate through older life’s normal challenges, while recognizing and taking advantage of the inherent and often underlying rich opportunities. Seeing a competent and kind professional counselor can provide you with an objective listener and guide – someone you can speak with confidentially, and someone you do not have to take care of.

 

Why Is It Important for Midlife and Older Adults to Work with a Specialist in Aging?

 

All Licensed Marriage & Family Therapists receive a deep training in counseling-psychology, a variety of evidence-based treatment models and solid intervention techniques. Similar to geriatric MD’s, however, geriatric or gerontological psychotherapists also have extensive additional training and experience in addressing the myriad of issues which we encounter in our mature years. Many more pieces of our overall health and well-being “puzzle” come into play. We, at age 70 or 80 or up, do not face the same developmental tasks and stages of a 40 year old! 

 

For instance, all of these pieces are part of what we typically experience in mid and later life:

• a constantly changing physical health status
• the interplay and side effects of multiple medications
• changing living environments – often downsizing our physical space
• a greater focus on safety, e.g. fall prevention
• coping with transitions from independence to dependence
• transitioning from being the driver to being the passenger
• stronger emphasis on exploring spirituality and/or connection with something larger than self
• reviewing our life stories
• increasing focus on self care in order to keep functioning as well as possible
• shifting roles in families and in the community
• grappling with the impacts of ageism (e.g. negative stereotypes, assumptions, invisibility) 
• exploring new purpose and creativity
• making meaning of our lives – past, present and future
• finding personal balance between social engagement and positive solitude

 

A close attention to working collaboratively as part of a compassionate and competent support team is very important those who serve older clients and their families. With each client’s express written permission and where beneficial to each client, gero-psychotherapists can contribute greatly to the client’s well-being through effective communication and advocacy with people like: physicians, caregivers, social workers, nurses, psychiatrists, care managers, spiritual leaders or family members. “It takes a village” is often true for providing compassionate and competent service to midlife and older clients.

 

Gero-psychotherapists are experienced and stay up-to-date with common physical challenges, safety issues, mental health challenges, relationship/role changes, societal influences, family dynamics, advocacy needs, environmental concerns and local resources for their clients.

 

In order to effectively advocate for, educate on behalf of and serve this population as a therapist, simply knowing the basics of counseling psychology is not enough.

 

There are proven solutions, coping skills, therapeutic practices and resources to help older people and their loved ones effectively cope with fears, depression, anxiety, loneliness and other challenges that can beset us in older age. Cognitive behavioral therapy has been shown to provide relief from many internal and external stressors. Reminiscence Therapy has been proven, through the use of life review techniques, to lessen depression and increase enjoyment and quality of life. Supportive psychotherapy can provide welcomed companionship and guidance along the walk.

 

Specific Benefits of Gerontological Counseling & Consultation

 

Here are some of the benefits geriatric counseling and consultation has been proven to provide for ADULT CHILDREN OF AGING PARENTS:

 

• Learning how to avoid caregiver burnout 
• Decreasing stress levels using techniques of Cognitive Behavioral Therapy
• Crisis management using short-term solution oriented therapy
• Education about and normalization of stages of development for adults in older life
• Recommendations for local community resources & services 
• Learning effective communication skills for this stage in life
• Relationship repair using techniques of Multigenerational Family Systems Therapy

• Decreasing anxiety and depression using Cognitive Behavioral Therapy techniques
  
• Support and development of skills to cope with grief and the challenges of cumulative losses
• Skills development to cope with chronic pain and illness
• Compassionate support & counseling at end-of-life 
• Solutions and support for healthy transitioning to retirement 
• Adjusting successfully to new life in a retirement community
• Successful and collaborative client advocacy with support teams
• Meaningful legacy and life review processes using Reminiscence Therapy
• Discovery of enjoyment and purpose in the second half of life

 

Cognitive Behavioral Therapy with Older People:

1. is an effective treatment for depression
2. is an effective treatment for anxiety disorders
3. is an effective treatment for bipolar disorder
4. challenges negative thoughts

From Advances in Psychiatric Treatment “Psychotherapies with Older People: an Overview”

 

If you’re ready to take that leap of faith towards helping yourself and finding healing, you can reach me anytime at 415-378-6577 or by email at  nancyrhine@aol.com  . I offer consultation or counseling sessions for individuals, couples and families in-home and in-facility for homebound clients, at my office in San Anselmo or on the telephone. I look forward to hearing from you!