Beating Carers’ Grief: The Heartstring Support Network

All patient names have been changed.

Caring for someone and watching them debilitate and then die is the saddest, most inevitable part of working with the elderly. For a long time, I felt like each person that died took a small part of me with them, and I worried about one day being whittled away to nothing. I became weary of burning out, an unfortunate reality in my industry.

My GP is a dear family friend and an incredible doctor; I told her I felt like working in this industry might be chipping away at me and that I couldn’t possible sustain this for an entire lifetime. She told me the following, which I admit sounds corny when you hear it, but I urge you to hear it out:

“I imagine every patient I’ve ever cared for and I have a connection, a heartstring between me and them. Living or dead, that connection remains between us; any time I’m feeling sad, frustrated or like I’m missing them, I tug their heartstring and there they are. They come to me and bring with them all the love and care we’ve shared, and I think about the good memories we have.

I have so many connections now that I feel rich, I have access to so many wonderful people and memories just by pulling their heartstrings. You may feel like your patients are taking something away from you or you’re giving them something, but you’re actually building something together; treat those connections as a support network you can access at any time.”

bleeding-hearts-2-1370705-1920x1440It took me a while to actually internalise it, and I somewhat balked at the idea of a “heartstring”. I kept it in mind though and adapted it into my thinking, and it’s become a vital way for me to view what can sometimes feel like a soul-crushing process.

Recently I’ve felt deflated due to a combination of things slowly wearing me down. Today I tugged Mary’s heartstring and brought back the smile she used to give when she saw it was me entering her room. I tugged George’s heartstring and brought back his fatherly wisdom and the proud way he would congratulate me for my uni results. I tagged Raymond’s heartstring and he told me same joke he used to tell me every time I’d see him. I tugged Dora’s heartstring and saw her naming her goldfish after me.

Those memories have reminded me of so much joy, pride and purpose; I’m still feeling a bit tender but I’m supported by the connections I’ve made. The more people you care for the more connections you get, and we’re lucky to be in this position that gives such great opportunities to do so. This technique isn’t the final solution to “burning out”, but is one tool you can evoke when you need it and it may help to give you a different perspective. If you do feel completely overwhelmed, you should see if your workplace offers any counselling services (you can often remain anonymous) or see a psychologist.

Let me know in the comments if you decide to give this a try, or what you pull when you tap into your own heartstring support network.

Going to your elderly residents for advice: benefits for young and old

Whether you work in aged care or you just want the best for your older relatives, we constantly look to create purpose in the lives of our elderly. For the longest time the eldest members of a community had a very important and well defined purpose, they were the wise and respected elders who dispensed wisdom. It’s possible to restore some of this purpose in the way you interact with your elderly, and it starts by going to them for advice. The next few paragraphs will outline cultural differences and the benefits of respecting the elderly. If you’re impatient skip ahead to the last section where we discuss methods you can use to integrate some of these techniques into your work or relationships.

 

Why did we stop seeing our elders as wise?

The West has unfortunately embraced the stereotype of the elderly as being useless and incompetent, one cause of this may be due to our massive increases in life expectancy. This means that compared to older civilisations, our eldest citizens are much older and may therefore be more frail and prone to experience cognitive decline. Martinez-Carter believes the lack of respect may be due to the Western Protestant work ethic, “which ties an individual’s value to his or her ability to work — something that diminishes in old age”. Comparatively, Eastern cultures such as China and Korea hold the elderly in much greater esteem.

 

Why is this important?

Apart from being a good way to honour those that came before you, respect for the elderly plays an important role in their mental state. One of the ways this functions is through a concept known as Stereotype Threat. See the video below for a good explanation, but what’s important to know is that knowledge of a stereotype can cause it to become true. The classic example is that African American students performed worse on a test ONLY if they were told it measured academic abilities (Steele & Aronson, 1995). This is because the stereotype is that African-Americans are not academically smart, and knowledge of the stereotype becomes activated and hinders the performance of the participants, who expect themselves to do worse.

This dilemma stretches over to the elderly, who when reminded of either their age, or when told that they’re being tested on cognitive abilities, perform much worse at memory tasks (Hess, Auman, Colcombe, & Rahhal, 2003). This is important, as it shows that our stereotypes about the elderly are holding them back, forming a self-fulfilling prophecy. Luckily there’s a way we can reverse these effects.

 

Experience: the resource they do have

The best thing you can possibly do for an elderly resident or relative is give them purpose. In many cases this ranges from doing simple tasks like setting tables, folding towels or helping deliver mail. This isn’t the norm though, as many older adults are in care because they are not capable of managing tasks like this, and with the increase in the elderly demographic most homes are aiming to take those that are least capable of remaining in the community. Finding a purpose for someone who is bed-ridden and does not have the memory needed to manage simple tasks can be daunting, but there’s one important resource that all our elderly possess: experience.

 

In practice

The best way to utilise an older person’s years of experience, both to give them purpose and for your own benefit, is to ask for that person’s advice or opinion. This can be about a wide range of things such as news, politics or history, but the one thing I find most rewarding is to ask their advice on a problem in life that I’m having trouble with, such as relationship issues. The good thing about this is that you start by showing weakness or ignorance, which puts them in a position of power (something they often don’t have a lot of). They then get the opportunity to act as the wise older tribe member, passing on their wisdom to a younger generation.

The method for doing this is to simply speak honestly to them, if they ask how you are let them know you’re worried about your workload at university, or you think you said the wrong thing to your partner and need advice on how to smooth it over. Of course it doesn’t have to be about life issues, you could ask something historical like “I was reading about how in the war the women had to do a lot of the men’s jobs while they were away, did this affect you?” You might be surprised how useful this is, our elderly have lived a much more exciting life than we often give them credit for. Of course you may get answers that don’t make any sense at all, but the sentiment is the same and it still provides a way for you to put an elder in a place of high-esteem.

armwrestling-1433099-1279x945A few things to remember

  • Don’t ask them anything that’s inappropriate. In your personal life you may be struggling with a crippling heroin addiction but it’s not a wise move to ask your grandma what she’d recommend you do.
  • Tailor the questions around things they are knowledgeable about. Good options are questions relating to their previous work or hobbies.
  • Remember their limitations and work around them. If they have trouble remembering the past, ask them questions that are focused around the future like “If I was going to propose to my partner, how do you think I should do it?”
  • Don’t argue or correct. They may have differing opinions to you or may have memory issues due to dementia, but just go along with what they’re saying. This is about them getting a chance to pass on their experience, not about being accurate, and trying to change the mind of someone with dementia can be agitating for both parties.
  • Be honest. Don’t make up problems or interests just so you can ask their advice, if you have no idea about something they’re knowledgeable in ask them to explain what they like about it, instead of feigning interest.

 

Conclusion

The elderly are aware of the negative stereotypes that surround them, which in turn increases the likelihood that they fulfil them. Due to declining mobility and cognitive abilities in nursing home residents, finding purpose is now harder than ever. You can help address both of these problems by respecting the elderly for the value they do have: experience. Do this by actively seeking out their advice and opinions; treat them as the wise men and women they would love to be. It seems obvious, but once you start consciously going to your residents for advice you will see the difference it can make.

If you have any other ways to do this, ideas for questions to ask, or experiences of your own leave them in a comment below.