COUNSELING FOR OLDER ADULT

COUNSELING FOR OLDER ADULT �AREAS OF COUNSELLING ��COUNSELLING AGENDAS FOR SENIOR CITIZENS��TYPES OF COUNSELING��CARING INSTITUTIONALIZED ELDERLY��COUNSELLING FOR SENIOR CITIZENS ��ADAPTATIONS TO THE COUNSELING PROCESS�SPECIAL EMPHASIS AND TECHNIQUES OF COUNSELING

1. SEMINAR ON COUNSELING FOR OLDER ADULT Presented by Selvaraj.P Ph.D Scholar Oct-2019 Batch Guide Dr.Sasi.Vaithilingan Professor Cum Vice-Principal VMCON Pondicherry .

2. OBJECTIVES 9/21/2020 VMRF (DU) NSG19 OCT 07

3. INTRODUCTION Old age is a natural process of individual’s life that begins at birth and ends at death. In India people during the sixty are usually referred to as "old age ". It has been found that rapid growth of the old population due to better living conditions, medical advancement and favourable government policy . It is estimated that by the year 2050 the old population may reach 25% level. 9/21/2020 VMRF (DU) NSG19 OCT 07

4. Con’t Age 60 is the demarcation for clients referred to as “third-age” clients . It is apparent the oldest of the old live much longer, into their 90s and beyond. Senior citizens are neglected by the society ,. The family members also neglect them . Actually senior citizens are most valuable section of the society because they have a lifetime of practical wisdom and experience 9/21/2020 VMRF (DU) NSG19 OCT 07

5. WHAT IS OLD AGE Old age is (Ageing) defined as a state of mind, that does not always keep pace with our chronological age. And how one can face the normal changes, challenges and opportunities of one’s life. Especially those who are in their late sixties or above Age sixty is usually considered the dividing line between middle and old age. (a) India-60 and Above; (b) America-65; (c) Sweden-67 9/21/2020 VMRF (DU) NSG19 OCT 07

6. TYPES OF OLD AGE (AGEING) Primary Ageing: Primary ageing is natural changing and result of disease. It refers to change in human capacity due to changes in cell and tissue, causing deterioration of biological system and is subsystems and susceptibility to disease and mortality. Physiological ageing: Physiological ageing is the continuous growth and change in cognition and personality. This change in cognition affects person’s ability to process the information and their susceptibility to persuasion 9/21/2020 VMRF (DU) NSG19 OCT 07

7. Con’t 3 . Social ageing: It refers to changes in social relationships that define social status within a society, power relationship within social groups and various roles people are expected to play at various stage of life. 4. Secondary ageing: It results from negative environmental influences, poor diet and disease, lack of physical activity, poor nutrition, environmental pollution, stress and unhealthy activities like smoking and drinking, and exposure to hazardous materials. 9/21/2020 VMRF (DU) NSG19 OCT 07

8. DEFINITION OF COUNSELLING Counselling is an interactive process conjoining the counselee who needs assistance and the counselor who is trained educated to give this association ( perz , 1965). According to John Mcliyod (2007) Counselling is an activity that takes place when someone who is troubled invites and follows another person to enter a particular kind of relationship with them. 9/21/2020 VMRF (DU) NSG19 OCT 07

9. AREAS OF COUNSELLING Personal Counselling, Interpersonal Counselling, Family Counselling, Educational Counselling, Carrier Counselling, Marriage Counselling, Counselling For Women, Counselling For Weaker Section, Counselling For Drug Addicted Etc. Old Age Counselling Is One Of The Important Types Of Counselling. 9/21/2020 VMRF (DU) NSG19 OCT 07

10. OBJECTIVES OF SENIOR CITIZENS COUNSELLING 1. To understand the psycho-social and biological problems of old people. 2. To help them to solve their problems. 3. To enhance wellness in their life. 9/21/2020 VMRF (DU) NSG19 OCT 07

11. CHARACTERISTICS OF SENIOR CITIZENS AS CLIENTS 1. Willingness to seek counselling At present it has been sated that many older adults are a special case of the reluctant client. The attitude of aged is ‘I can do it myself’ and that going to counseling is a sign of weakness. 2. Physiological changes that affect counseling Physiological change is possible in sensory, physical and mental losses that are related to the age. 9/21/2020 VMRF (DU) NSG19 OCT 07

12. Con’t 3. Variability of individuals within the life-stage Old age people are from diverse background, there are difference between 62 years old person for their living style and their way activity. Some are too much active while some are not active, they also unable to do their own work. Vulnerable Third Age = Difficult Childhood + Dysfunctional Adulthood 9/21/2020 VMRF (DU) NSG19 OCT 07

13. CON’T 4. Change potential The theory of Erik Erikson (1963) describe eight stages of life, with tasks that must be at least partly accomplished at each stage for the person function effectively the next stage. A people who accomplish all these stages successfully can then move on to older adulthood, with the sense of ego integrity. ‘ Older age is a reflection of young age’ and it leads to change potential. 9/21/2020 VMRF (DU) NSG19 OCT 07

14. EXPERIENCES AND COUNSELING AGENDAS Adjusting to decreasing physical strength and health. Adjustment to retirement and reduced income. Adjusting to the death of a life partner or spouse. Establishing an explicit association with one’s age group. Adopting and adapting societal roles in a flexible way Establishing satisfactory practical living arrangement 9/21/2020 VMRF (DU) NSG19 OCT 07

15. COUNSELLING AGENDAS FOR SENIOR CITIZENS Decision making of adjustment problems of their transition events. Older need to build satisfying new identities as older person and they need help in understanding and accepting the value and reality of their life. Issues of anxiety and stress, related to the losses of their life, Depression and demoralization Abuse nature may be pattern of midlife or the effect of the pressure of old age. 9/21/2020 VMRF (DU) NSG19 OCT 07

16. SPECIAL EMPHASIS AND TECHNIQUES OF COUNSELING 1 . Challenging self - Defeating myths. 2. Clarifying identify and Enhancing self- esteem. 3. Reframing Unnecessary and negative Thoughts. 4. Substance abuse. 5. Grief work. 9/21/2020 VMRF (DU) NSG19 OCT 07

17. TASKS OLD AGE PEOPLE (CLIENT) Accept the reality of loss Experience the pain and grief Adjust to an environment in which the deceased is Missing withdraw emotional energy from the older relationship and reinvest it in another relationship or other activities. 9/21/2020 VMRF (DU) NSG19 OCT 07

18. LISTS THOUGHTS Grief is the price we pay for loving To bury grief, take little steps forward. The laws of nature do not protect good people. Vulnerability to death is one of life`s condition. After living through the death of a loved one we fear the future less 9/21/2020 VMRF (DU) NSG19 OCT 07

19. TYPES OF COUNSELING Individual and Group counseling Individual counseling provides older clients the time and privacy to discuss thoughts and feelings they may be experiencing. Group counseling has also been shown to be efficacious with an elderly population, and it provides an additional benefit of decreased isolation through interaction among members. 9/21/2020 VMRF (DU) NSG19 OCT 07

20. Con’t Reminiscence (Integrating Past Memories Into Present-day Functioning), Interpersonal (Exploring Personal Interactions And Relationships), Current Events (Encouraging Attention To Current News), Adjustment (Focusing On Transitions). 9/21/2020 VMRF (DU) NSG19 OCT 07

21. ADAPTATIONS TO THE COUNSELING PROCESS Counselors need to be aware of the social context in which their older adult clients exist and the challenges of navigating an ageist world . For many older adults, entering into counseling is a new and possibly intimidating experience. Education about the counseling process may assist with rapport building and setting appropriate expectations. 9/21/2020 VMRF (DU) NSG19 OCT 07

22. Con’t By Outlining The Logistics Of The Sessions (E.G., How Long Each Meeting Will Last, The Cost, And Duration Of Therapy) Counselors May Allow For Additional Time To Explain The Progression Of Counseling, Describing Their Theoretical Orientation And Therapeutic Approach In A Jargon-free Manner, Using Concrete Terms And Examples When Possible. 9/21/2020 VMRF (DU) NSG19 OCT 07

23. Con’t Counselors should also be cautious of using terms with potential negative meaning too quickly, “Feeling blue,” “being down in the dumps,” or “having low spirits.” Older clients may indicate anxiety by noting they are “climbing the walls” or stating something such as, “I don’t feel right in my skin .” 9/21/2020 VMRF (DU) NSG19 OCT 07

24. Con’t Older Clients May Exhibit Physical Declines That Affect The Course Of Therapy. They May Have Difficulty Hearing, And Provisions Can Be Made To Ease The Frustrations Of Both Parties To The Counseling Relationship. Some Clients May Have Decreased Eyesight, Counselors May Wish To Have Written Materials In Large Print. They Should Be Prepared If Older Clients Experience Physical Limitations Preventing Them From Completing Paperwork Or Providing A Signature. 9/21/2020 VMRF (DU) NSG19 OCT 07

25. Con’t Counselors May Want To Decrease The Pace Of Therapy; This May Be An Effective Method Of Ensuring Client Understanding. Clinicians Should Be Prepared For Clients That Have Overall Changes In Memory Functioning; Complex And Jargon-filled Interpretations Will Likely Not Be Successful,. Modifications To Therapy May Be Necessary Due To Caregiving Issues Or Living Situation. As A Person Ceases Working Outside The Home, Becomes Less Able To Participate In The Community, Or Experiences.

26. Con’t Counselors Need To Understand The System In Which The Client Lives, They Can Better Recognize And Appreciate The Corresponding Challenges That May Arise. For Instance, If A Client Living In A Long-term Care Facility Complains Of Clothes That Are Missing And Being Worn By Someone Else, The Counselor Must Determine If The Client Is Demonstrating Signs Of Paranoia Or Memory Deficits, 9/21/2020 VMRF (DU) NSG19 OCT 07

27. TRANSFERENCE AND COUNTERTRANSFERENCE Client and counselor learn more about societal perceptions of older adulthood ,. Transference involves the attribution of characteristics, traits, or behaviors to a person based on ideas about who the person is reminiscent of or who he or she represents. A younger therapist may focus too much on illness or death, or may treat an older client as “grouchy” or “fragile,” or may think of the client as a “kind grandparent-like” individual. 9/21/2020 VMRF (DU) NSG19 OCT 07

28. Con’t Counselors may be aware of their reaction to client death as being a double-level experience. As humans, they may face grief, guilt, and loss similar to others who have lost a close relationship . But counselors may also be cognizant of the client’s death in terms of their special role in that person’s life. This can have the potential to be confusing, emotionally draining, and isolating for counselors working with the elderly. 9/21/2020 VMRF (DU) NSG19 OCT 07

29. CARING INSTITUTIONALIZED ELDERLY According to the Practical Guide of the Caregiver from Ministry of Health . Caring means attention, precaution, caution, dedication, affection, burden and responsibility. Take Care is serve, is offer to other, in the form of service, the result of your talents, preparation and choices; is to practice the care. 9/21/2020 VMRF (DU) NSG19 OCT 07

30. Con’t The activities with older populations should be applied from the understanding and acceptance of the principle that plasticity (neural and behavioral ) The respect for individuality, for desire of the elder is an essential principle . Without such knowledge is, for example, impossible to motivate, establish relations of cause and effect and, mainly, to transcend a unilateral relationship in which the 'caregiver' simply establishes rules and procedures, i.e. 'indicates the path to' and not 'walks along to'. 9/21/2020 VMRF (DU) NSG19 OCT 07

31. Con’t The practical activities/therapies with the elderly should take into account that the body works as a whole in dynamic relationship with the environment .. The non- infantilization of elderly is a basic fundament. When the elderly person is treated as a 'child', mainly through words, such as "cutie", " beautie ", "poor soul", "so cutie", etc., or actions, in the sense of paternalistic behaviors that offend the autonomy of the subject; there is an impact in terms of self-esteem 9/21/2020 VMRF (DU) NSG19 OCT 07

32. Con’t The elder cared should be treated with education and urbanity. Must be treated like our 'friend' or as our 'older neighbor ', with whom we talk with certain constancy. Try to break the silence. Most of the times, the elderly, especially the institutionalized elderly, are immersed in their world, The elderly presents a difficulty to express themselves, especially if they show any sensory or cognitive deficit. Meanwhile, Berger observes that 9/21/2020 VMRF (DU) NSG19 OCT 07

33. Con’t Another basic principle is: 'Listen more than talk. It is important to stimulate the expression and, not only show interest on what the elderly expressed Value the experience of the elderly is make him feel important, useful. In this sense, Foucault points to the importance of adopting the silence and not interrupt anyone who speaks . Be careful to assimilate what is spoken and avoid physical attitudes, such as agitation, not to interfere in listening. 9/21/2020 VMRF (DU) NSG19 OCT 07

34. Con’t Liability in relation to affective involvement is of extreme importance In most of times the subject is institutionalized in a situation of affective shortage and, in such a situation, usually cling with extreme ease the caregiver, and can even create a bond of affective dependence . Makes necessary the establishment of a close relationship to the elderly, there should be no "exclusivity" in these relations. 9/21/2020 VMRF (DU) NSG19 OCT 07

35. Con’t Avoid issue, especially in conversation with the elderly, opinions about the institution, therapies, employees and caregivers. Take care that there is no dominance among the subjects treated, especially during the development of group activities. 9/21/2020 VMRF (DU) NSG19 OCT 07

36. COUNSELLING FOR SENIOR CITIZENS Be active and participate in varies activities. Accept reality. Be optimistic. Accept changing social norms. Spend leisure time properly. Proper thinking of Past, present and future events. Take care of health (physical, mental, social and Spiritual). 9/21/2020 VMRF (DU) NSG19 OCT 07

37. Con’t Do proper physical exercise and yoga. Keep busy yourself with work (productive, unproductive). Help others. Keep busy yourself in domicile work. Spend your time in social and spiritual activities. Spend your time with relatives. Join with varies group. Seek challenges (Accept new challenges)

38. SUMMARY Senior citizens are an ever-increasing presence in our society due to increase in human longevity. Counsellors are encouraged to maintain positive collaborations with families of older client when these families are creating role. Counselor can understand the psycho-social and biological problems and needs of old people help them to solve their problems and to help them to enhance wellness in their life. 9/21/2020 VMRF (DU) NSG19 OCT 07

39. Counselor can create happiness in their life. Once senior citizens people are satisfied in their life they can spend their time creatively and constructively if they decide to spend his life doing well to themselves, family, society and ultimately to the nation also. They can function with self-respect. Counselor emphasizes growth as well as remediation. Aged counseling is difficult to apply with an exact approach but taking curable ways will be more effective. This is the role conceived for senior citizens by counsellor 9/21/2020 VMRF (DU) NSG19 OCT 07

40. REFERENCE Sharma RA. Fundamentals of Guidence and Counselling. Surya Publication, Near Govt. Inter College Meerut, 2006. Soares E (2014) The Care of Institutionalized Elderly: Principles for Action of Multidisciplinary Team. J Gerontol Geriatr Res 3: 1000191. doi:10.4172/2167-7182.1000191 Dr. PV Rasal . Role of Counseling for wellbeing of Senior Citizens. International Journal of Humanities and Social Science Research ISSN: 2455-2070; Volume 2; Issue 4; April 2016; Page No. 04-06 http://psychology.iresearchnet.com/counseling-psychology/counseling-process/counseling-the-elderly/ http://psychology.iresearchnet.com/counseling-psychology/counseling-process/counseling-the-elderly/ 9/21/2020 VMRF (DU) NSG19 OCT 07