Post a thoughtful response to at least two (2) other colleagues’ initial postings. Responses to colleagues should be supportive and helpful (examples of an acceptable comment are: “This is interesting – in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds, theory, management principle) and according to the literature…” and add supportive reference. Avoid comments such as “I agree” or “good comment.”
Peer discussion 1
This week’s assignment focuses on gerontological reminiscence. Included in the assigned readings and viewings is the film “Tuesdays with Morrie”. In this discussion post, I will discuss the modalities of reminiscence and life review and the significance of the life story of an elder. I will also discuss what I believe can be improved upon for effective communication, in addition to identifying the impact of culture and family values in care provided for the elderly.
“Tuesday’s with Morrie” involved a heavy amount of reminiscence from Morrie, as he discusses life lessons and how he personally learned them. Morrie makes it a point to tell his friend, Mitch, these life lessons that he learned, in an effort to help Mitch better his own life. By trying to help the younger generation understand that they could potentially die at any time, he urges Mitch to work to lead the life he wants to live, and try to avoid making some of the same mistakes that he did. Morrie feels that reminiscing validates his life, by remembering both the good times and the bad. He reminisces on his regrets of pride, vanity, and hardness of heart, and urges to forgive, so you can die surrounded by love and peace. Throughout the film, we see Morrie continually works to teach Mitch that shouldn’t be afraid to love, and don’t be afraid of giving himself to someone he may lose. Reminiscing about one’s life as an elder, especially those who are battling chronic diseases, can decrease depression (Syed Elias, Neville, Scott, 2015). Morrie is dying from ALS, and talks about how he lost the ability to use his legs first; this is something that haunts him, as he often reminisces about how much he loved to dance. Since many chronic and progressive diseases often come with the inability to do the things they love, it is important to allow the elderly to reminisce as part of a healthy coping process.
When it comes to improving communication strategies with the elderly, I feel that Morrie was trying to tell Mitch that it is important to listen to the lessons he was trying to teach. He strives to make Mitch understand that it is important not to pretend that the elderly don’t have feelings, and tells him that communication should be open and honest. It is silly to pretend that disease and death do not exist. He also discusses with Mitch the importance of touch…when we are infants, we yearn for it, yet we shun it as we age. Sometimes, as the elderly enter their final stages of life, they begin to yearn for touch again, even if it is as simple as holding their hand. This is something that I did when I sat by my grandmother’s hospice bed for a week, almost three years ago today as I write this post. I typed my papers for my very first nursing class of my BSN with one hand, while holding her hand with the other. Even though she wasn’t able to see me, I know on some level, she was comforted by my touch. We can even use music as a way to help communicate, and even help someone reminisce and cope with a disease process (Maruszewski, Bonk, Karcz, Retowski, 2017). Finally, Morrie tells Mitch not to be afraid of silence, as sometimes another’s presence alone is comforting enough. I feel that through active listening, touch, and presence, we can overcome many barriers to those with deficits during their final years.
In the film, Morrie has a funeral while he is still alive, so that he can see all of his family and close friends, and hear all of the nice things they have to say about him. Later on, he tells Mitch about his perfect day, which involves spending the day with those same close friends and family members. His day is nothing extravagant, simply walking in the park after a light lunch and then a big pasta dinner, followed by dancing. It is the simple things that meant the most to him, that he truly cherished, and wanted to do on his one perfect day. In the end of the film, he passes away at home (like he wanted), surrounded by his family and friends. When our loved one is dying, I believe it is imperative that we do the best we can to honor their wishes, and make their last bit of time as comfortable as possible.
In conclusion, I felt this film was a great window into essentially the dying process. Morrie discusses some of the most important moments in his life, while accomplishing his goal of teaching one more class to Mitch. He does all of this while reminiscing on his life, and teaching Mitch that “if you learn how to die, you will learn how to live” (Forte, Heyer, Ogden, Winfrey, 1999).
Forte, K. (Producer), Heyer, S. (Producer), Ogden, J. (Producer), Winfrey, O. (Producer), & Jackson, M. (Director). (1999). Tuesday’s with Morrie [Motion picture]. United States of America: American Broadcasting Company.
Maruszewski, T., Bonk, E., Karcz, B., & Retowski, S. (2017 November). Elderly peoples preferences regarding reminiscence material. Educational Gerontology, 43(11): 531-539. Retrieved from: https://eds-b-ebscohost-com.proxy.library.ohio.edu…
Syed Elias, S. M., Neville, C., & Scott, T. (2015 September-October). The effectiveness of group reminiscence therapy for loneliness, anxiety, and depression in older adults in long-term care: a systematic review. Geriatric Nursing, 36(5): 372-380. doi: 10.1016/j.gerinurse.2015.05.004
Peer discussion 2
A person’s life story is important because it gives a history of a person’s past, providing insight into that person’s present circumstances. The purpose of this discussion post is to discuss how life review and reminiscence therapy facilitates and highlights an elderly person’s life story, improvements that can be made to effectively communicate with geriatric patients with sensory impairments, and identifying the impacts that cultural and family values have in providing quality care for older patients.
For elderly people especially struggling with depression and loneliness, reminiscence therapy is a non-pharmacological intervention aimed at increasing a person’s self-esteem by relieving feelings of depression, anxiety, and loneliness (Elias, Neville, & Scott, 2015). Likewise, life review is a form of reminiscence therapy (called spiritual reminiscence therapy) that involves the person finding meaning in their past and future life (Elias et al., 2015). This form of reminiscence therapy focuses on a person’s life, and a person can find meaning and have positive self-esteem as they recount their life story. Furthermore, when this therapy is conducted in a group setting, the elderly patient benefits by establishing social connections, new relationships, and enhanced communication skills, thereby increasing self-esteem and reducing loneliness and depression (Elias et al., 2015).
To improve effective communication strategies for older adults with speech, hearing, vision, language, and cognitive impairments, investing extra time alone into each elderly patient interaction can greatly improve communication. Elderly patients are typically slower to respond, need information repeated, may take longer to process information, and desire to be treated as a valued human, and allowing for extra time can augment these interactions. Also, respectfully addressing the patient by their name, utilizing large-font written instructions, pictures, or diagrams, and providing audio instructions for patients who have difficulty seeing or reading can decrease communication barriers. Additionally, ensuring the patient is wearing their hearing aid and it is on, speaking slowly, and facing the patient directly at eye level can reduce hearing barriers (“Understanding Older Patients,” n.d.). For me, the biggest inference I can gain from the videos and articles of this week’s module is to have patience and empathy for elderly patients while giving them extra time. I think this is the most effective method for improving communication. In my practice, when I have a geriatric patient, I have to remind myself to slow down in my interview process, listen closely to them, and answer their questions slowly while making eye contact. It is my goal to provide respectful and empathetic care.
Finally, family and cultural values impact a person’s principles, life, and preferences, and these factors need to be considered to provide quality, appropriate care. Being aware of a patient’s family and cultural differences can direct the nurse to have cultural humility, which is an open-minded acceptance of differences, and this attitude helps one to provide culturally competent care (Andrews & Boyle, 2016).
In summary, the importance that reminiscence and life review therapy has on geriatric patients’ depression, anxiety, and loneliness have been analyzed related to recounting one’s life story. Effective communication improvements for elderly patients with impairments have also been discussed, as well and how one’s family and cultural values influence their care and preferences.
Andrews, M. M., & Boyle, J. S. (2016). Transcultural concepts in nursing care (7th ed.). Philadelphia, PA: Wolters Kluwer.
Elias, S. M. S., Neville, C., & Scott, T. (2015). The effectiveness of group reminiscence therapy for loneliness, anxiety and depression in older adults in long-term care: A systematic review. Geriatric Nursing, 36(5), 372–380. https://doi.org/10.1016/j.gerinurse.2015.05.004
Understanding Older Patients. (n.d.). Retrieved October 16, 2018, from https://www.nia.nih.gov/health/understanding-older…