Transpersonal Caring and the Psychological Wellbeing of Older

Transpersonal Caring and the Psychological Wellbeing of Older Adults By: Leigh Anne Koonmen, Gail Luskin, Lashonda Martin, and Karen Wiekierak

Introduction ● Over 20% of adults age 60 and over suffer from a mental or neurological disorder ● Mental health plays a large role in the elderly’s ability to maintain their physical health and well-being. ● In turn, poor physical health such as chronic diseases and disabilities can impact their mental health

Vulnerable Population Older Adult = 65+ years Older Adults Unprecedented Growth: - Longer life spans - Aging baby boomers (2011) Source: U. S. Department of Health and Human Services (2014)

Vulnerable Population Current Population: 36 Million Will double to 72 million during the next 25 years. o 1 out of 5 Americans By 2050: 89 million Source: Center for Disease Control and Prevention (2013)

Demographics Racial and Ethnic Diversity - Dramatic Shift Source: Center for Disease Control and Prevention (2013)

Cultural Descriptors Impacting Health High risk for developing chronic illnesses and related disabilities including: o Diabetes mellitus o Arthritis o Congestive heart failure o Stroke o Cancer Source: U. S. Department of Health and Human Services (2014)

Cultural Descriptors Impacting Health Genetics: Impacts 9 of the 10 leading causes of death including: ● Heart disease ● Cancer ● Stroke ● Diabetes ● Alzheimer’s disease Source: U. S. Department of Health and Human Services (2014)

Psychological Health Risk Factors ● ● ● ● Illness Social isolation Ageism Stress and coping with changes Abuse (physical, emotional, sexual) and Neglect Financial exploitation Self-neglect Depression

Statistics r/t Population and Health Risk Factors “Percentage of people aged 65 or older reporting clinically relevant symptoms of depression was 12% for men and 19% for women in 2006. ” -Federal Interagency Forum on Aging-Related Statistics, 2010

Literature Reviews ● Older Adults and Hearing Help-Seeking Behaviors Saunders, Chisolm, and Wallhagen (2012) ● Identification of Environmental Supports for Healthy Eating in Older Adults - Sylvie, Jiang, and Cohen (2014) ● In the Best Interest of the (Adult) Child: Ideas About Kinship Care of Older Adults - Jennings, Perry, and Valeriani (2014)

Risk Assessment for the Elderly ● ● ● ● Nutrition Exercise Tobacco avoidance Injury prevention Immunizations Stress and mental health issues Oral and skin care Sexuality

Jean Watson ● Moral ideal of nursing = caring ● Holistic care of mind, body, spirit, and nature ● Physical, psychological, and psychosocial needs ● Disease results from incongruencies

Transpersonal Caring Theory Major elements: A) 10 carative factors B) The transpersonal caring relationship C) The caring occasion/moment

10 Carative Factors 1. Humanistic-altruistic system of value 2. Instill faith and hope; honor others 3. Sensitivity to self and others 4. Develop helping & trusting, human care relationship 5. Promote & accept expression of positive and negative feelings 6. Use creative problem-solving methods in the caring process 7. Share transpersonal teaching-learning to address needs & comprehension styles 8. Create a supportive, protective, &/or corrective mental, physical, societal, & spiritual environment 9. Human needs assistance - physical, emotional, and spiritual 10. Be open to existential-phenomenological-spiritual forces & allow miracles to enter

Transpersonal Caring Relationship ● Higher level of caring ● Goals: o Protect, enhance, and preserve the patient’s dignity, humanity, wholeness, and inner harmony o Be engaged and conscious of yourself and the patient o Connect/establish a relationship to promote comfort, health, and healing

Caring Occasion/Moment ● Heart-centered encounters between nurse and patient ● Meaningful, authentic, and intentional interactions ● Sharing

Plan of Action and Implementation ● Creating environments and living conditions supportive of healthy lifestyles ● Providing necessary resources to meet basic needs ● Ensuring environment is beneficial to security and freedom needs ● Providing social support and health programs for both elderly and caregivers ● Educating on older adult violence and maltreatment prevention ● Creating community development programs ● Having prompt recognition and treatment of ailments

Settings for Activity ● ● Home Assisted living facilities Community nutrition sites Health and social programs within the community ● Church or other faith based meeting areas ● Hospitals

Services Provided by Mecosta County ● ● ● ● Transportation Homemaker Aide Specialized Respite Senior Meals Program S. O. A. R. Outreach & Assistance Disaster Coordination Senior Home Maintenance Program Services ● Equipment Loan Closet ● Medicare/Medicaid Assistance Program ● Advocacy ● Information & Referral ● Living Wills & Durable Power of Attorney for Health Care ● Newsletter ● Resource Guide & List

Healthy People 2020 10 -year nationwide health-promotion and disease-prevention goals

Healthy People 2020 Mission: ● Identify health improvement priorities ● Increase public awareness ● Provide objectives & goals ● Engage other sectors ● Identify research, evaluation, & data collection needs

Healthy People 2020 & the Elderly Goals: 1. Improve the health, function, & quality of life of older adults 2. Reduce the morbidity & costs associated with & maintain or enhance the quality of life for persons with dementia including Alzheimer’s disease 3. Promote the health & well-being of people with disabilities 4. Reduce the prevalence & severity of disorders of hearing and balance; smell and taste; and voice, speech, and language 5. Prevent illness & disability related to arthritis and other rheumatic conditions, osteoporosis, & chronic back conditions. 6. Improve mental health through prevention & by ensuring access to appropriate, quality mental health services.

Conclusion ● Mental health is essential to overall health and wellbeing, especially in older adults ● It must be recognized and treated with the same urgency as physical health

References Center for Disease Control and Prevention (2013). The state of aging and health in america. Retrieved from [http: //www. cdc. gov/features/agingandhealth/state_of_aging_and_health_in_america_2013. pdf] Centers for Disease Control and Prevention and National Association of Chronic Disease Directors. (2009). The state of mental health and aging in america. Addressing depression in older adults: Selected evidence-based programs. Issue Brief 2. Atlanta, GA: National Association of Chronic Disease Directors. Retrieved from [http: //www. cdc. gov/aging/pdf/mental_health_brief_2. pdf] Children’s, Women’s, and Seniors Health Branch. (2004). Social isolation among seniors: An emerging issue. British Columbia Ministry of Health. Retreived from [https: //www. health. gov. bc. ca/library/publications/year/2004/Social_Isolation_Among_Seniors. pdf] Currey, R. (2008). Ageism in health care: Time for a change. Aging Well. 1(1). P. 16. Jennings, T. , Perry, T. E. , & Valeriani, J. (2014). In the best interest of the (adult) child: Ideas about kinship care of older adults. Journal Of Family Social Work, 17(1), 37 -50. doi: 10. 1080/10522158. 2013. 865289 Maville, J. A. , & Huerta, C. G. (2013). Health promotion in nursing (3 rd ed. ). Clifton Park, NY: Delmar. Mecosta County Michigan (2003). In-home support services. Retrieved from: http: //www. co. mecosta. mi. us/services. asp

References continued Saunders, G. H. , Chisolm, T. H. , & Wallhagen, M. I. (2012). Older adults and hearing help-seeking behaviors. American Journal Of Audiology, 21(2), 331 -337. doi: 10. 1044/1059 -0889(2012/12 -0028) Segerstrom, S. (2014). Affect and self-related health: A dynamic approach with older adults. Health Psychology. 33(7). P. 720 -728. Sylvie, A. K. , Jiang, Q. , & Cohen, N. (2013). Identification of environmental supports for healthy eating in older adults. Journal Of Nutrition In Gerontology & Geriatrics, 32(2), 161 -174. doi: 10. 1080/21551197. 2013. 779621 U. S. Department of Health and Human Services (2014). Retrieved from [http: //www. healthypeople. gov/2020/topicsobjectives 2020/default. aspx] Wagner, A. L. (2010). Core concepts of jean watson’s theory of human caring/caring science. Watson Caring Science Institute & international caritas consortium. Retrieved from [http: //watsoncaringscience. org/files/Cohort%206/watsons-theory-of-humancaring-core-concepts-andevolution-to-caritas-processes-handout. pdf] World Health Organization (2013). Mental health and older adults. Retrieved from [http: //www. who. int/mediacentre/factsheets/fs 381/en/] World Health Organization. (2003). The social determinants of health: The solid facts. (2 nd ed. ). Retrieved from [http: //www. who. int/mental_health/mhgap/risks_to_mental_health_EN_27_08_12. pdf].