by Diana Gruhl, MSW, ASW, Excerpt from Master’s Thesis, May 2010
Many seniors who have lived their whole lives being productive, purposeful, and engaged with others can become depressed and debilitated when they lose their independence due to illness, loss of work, or functional ability (Borg et al., 2006). Especially if they are not able to take care of their own needs; have poor health; and have low educational, socio-economic support, or social capital, they can become devastated by the factors of their lives and feel great despair (Borg et al., 2006). The impact of increased frail health and lower quality of life due to limited finances and social neglect can make them feel incapacitated, incompetent, and unable to see their value in daily life.
In addition, senior isolation is usually caused by lack of connection to close family members, who are considered to be the closest source of intimacy among this population (Mullins et al., 1996). Seniors have a need for social relationship support in their older age to provide expressions of empathy, love, trust, and caring, as well as instrumental help, informational support, and appraisal, which are expected to be a function of the family (Ashida & Heaney, 2008). However, in modern times, many seniors live alone, due to the death of their life partner or due to a lack of nuclear or extended family systems, and may live in low socio-economic circumstances without support (Ashida & Heaney, 2008; Hashimoto, 1993).
In response to this crisis, social relationships with friends, volunteers, and other society members are necessary to enhance the quality of life for the elderly (Ashida & Heaney, 2008). Social relationships help with the maintenance of good physical and mental health, while providing a network of support (Ashida & Heaney, 2008). These networks depend on reliability of network members, frequency of contact with members, and geographic proximity to network members to provide social connectedness, support, influence, and social companionship (Ashida & Heaney, 2008). They are also needed to buttress or complement the support that family members may not be able to exclusively provide, such as empathy, love, trust and caring, instrumental support or aid, informational support, and appraisal (Ashida & Heaney, 2008). Social support also helps with well-being and self-esteem and influences people to engage in more healthy behaviors while buffering life stresses. This, combined with home visitation, is one way to serve seniors and society, by supporting their wellness and mental health.
Activities an an Intervention
According to the Activity Theory of Successful Aging, activity participation is an essential determinant of life satisfaction, fulfillment, and health among senior citizens, aged 65 and older (Onedera & Stickle, 2008). This theory states that regular involvement in social and cognitive engagement can help elders maintain their health and wellness, while improving mood, memory, and overall functioning.
Specifically, the most beneficial activities suggested by this theory are those that positively impact seniors and others, such as sharing life stories with children and volunteering, engaging with social support systems and meaningful relationships, staying in touch with the present moment by learning about current events, having short- and long-term goals that give them meaning, and taking time for reflection (Onedera & Stickle, 2008).
In addition, a Japanese study confirmed that seniors who are involved in a regular social support group have higher levels of functional capacity, increased self-esteem, and enhanced morale, which is associated with recovery from disabilities and slower declines in health, than those who do not participate in activities (Kondo, Minai, Imai, & Yamagata, 2007). These findings are critical as they demonstrate the essential need for seniors of all health conditions to participate in activities, in order to enhance life satisfaction and counteract the negative effects of aging (Kondo et al., 2007; Onedera & Stickle, 2008).
Specific activity models for distinct senior populations
Although most activities are beneficial, each senior population requires a certain type of activity to meet their particular needs. Research suggests that active community-living seniors benefit from more engaging, cognitively stimulating, and in-depth activities, such as mentoring a child in school subjects or teaching a person English as a second language (McInnis-Dittrich, 2005). This is due to their motivation to maintain their active cognitive status, good health, memory, and independence for as long as possible. In addition, the most beneficial activities for homebound seniors include meaningful conversations and discussions with younger persons where they can reminisce and relive memories, share their skills, experiences, and wisdom, and learn about another person. This is due to having increased needs for social support and memory stimulation, and less physical capability for external activities.
Reminiscing about the past is an intensively engaging activity that provides a sense of accomplishment, showing that they can engage in dialogue about meaningful memories and counteract the negative feelings associated with potentially poor physical health (McInnis-Dittrich, 2005). It is also a way to increase feelings of competency and adaptive skills, as focusing on past memories recalls strengths from the past that might not be present if focusing on current problems. This activity is also helpful for youth who participate, since students who engage in the reminiscence process learn about life stages, the process of aging, life in different generations, respect for the elderly, and the growing field of elder care (Neysmith-Roy & Kleisinger, 1997).
For more frail seniors, beneficial activities include hearing the paper read out loud, trivia, mentally stimulating games, chair exercise, cooking, listening to music, or going to events or concerts that they enjoy. This is particularly appealing if they lack transportation and other means to engage with the larger community; it not only provides intergenerational stimulation, but also access to activities from their past in which they might not otherwise participate (McInnis-Dittrich, 2005). Other activities include functional support such as helping with shopping, cooking, or crossing the street, all of which can be neglected or overlooked by busy family members, and therefore be of great assistance to the whole family unit (McInnis-Dittrich, 2005). The activity theory also states that challenging one’s cognitive functioning is a great way to maintain memory, which is a goal for frail as well as active seniors (Onedera & Stickle, 2008). This can be met by participation in this variety of activities and benefits all participants involved, while being of critical importance to senior health and well-being.
Lastly, seniors with memory challenges benefit from activities that engage their long-term memory recall and feelings of well-being (McInnis-Dittrich, 2005). The best activities for this purpose include musical stimulation and reminiscence activities, because even though many of these seniors are “no longer able to orient to time, space, or person” and have limited cognitive functioning, they can respond to music (McInnis-Dittrich, 2005, p. 188). Specifically, those who have Alzheimer’s disease, who can experience a significant decrease in mainstream verbal communication, benefit from the utilization of instruments, sing-along programs with their favorite music, reminiscence about the past, and multi-sensory engagement; this provides a new language that opens doors to perception and enhances the present moment. Furthermore, recalling old songs, keeping rhythm and remembering words also focuses on the strengths of what they are able to do, instead of focusing on what they can no longer accomplish.
In addition, these elders can enjoy arts and crafts projects that stimulate their minds with colors and shapes, as well as gear them toward the seasons, which helps orient them to time and space. Also, pet visits can be very nurturing for this population as they can meet their needs for touch, while enhancing communication with others (McInnis-Dittrich, 2005).
Summary and Conclusion
For senior citizens of all ages, it is clear that social support and activity engagement provide significant benefits, including increased life satisfaction and fulfillment, memory improvement, and depression reduction (Ashida & Heaney, 2008; Borg et al., 2006; Bullock & Osborne, 1999; Mullins et al., 1996; Ron, 2004).
References listed at the end of complete Master’s Thesis manuscript, “Adopt-a Grandparent Plus Program: A Grant Proposal Project”, by Diana Gruhl, MSW.