Transcript A consideration of issues of wellbeing, memory loss and ageing

ACCENTUATING THE POSITIVES ISSUES IN WELLBEING, AGEING AND
MEMORY LOSS FROM AN OT
PERSPECTIVE
Karen Wood, OT Gwynedd & Mon Memory Clinic
AIMS OF THE TALK
An overview of how the changes that can occur in
ageing and development of memory problems
may have an impact on wellbeing
How some older people, people with memory
problems and caregivers view their situation
Discuss how occupational therapy can have a role
in promoting wellbeing
WELLBEING
2012 Dodge et al: difficulties in defining wellbeing
“subjective well-being consists of 3 interrelated
components: life satisfaction, pleasant affect, and
unpleasant affect. Affect refers to pleasant &
unpleasant moods & emotions, whereas life
satisfaction refers to a cognitive sense of
satisfaction with life.” (Diener & Suh, 1997)
Ryff, 1989 looked at
constituents of well
being:
autonomy;
environmental mastery;
positive relationships
with others; purpose in
life; realisation of
potential and self
acceptance.
Other dimensions:
ability to fulfil goals;
happiness; life
satisfaction
Rogers, 1961, looked at wellbeing in terms of “the
good life” each person strives towards becoming a
“fully functioning person” - open to experience, is
trusting in his/her own organism and leads an
increasingly existential life:
“adjectives such as happy, contented, blissful,
enjoyable, do not seem quite appropriate to any
general description of this process I have called the
good life...adjectives which seem more fitting are
[those] such as enriching, exciting, rewarding,
challenging, meaningful. This process of the good life
is not...a life for the fainthearted. It involves the
stretching and growing of becoming more and more of
one’s potentialities. It involves the courage to be. It
means launching oneself fully into the stream of
life...”
“each time an individual meets a challenge, the
system of challenges and resources comes into a
state of imbalance, as the individual is forced to
adapt his or her resources to meet this particular
challenge” (Kloep, Hendry & Saunders, 2009)
“when individuals have more challenges than
resources, the see-saw dips along with their
wellbeing and vice-versa”(Dodge, Daly, Huyton &
Sanders, 2012)
AGEING
Physical changes
Psychological
Cognitive
Economic
Social
DEVELOPMENT OF MEMORY PROBLEMS;
DEMENTIA – THE DOUBLE WHAMMY...
Memory
Concentration
Visuospatial & constructional skills
Executive function
Language
EFFECT ON:
Self image & Expectations
Roles & Occupations
Relationships & Responsibilities
EXPERIENCING THE NEGATIVES

Gwen – mood, reporting cognitive problems,

Lily – early dementia

Tom – cognitive problems

Elizabeth – Tom’s wife & caregiver

Mair – early dementia
IS IT ALL BAD?
Maturity
 Experience
 Freedom
 Time
 Knowledge & skills
 Ability to adapt
 Resilience

AGAINST AGEISM
“The aged are an asset not a liability to society
because of the invaluable contribution they can
make by virtue of their accumulated wealth of
knowledge and experience” (UN 1982)
SOME INSPIRING OLDER PEOPLE
Helen Mirren
 Paul McCartney
 Buster Martin
 Mary Berry
 Terry Pratchett
 Some of my best friends...

WHAT IS OCCUPATIONAL THERAPY?
“OT takes a person centred approach to both
mental and physical health and wellbeing,
enabling individuals to achieve their full
potential.
OT provides practical support to enable people...to
overcome barriers that prevent them from doing
the activities (occupations) that matter to them.
This helps to increase people’s independence and
satisfaction in all aspects of life.”
(COT)
OCCUPATION
“refers to practical and purposeful activities that
allow people to live independently and have a
sense of identity. This could be essential day to
day tasks such as self care, work or leisure”
(COT)
Occupation should be a “synthesis of doing, being
and becoming” (Wilcock 1998)
ASSESSMENT
Of skills & abilities, limitations & needs –
person’s perspective & objective view
 Functional – application to activities &
occupations
 Home environment
 Holistic

INTERVENTIONS
Person centred – according to the individual,
their situation & environment
 Identify realistic goals
 Aim to optimise independence & wellbeing
through use of meaningful activity & occupation
 Practical problem solving
 Affirmation & reinforcement

REAL LIFE
FOR INDIVIDUALS
GWEN
Said she would like to : feel brighter & more
motivated, return to gym, start baking
To have kitchen assessment, start going out for
walks – setting targets, reported she needs to be
“pushed”, positive reinforcement, challenge
negative thoughts, facilitate exploration of
community resources/amenities
LILY
Said she needs: to be more confident using her
mobile; to be able to use her microwave to cook
chicken pieces; forgets times of the buses; feels
lonely
Assessed using appliances; demos & practice, she
has written instructions. Bus timetable
highlighted. Agreed to be referred to memory
club & Age Cymru befriending project
TOM & ELIZABETH
They have different issues, abilities & needs but
these have to be looked at together
Tom finds that forgetting day and date undermines
his confidence. He does use a diary but not
effectively.
Elizabeth – would like Tom to be able to recall
what he has to do in the day and not have to
worry about him when she goes out or visits
family who live away. She would like him to have
more structure and intellectual stimulation.
The couple are aiming to move closer to family
To help Tom recall day and date – calendar clock;
set up “information hub” & routine for checking
& taking medications. A dictaphone/memo
minder may be useful for recording events when
out. Strategy leaflets given to Tom & potential
activities discussed.
Elizabeth signposted to local caregiver &
community resources and discussed potential
resources in new locality; caregiver issues
discussed as well as general safety & driving
MAIR
Has a genuine sense of wellbeing
She feels her memory problems do not significantly
affect her life as she can:
Carry out most of her daily activities, her
daughters visit frequently with their children
who she helps to look after. She attends chapel
and a local club and has friends who visit.
She had a good marriage and has happy memories
that she enjoys sharing.
Mair did not wish to have any OT interventions as
she feels her family provide any reminders and
no safety issues were reported or identified at the
time of the assessment.
HOW DO THEY RELATE TO WELLBEING?
Person centred – according to the individual,
their situation & environment
 Identify realistic goals
 Aim to optimise independence & wellbeing
through use of meaningful activity & occupation
 Practical problem solving
 Affirmation & reinforcement

REFERENCES
Dodge R, Daly AP, Huyton J, Lalage DS: The
challenge of defining wellbeing. Intl Journal of
Wellbeing 2 (3) 222-235, 2012
 Rogers C: On Becoming a Person, 1961;
Constable new ed 2004
 Doble SE, Santha JC, Occupational well-being:
Rethinking occupational therapy outcomes.
Canadian Jnl of OT no. 3 vol 75 June 2008
 COT website
 CMOP accessed off www.munchkinandflan.com

CHEERS & THANKS FOR LISTENING!