As caregivers, it is an understatement to say that our lives are busy. Our days may be filled with endless tasks such as helping a parent with bathing, administering medications, managing appointments and insurance claims. We may be balancing caregiving with employment and many other responsibilities. Checking off as many items as possible from our to-do list becomes our priority.
However, what is often most important to the person we are caring for is not the “doing” but the “being”. Recently I saw an older patient who had many contacts through the day from his son as well as the numerous health care workers who come to his home. However, he was very lonely. No one was able to spend the time to do what mattered most to him… have a meaningful conversation.
For many older adults whose health is compromised, these conversations may naturally focus on reminiscing about the past. It is important to recognize that these conversations are not just an exercise in “reliving the good old days”; they have therapeutic value. They fulfill what I believe is a universal need as we age… to know that our life has had meaning and value and that we have made a difference to others. We can help our family members in this process by being fully present and actively engaging in meaningful conversations.
Begin By Gaining an Empathetic Perspective
As caregivers, we may often feel that there aren’t enough hours in the day to accomplish everything. Time passes quickly as we juggle multiple responsibilities. The time perspective for ill older adults is different. Days may go slowly and their world becomes smaller as activities, abilities, and relationships diminish. They may perceive that it has been a long time since we’ve seen them when in fact this is not the case. And while they may appreciate the tasks we do, what they truly value is meaningful time with us. It’s also important to recognize the many losses our family member may be experiencing, such as friendships, independence, activity, and the ability to care for themselves and others. They no longer have these as sources to bring them a sense of accomplishment and fulfillment in their daily lives.
The Value of Reminiscence
Regardless of whether the older person has memory loss, the desire to reminiscence about the past is common because of the multiple losses that are experienced. Reminiscence provides an opportunity for our family members to recall a time when they were independent, active, productive, and in control of their lives. As an active listener, we can begin where they are in terms of what they want to discuss. We can ask questions to gain more detail about their experiences. Most importantly, reminiscence allow us the opportunity to reflect and validate their accomplishments and contributions.
Validating Worth and Value
As a social worker, I reflect with older persons the meaning and values that I notice as they reminiscence, reinforcing the impact they have made on others. I also focus on the choices they made which contributed to positive outcomes in their life. Some commons reflections I may offer as
– It sounds like you really worked hard and sacrificed to make a good life for your family.
– You really provided a meaningful childhood for your kids, building wonderful memories and teaching them
– You had a passion for your job, it sounds like you found your calling and were successful in your career.
– You had so many experiences in your life, it seems that you have lived a very full life.
– Your faith has been important and you have lived a life in keeping with those values.
– You have always had an adventurous spirit and made the most out of every day.
– You were really a survivor; what tremendous strength and courage you displayed in getting through those
– You have such an important role in your grandchildren’s lives, you are passing on your values to them.
– You have raised your kids right because now they are here for you.
– Caring for others has always been important to you not only with family but in your volunteer work.
– You really took your marriage vows seriously and cared for your spouse in good times and bad.
The Impact of Meaningful Conversations
Sometimes these discussions will raise past regrets or disappointments; this is an opportunity to reconcile these experiences, putting them in perspective and perhaps leading to forgiveness of self or others. Frequently these communications will elicit a brightening of mood and a sense of satisfaction and contentment. They may also lead to greater acceptance of current challenges as they are put in the perspective of their life’s journey. After a conversation with the patient I previously referred to, he took my hand and said “you have no idea how much this meant to me.” As I reflected to a patient with dementia a particular memory that reinforced her lifelong role as a volunteer, she said, “thank you for sharing that important memory, it had gone from my mind.” For us as caregivers, these conversations can be meaningful as well, as we may gain a renewed appreciation for our family member’s life and compassion for the challenges they are experiencing.
So as we slow down from the hectic pace of accomplishing tasks and take time to be fully present with our family member, we will find that our interactions will be more fulfilling and our lives enriched in the process. And years from now when we remember our loved ones, it won’t be that completed to- do list that brings us a sense of peace and contentment, but rather the memory of the meaningful conversations we had that honored their well lived life.