Aged Care and Counselling

• Learn what happens to a person's state of mind as they age
• Discover ways in which a counselor, carer or anyone else might interact with and support an older person
• Expand your knowledge and skills for professional development; or to better help those around you.

Ageing is the gradual, biological impairment of usual functioning. These changes have a direct impact on the ability of organs such as the heart, kidney and lungs and biological systems such as the reproductive and digestive systems, which affect the person as a whole.

What we mean by “old” has also changed over recent years. Due to medical advances, improved hygiene and sanitation, people tend to live longer. Our life expectancy is the average number of years of life remaining at a given age. It is the average expected life span of an individual. Our life expectancy is dependent on the country we live in, our health and so on. For example, in countries with high infant mortality rates, the life expectancy will be different than in countries where the infant mortality rate is lower.

“Working with the elderly requires a different set of skills and knowledge to ensure that they receive the appropriate support. This course considers the different issues that are faced by older people, such as bereavement, chronic illness, terminal illness and death, and how to provide them with appropriate support.” Tracey Jones, B.Sc. (Hons) (Psychology), M.Soc.Sc (social work), DipSW (social work), PGCE (Education), PGD (Learning Disability Studies), ACS Tutor.

Lesson Structure

There are 9 lessons in this course:

1. Understanding Ageing
   • Gerontology, What do we mean by Ageing? Population Ageing, The Effects of the Ageing Population, Theories of Human Development, Erikson’s Theory of Development, Levinson , Theories of Retirement, Disengagement Theory, Activity Theory, Atchley’s Model of Retirement
2. Lifestyle Changes
   • Relationships, Relationships with Children, Relationships with Partners (Husband/wife), Relationships with Grandchildren, Friendships, Sexuality and Older People, Cognitive Changes, Intelligence, Depression, Determining Type of Depression, Unipolar Disorder, Bipolar Disorder, Causes of Depression, Risk factors for Depression, Men and Depression, Depression in Older People, Symptoms
3. Deterioration of Health
   • Physical Changes Skin, Hair, Height, Senses, Reflexes, Sex, Eyes,Chronic Health Problems, Osteoarthritis, Rheumatoid Arthritis, Gout, etc. Exercise, Diet, Nutrition, Eating habits, etc. Pain relief, Medication, Stress.
4. Support Services
   • Preventative Services, Occupational Therapists, Physiotherapists, Complimentary Practitioners, Counselling Professionals, Other Support Services (eg. Meals on Wheels, Funeral Services)
5. Enablement Techniques
   • Common Risks for Elderly: Risk of Falling, Vision, Hearing, Nutrition, Sexuality. Techniques to maintain Quality of Life: Driving a car, banking, shopping, house cleaning, Gardening, Socialising, Pets, Exercise, Sport
6. Grief and Loss Counselling
   • What is grief, Psychological aspects of Long Term Grief: Family, Work, Financial, Loneliness, Morality after bereavement, Counselors Response and Intervention, Practical Intervention, Depression
7. Debilitating and Terminal Illness
   • Dementia, Kinds of Dementia (Alzheimers, Vascular Dementia); Strategies for Counselling the Demented Client; Communication, Daily Activities, Sleeping Difficulties, Hallucinations and Delusions, Wandering, Depression, Terminal Illness: Patients Response, Anxiety, Depression, Guilt & Anger, Defense Mechanisms. Preparing for Approaching Death; Practical Preparations, Emotional Responses, Responses of Friends and Family
8. Losing a Loved One
   • Importance of Loss, Assessment, Role of the Deceased, Death of a Child, Stigmatised Death, Co-Morbidity. Counseling Strategies: Bibliotherapy, Use of Rituals, Bereavement Support Groups. Special Therapeutic Situations: Traumatic, Sudden, and Stigmatised Loss, Ongoing Support, Social Stigmas of Suicide
9. Ethics and Intervention
   • Barriers to Aged Care Counseling, Addressing the Client’s Needs, COMMON LEGAL AND ETHICAL ISSUES IN AGED CARE: Decision Making Capacity, Competence, Informed Consent, Confidentiality, Euthanasia, etc

Each lesson culminates in an assignment which is submitted to the school, marked by the school's tutors and returned to you with any relevant suggestions, comments, and if necessary, extra reading.

Aims

• To discuss theories of ageing, and to develop an understanding of the different stages of human development.
• To describe the psychological impact of changes which occur as a person reaches old age
• To understand the effect of physical health problems on older people.
• Describe the nature and scope of support services, including counseling, for the elderly.
• Describe a range of solutions that can enable an elderly person to adapt to changed circumstances in order to continue performing tasks or pursuing interests that are becoming increasingly difficult for them.
• Explain how a variety of counseling techniques can be applied to specific Grief and loss situations for counseling elderly persons.
• Develop a strategy for counseling an elderly person who has been diagnosed with a debilitating or terminal illness.
• Develop a strategy for counselling an elderly person who has lost a loved one.
• Determine when and how to intervene in the life of an elderly person

SAMPLE COURSE NOTES

Dementia

Dementia is a condition in which a person progressively loses mental ability, including the ability to remember, think and reason. It can affect memory, decision-making, problem-solving, learning, and the ability to care for oneself. Eventually, when the dementia has reached a severe stage, the person is no longer able to perform the tasks of daily living.

Dementia is not a disease in itself. It is a group of symptoms caused by a number of diseases or conditions that affect the brain. Some of these causes are 'reversible' and can be treated, for example brain tumours, depression and alcohol dependence. Other causes are 'irreversible' and cannot be cured.

Dementia, a progressive brain dysfunction, leads to a gradually increasing restriction of daily activities. It is what is called senility by the layperson, the deterioration of intellectual functioning until social and occupational functions are impaired. The most well-known type of dementia is Alzheimer's disease.

The prevalence of dementia increases with age. IT is estimated that around 1% of people aged 65 – 74 have dementia, 4% of those aged 75 to 84, and 10% of those over 84. These figures may be underestimates, as some people will die from some causes of dementia. Dementia is caused by many conditions that affect the brain. Some causes of dementia can be reversed, and others cannot. The major signs are memory loss, confusion, disorientation and lessening of intellectual functioning. Dementia can come on slowly over a period of years, subtle changes can occur, such as difficulty remembering things, especially recent events is a prominent symptom of dementia.

Examples include –

Starting to run the tap then leaving the room.

Being unable to remember the name of their son or daughter.

They may also develop poor hygiene, forget to bath or dress adequately. Their judgement may become faulty and may have difficulties making plans or decisions. They may also lose control of their impulses, for example, tell coarse, inappropriate jokes, make sexual advances to strangers, shoplift etc. Other times, they may have symptoms of depression, such as flatness of affect, emotional outbursts. Around 50% of patients may experience hallucinations and delusions. Some people with dementia may have disturbances with language, such as vague patterns of speech. They may have difficulties recognising familiar surroundings. Episodes of delirium may also occur.

The course of dementia can be progressive, static or remitting, depending on the cause of the dementia. People with progressive dementia will eventually become withdrawn and apathetic. In the terminal phase of the dementia, their personality loses its sparkle and integrity.

Relatives and friends may say that the person is not themselves anymore. Social involvement with others will become more and more narrow. Finally, they will be oblivious to their surroundings.

Treatable conditions that can cause dementia include a high fever, dehydration, vitamin deficiency and poor nutrition, bad reactions to medicines, problems with the thyroid gland, or a minor head injury or tumour. Medical conditions like these can be serious and should be treated by a doctor as soon as possible.

Alzheimer's disease is the most common form of dementia. Among other causes are medical conditions (thyroid disease, drug toxicity, thiamine deficiency with alcoholism, and others), brain injury, strokes, multiple sclerosis, infection of the brain (such as meningitis and syphilis), HIV infection, hydrocephalus, Pick's disease, and brain tumours.

There are four main types of dementia –

Alzheimer’s Disease – the most common.

Frontal-temporal Dementia – this describes the area of the brain that is most affected.

Frontal-subcortical Dementia – again describes the area of the brain most affected.

Vascular Dementias – caused by stroke.

Conditions or diseases that cause irreversible dementia, especially in older people, include Alzheimer's disease (AD), dementia with Lewy bodies, and multi-infarct dementia (MID), also called vascular dementia.

What is Aging?

Ageing is the process of growing old. It is a gradual biological impairment of usual functioning. These changes have a direct impact on the ability of organs, such as the heart, kidney and lungs and biological systems such as the reproductive and digestive systems, which affect the organism as a whole.

On average, in the UK, men will live to be 77.2 and women 81.5. This will have an obvious effect on society. As people are living longer, this will mean that there will be more people who have retired and are no longer working. This has an obvious impact on the economy. There are medical advances, but as people age, their bodies and minds are affected by the ageing process. This is something we will discuss in more detail in later lessons.

In economic terms, an ageing population can lead to changes in expenditure in some areas, such as:

• Health care: this will increase as the population ages. This could result in higher taxes to pay for the increased costs of health care.
• Education: expenses will fall as there will be fewer young people.
• Pensions: the state pensions will be affected by the increased longevity of the population. 

   

Ageing also inevitably leads to physical decline. Many of the physical changes involved are not the result of illness or a direct consequence of the ageing process, but can be due to:

• Lack of exercise
• Poor diet
• Poor lifestyle.

However, they will experience a number of physical changes which can be attributed to the ageing process:

• Muscle mass decreases
• Cells decay. The DNA strand in our cells becomes damaged, which ultimately leads to the failure of the cells’ energy production
• Energy reserves will reduce
• The immune system will have a reduced capacity to fight against disease
• The organs and bodily systems, such as hearts and lungs will become less efficient.

Ageing is therefore the result of damage to the cells in our bodies. However, the speed at which a person ages will be affected by: their outlook on life, as well as their personal experiences and circumstances. Hence, it will vary from person to person. However, ageing is not necessarily a negative experience. As a person loses in some areas, they may gain in others. For example, they may lose some energy, but they may learn the ability to conserve energy. They may learn patience, understanding, wisdom and how to make the best use of their life experiences, all of which may improve their lives regardless of any physical changes.

• Aged Care is becoming of increasing concern, not only in developed countries; but developing countries as well.

• This course helps you understand ageing and the aged; and provides a foundation for working with the elderly; as a counselor, carer or in any other area of support. 

SAMPLE ASSIGNMENT

1. State three common physical health problems which can affect people as they age. One sentence for each.

2. For each of the three health problems mentioned in question one, write one paragraph outlining ways in which an elderly person can learn to cope with the physical aspect of the problem.

3. What strategies could a counsellor use to help an elderly person deal with each of the following: failing eyesight, decreasing mobility, and physical pain? Write a paragraph for each.

4. Submit a brief report (up to one page) on your research from the set task.