Caring for our Elders. A Holistic Approach - November 2011

Problems and limitations of the present aging and elder care system, and how we can fix it

By Del Muzzillo

Hey everyone.

Living a healthy life that encourages and supports curiosity, learning, personal growth, and vibrant longevity is our birthright, and it is the birthright of our children, our elders, and all people in between.

Often the principles of vibrant wellbeing are taken into account when we are young and certainly through middle age. But, there has been a lack of emphasis for those people in their most senior years. Yet, it is in these years that this stuff is even more important.

This series of articles have been written to address some of these issues as applied to our senior population. My past five articles have focused more on healthy aging for those of us who will become seniors in the not too distant future. This next series will focus specifically on our elders.

We live in a culture that glorifies youth and everything young. There is whole billion dollar industry of “anti-aging” products and services that has grown from our fear of aging. 

In fact, aging can be cool; especially is we are talking about healthy aging. In a healthy well balanced society both the young and the old are honored and listened to.

Especially in the more tradition based, land based cultures, elders are held in the very highest esteem. It is only our culture that seems to be obsessed with youthfulness, sometimes at the cost of our elderly.

Heck, look at Yoda. He was 600 years old and could still kick butt! And he was cool. Wonder what he ate . . . . .?

OK, seriously, graceful, dignified aging in a healthy way, in a healthy, vibrant environment is actually quite cool and hip. There is a whole new exciting way that we can age well, and most importantly in this new series of articles, how we can support our elders in aging well.

All of us who have aging parents are either about to face some of these issues, or we are already in the thick of it. It is not an easy task, but the good news is there are some promising solutions.

In some ways, the third world has us beat in elder care, because in some of these cultures they honor their elders so highly that they are given the best care through their extended family. They don’t need home support companies or nursing homes.

In our culture, we have a more isolated nuclear family model that makes elder care-giving quite a daunting task. Often we need outside support.

Yet, we have the wealth, the technology, the information, and the support systems in place to be able to create something even better. We could do family care giving and professional care giving in a way that is comforting to our elders, cost efficient, time efficient, and provides superior care.

Instead, what is often the norm is the progression goes from elders living independently at home, to family assisting their elders and supporting them when they can, to professional care(that is contracted out), to assisted living facilities, and eventually on to residential care facilities (nursing homes) where these elders live out their last days until they die.

Now I fully realize that over the past 40 years or so, we have come a long way. Almost every aspect of caring for our elders has improved immensely.

They are many wonderful people within the elder care industry who have the right intentions, really care, and are doing the very best they can. Nevertheless, there still is great room for improvement.

I will briefly highlight some of the problems and limitations that we are presently dealing with. But more importantly over the course of the next three months, I will highlight some of the most promising solutions. These are practical solutions that we can embrace right now.

You can learn from these examples. You can use some of them with your own parents or elderly friends. You will know what to campaign for and champion when you are dealing with home support providers, care facilities, health authorities, or the government.

Early intervention is so important, but it often does not happen.

As well as individual healthy living choices; cognitive, mental, and physical health support should be in place from family and care-givers. But, it often is not, until way too late.

Then when residential care is required, that person is often quite compromised. They then enter a somewhat outdated “hospital based” environment. There has been much improvement, and many very good reforms. But, it is still a “work in progress” and there is still much room for improvement.

-Home support options are better today than they have been, but there still are many limitations.  There are a few outstanding home support companies that are now using some very modern and effective approaches. But, the costs can add up quickly as more coverage is required.

-Most families are not near enough engaged in the caring process (nor are they educated in this field enough to actually be helpful). Of course there are some exceptions and these dedicated family members should be honored and respected for their hard work.

- Generally, most residential care facilities do not provide a truly stimulating, life enhancing environment so that these elders can actually thrive. Of course there are a few shining exceptions, but I am referring to the norm.

- Many elders may not be getting good nutrition nor do they have the supplementation that could be helpful to their wellbeing.

- In many places there are some serious safety issues: rock hard floors that shatter bones upon impact, chronic under-staffing, the use of poorly oriented “casual” staffing, common areas that are unsupervised at times, over use of sleeping medication and psycho-tropic medication that can make an elder dizzy, can reduce balance, and can lead to potential falls, etc.

- Many elders in residential care facilities lack a real connection with nature, with young children, with animals, with plants, arts, crafts, nor the ability and opportunity to mentor. All important, but often neglected.

- A number of the elders in these facilities are over-medicated with pharmaceutical medications that have a questionable success rate in the first place, and often have some nasty side-effects. Again, some medications are miracles. Some save lives. But sometimes there are medications that are over-prescribed, and beyond their intended monogram.

- Many residents will tell you they are both bored and lonely.

- Most residents in long term care have a personal living space that is smaller than 250 sq ft.  This is about the size of a very small motel room. And that is their living space for the rest of their life. How much of your life can you squeeze into less than 250 sq. ft?

- There are very few real wellness activities or wellness support.

- The way these facilities are developed and operated can have a significant impact on their environments. Very few are actually green facilities.

- A high per centage of the elders who are put into these environments decline very quickly after moving in.

- The present system is often quite stressful for the staff as well as many of the residents.

- Most residential care facilities are actually under-staffed. The staff  there are often stretched in many directions and cannot spend as much time with their residents as they would like to. In the midst of it all, there is some absolutely wonderful staff doing a stellar job, but often their hands are often tied.

These are a few of the issues at hand and the limitations of the present system.

As the title of this article alludes to, I am focusing on a “holistic” approach to elder care. In this approach the elder is seen as a whole person living in an inter-connected world.

Rather than the reductionist, mechanistic view that has propelled this whole multibillion dollar industry for decades, we are looking at a more organic, person-oriented approach that takes into account the whole person, the family, the care team, the environment, and the community at large.

It is only when we evolve into this larger view that we can affect real positive change.

This month, we have identified some of the problems and limitations of the present system.  Next month, we start to explore the solutions.

Imagine if there were a way to care for our elders in a supportive, life enhancing, environmentally friendly, humanistic manner that provided superior health, safety, happiness, community, and wellbeing, while simultaneously reducing costs and providing a much more positive work environment for all those care givers and staff?

There are some exciting new developments and discoveries that give us much hope for a healthy, vibrant, happy future for our elders of today (and all of the rest of us tomorrow). Stay tuned to learn what this can look like if we do it right.

Del's Bio: Del Muzzillo has been involved in the wellness industry, the health resort business, and the human potential world for over 35 years. He has served at a leadership level in these areas in Canada as well as three decades in the U.S. He has brought this background into the field of aging and especially in the care of elders. He presently is directing the SENICA Project which aims to reform elder-care with a modern holistic approach. 250-328-8834 - Email