Living with Memories

Illness, suffering, grief, and worries can become part of everyday life. Some people dwell on old memories or events. For healthcare and social care workers, it is important to be prepared to listen but also to receive and shelter what comes up.

It happens that elderly people need to talk about life and death. The employee is often unprepared and does not quite know how to respond. Often it can be enough to just listen and ask "what are you thinking then? What worries you?" Then the conversation often starts on its own.

Guilt and Shame

Lennart, who lived in a nursing home, was stuck in memories of an incident in his youth and was convinced that he would end up in hell as a result. For my part, I saw a man in front of me who had made the best of his life. He had friends and was generally liked, but this event made everything else in life meaningless. He went into depression and asked for help to be admitted to psychiatric care. A few days later he took his own life in the psychiatric ward. In hindsight, I realized that he had wanted to spare the staff from his dark thoughts and from finding him dead.

Someone Who Listens

It is common for elderly people to need solitude and time for reflection. It may be that the elderly person is involved in processing memories and going back in time. The boundaries between past, present, and future blur and the elderly person can often feel an increased connection with the cosmos and the universe. Interest in material things decreases. At the same time, thoughts may arise that need to be expressed in words. Words that only make sense when someone stops, listens and confirms.

Avoid or Encounter

There is a risk that we avoid people who feel lonely and have lost their lust for life. Healthcare and social care workers should consider what fears they have so that they do not avoid the person who needs time and attention most.

The elderly person can feel full of life, and then it is relatively unproblematic to let go. The view of death and dying varies between different people. For the elderly, friends pass away which evokes emotions. It can create a feeling of loneliness and that there is no one who can really understand how it feels.

Many people have wishes for their own funeral that can be expressed in the White Archive or the Life Archive, for example. These are digital services where the individual can express their wishes regarding the funeral itself. Another way to express your wishes is to write a will.

There is no right or wrong here. As an employee, you can only confirm, listen, and be open to conversation. To be a good listener, it is advantageous to have reflected on death and dying yourself.

Salutogenic Approach

Researcher Aaron Antonovsky has studied what makes some people stay healthy even under difficult circumstances, salutogenic factors. This is the opposite perspective to the large amount of research in healthcare and social care that studies so-called pathogenic factors that make us sick.

Aaron concluded that there were three factors that contributed greatly. What he found is that people who feel involved in a context that is understandable and meaningful can experience health despite being seriously ill. He called it all SOC – a sense of coherence.

Well-being, participation, respect, and an active and meaningful existence in community with others are some of the value words that are highlighted in the Social Services Act. Knowledge about SOC has been included when the law was written and it is good to have with us when we plan daily work and create a functional everyday life for our residents.

What is meaningful and understandable to us is different for each individual, we participate in several contexts and have several different roles during our lifetime. We who work with care and social care must get past our own perceptions of what is meaningful to the elderly so we can understand what the person themselves experience has a significance in everyday life.

Mental Illness

Mental illness, especially depression, is common in older people. Employees must be attentive and interpret signals, provide opportunities to socialize with others to create a community and a sense of coherence. Socializing with others breaks loneliness, gives a person the opportunity to share memories and feelings that can heal both "body and soul". Physical activities and the opportunity for outdoor activities counteract both mental illness and physical disease. The successful program "Four-year-olds in the nursing home" shows that company is better than medicine, that the joy of life and curiosity of the children counteracted both depression and loneliness, that the spontaneous activities provided the opportunity to exercise both brain and emotional life.

The salutogenic perspective in the work can be strengthened by working with ÄBIC and Person-centered care. These two complement each other as they start from the social and medical needs of the resident respectively.

Spirit Beings

Today there are TV programs where mediums are helpful in clearing properties from ghosts and unhappy spirits. The question can come up in the nursing home. It is important to have thought about how the business should relate to spirits and hauntings.

A friend of mine told me that she and her daughter occasionally see spirit beings in different contexts that they experience as people who have passed away and who come to visit a place or a person. She also experiences it happening where she works.

On TV, several TV programs deal with the supernatural, both with deceased relatives who come to say hello and say goodbye, but also with more unhappy spirits that create discomfort for those who live in the house. It happens that residents feel uncomfortable in the apartment they live in and ask to change.

It can be about a feeling of being watched, uncomfortable smells or sounds that feel disturbing. A manager at a nursing home where hauntings are discussed may have a difficult situation. It obviously leads to criticism if managers use tax money to hire mediums. The municipality does not pay for the priest or imam to come.

The staff seemed to feel safer afterward. There are events where employees have hired mediums as they have thought they wanted to quell haunting in a care home and there are cases that have been reported for that reason to Lex Sarah.

More than one in five Swedes believes that people can go again. Many have experiences that they cannot explain and interpret as the spirits of the deceased or other beings. The discussion is about religious belief. Some are horrified that paganism is spreading, but are there better and worse beliefs? There the business ends up in another ethical discussion, namely that employees should show respect for other people's beliefs.

The business should be run in accordance with science and proven experience, which can come into conflict with beliefs and religious experiences. It must be a starting point we must relate to. It is probably the case that spirituality feels more uncomplicated and accepted to talk about than to have views about religions.

Many people are spiritual in some form, something that we cherish extra and that gives us energy and calm. Hiking, being with animals, and enjoying beautiful places. It does something to us, arouses thoughts and memories, and is enjoyable. The question of whether we are religious is often answered with a, no, but I believe in something. It is, in my opinion, some form of spirituality. Every person is unique and there are probably as many different ways to define spirituality as there are people.

For healthcare staff, it might be easier to consider all forms of religions and beliefs as spiritual. We all have to tread our own path and carry our own backpack. Everyone goes their own way to achieve increased well-being and acceptance regarding existential issues, to be able to handle fears and potential obstacles in life.

Our focus must be to listen in, not to comment and have solutions to life's big questions. Our role in care and social care, I judge, is to be professionally empathetic and empathetic, for who owns the right to judge others?

Reflection - Existential Issues
Care Staff:
• Have you reflected on death and dying yourself?
• Do you take care of the healthy aspects of your residents?
• What are your thoughts on supernatural experiences?

Manager, Nurse, Occupational Therapist, and Physiotherapist:
• Have you had any training or supervision in discussing existential issues?
• How do you handle residents who are actively believing?
• Is there time for those who wish to talk?
• How should the business act if a resident or their relative brings home a medium or asks to change apartments?

Residents and Relatives:
• Do you talk about existential issues when you visit?
• Do you have a readiness to listen?
• Does the business take care of and strengthen the health of the residents?

Erland Olsson
Specialist nurse
Sofrosyne - Better care every day