METHODS AND ACTIVITIES FOR SUPPORTING

 

The holistic supporting of the functional capacity of older people is challenging and the carer needs to have skills, genuine interest, creativity and will to develop her- / himself and her / his skills and knowledge continuously. The correct methods at correct time create the prerequisites for maintaining and improving the functional capacity. Good, holistic supporting includes physical, psychosocial and spiritual areas and the carer needs to have skills and knowledge how to guide the elderly in all these areas.

 

Figure   The know-how and use of the methods of supporting the functional capacity

Supporting the physical functional capacity

 

Supporting the physical functional capacity is goal-oriented activity and it helps older people to cope as independently as possible and to maintain good health. The level of independence and the way of living vary according to the functional capacity. In supporting it is essential that the carer motivates and guides the elderly to optimal physical activity and to cope with the activities of daily living. The carer needs to plan and organize the living environment to aid the independent coping. For safety and coping it may be necessary to do changes in the living environment and arrange the necessary aid instruments. These facilities may support the independent coping of the elderly or help the carer. The aids for manual handling of the elderly make it possible both for the carer and the elderly to do transfers or lifts safely and pleasantly.

 

The aims for supporting the functional capacity must be realistic according to the abilities and skills of older people. The aims are

• maintaining and improving g the physiological functions
• maintaining and improving the abilities in activities of daily living
• motivating and guiding to outdoor activities
• motivating and guiding to health-related physical activities and fitness exercises

 

 

Supporting the mental functional capacity

 

The supporting of mental functional capacity is goal-oriented and the aim is to support older people to cope as independently as possible and to maintain good health.

 

It is necessary that the carer is able to consider the cognitive capacity of older people. Cognitive functioning includes perception, learning and memory, verbal skills, thinking, problem solving and decision making. An important part of cognitive capacity are the metacognitions which mean the elderly’s own conception of her / his perception, memory, learning and thinking abilities. It is important that the carer processes these together with the elderly. Creativity and wisdom are also parts of cognitive functioning and must be considered in supporting the mental functional capacity.

 

It is important to support the cognitive skills and emotional balance, mood, because mental health and wellbeing enable the mental functional capacity on older people.

 

The changes of life are connected to bereavements. The deaths of one’s spouse, near relatives or friends create loneliness and alienation from the younger generations. By supporting the psychosocial functional capacity of older people it is possible to increase the life control and coping at home and delay the need for institutional care.

 

The decline of the mental functional capacity affects the health of older people. By aging the memorizing weakens, recalling gets slower, the processing demanding initiative and exertion weakens and retention weakens. It is possible to recall by hints and recognition.

In addition the impact of situation and affection factors are emphasized in supporting the cognitive functioning. The processing of knowledge is connected to the changes of aging in brains but all factors are not known yet.

 

The carer must be aware that memory and memorizing are part of elderly’s everyday life and wellbeing. That is why their training is important. By supporting the mental functional capacity it is possible to decrease the need of help and care.

 

The emphasis in supporting the mental functional capacity is on finding the resources and capabilities of older people. The adapting to the mental changes is individual. The elderly needs in coping in everyday life voluntary activity, motivation and the possibility to act her- / himself. The carer must give the elderly a chance to run own errands and make own decisions. The carer can activate cognitive functioning by arranging the timetable of the day to demand different skills from the elderly.

 

Various organizations arrange courses for the elderly for maintaining and exercising memory. The courses give information and encourage the elderly to do exercises. The carer can find out the courses and support the elderly to participate. 

 

The elderly can also activate one’s memory independently. Good means are crosswords, playing chess and cards and also following the news of the world and reading novels. Other preventive means are arts, social contacts, many hobbies and participating in education.

 

 

Supporting the social functional capacity

 

Supporting the social functional capacity is goal-oriented activity and it helps older people to cope as independently as possible and to maintain good health.

 

In supporting the social functional capacity it is essential that the carer understands the elderly’s need for other people, closeness and social life. Social relations, social support and social activity are meaningful also for the elderly’s psychosocial functional capacity. Social contacts are needed e.g. when the elderly gets sick. Good social contacts and skills also help in case the elderly meets bereavements and help to adapt to sickness and to the decreasing of functional capacity. Socially active way of life is important to most older people. Social interaction maintains and improves self-esteem and the belief in own skills and strengthens the feeling of being needed. Often it is more important to get satisfaction from the hobbies than to learn new things.

 

In the care of older people action models for social support need to be developed. Social support means positive health related to human relations and actions which improve functional capacity and decrease stress. Social support is a resource from social contacts.

 

Social support can be divided to emotional, informative, instrumental and negative support. In emotional support the carer shares feelings and experiences with the elderly and gives encouragement, comforting and respective feed-back. The carer is expresses confidentiality and knowledge for further help and support.

 

In informative support the carer gives information and guides the elderly in various situations. In instrumental support the carer helps the elderly concretely. In negative support the carer is unprofessional, gives unsuitable advice and information, dictates requirements, reproaches and takes care of errands and things that the elderly could do by her- / himself. In negative support there is often a pretension for control and the elderly’s strong feeling of dependency.

 

The environment of the elderly should offer various social opportunities. The elderly needs to have an important role and a feeling of meaningfulness. This role can be the relation to own children and grandchildren. The social network gives safety and togetherness to the elderly. The carer can by her / his own actions reinforce the social network. Many possibilities can be offered from different group meetings. Social support is knowledge which makes the elderly to believe that she / he is cared for, respected and loved. In addition the elderly is committed to mutual network and gets feed-back and a feeling that she / he can control own environment  at the same time when the environment gives support to her / him.

 

 

Supporting the spiritual functional capacity

 

Supporting the spiritual functional capacity is goal-oriented activity and it helps older people to live a well-balanced life at full and experience one’s life meaningful.

 

In supporting the spiritual functional capacity it is important that the carer recognizes the moral and religious beliefs of the elderly. A well-balanced life requires the satisfaction of spiritual needs regardless of religious or nonreligious beliefs. 

 

The basis for god care lies in respecting the elderly. Good and constructive communication is possible in respective atmosphere. Valuing means respect to person’s values, human life, experiences and feelings.  The most important is to see the elderly as a human being and not her / his achievements, success or failures and unreachable goals. The carer respects every elderly regardless of her / his view of life, understanding or character. The carer understands that every human being has in this world her / his unique life and personality.

 

Older people strive to find positive aspects to their life by revising the memories. The carer needs to listen, strengthen the memories and give hope. The carer helps the elderly to seek and find the memories that help to maintain self-esteem. By listening and understanding the life story of the elderly the carer gives respect to the specialty of one’s own life story. The carer is genuinely and deeply interested in the elderly’s life situation and life story. The elderly experiences the carer as an equal human being. The carer is humble in facing the elderly. Humility means gratitude, empathy and sharing and being here and right now. The carer forwards gratitude and hope to the elderly. Superiority of the carer builds an invisible barrier between the carer and the elderly and the expertise is worth nothing if the carer is not willing to listen to the elderly as the best and genuine expert. The answer to the question: “Who are you and how are you today?” must be listened to attentively.

 

Professional confidentiality is an essential part of good care and communication. All aspects of the elderly’s life are personal and the carer is not allowed to talk about them to anybody. The elderly has to give permission if something has to be dealt in e.g. multiprofessional team. The carer needs to progress matters for the best of the elderly. The elderly needs not deserve this e.g. by behavior that pleases the carer and she / he must not fear that the carer neglects something because of not pleasing.

 

Caring may cause contradictory feelings in the carer, but the carer must be responsible for these feelings and be careful not to inflict them to the elderly. The carer must meet the elderly as equal despite of age, ethnic background, social status or any other classifications. Good care means respecting the cultural background of the elderly.

 

The carer must know the spiritual side of the elderly’s life story to be able to support the worries and losses concerning old age and solving the question of sensibleness of life. Supporting brings also joy, hope and strength to everyday life. Supporting can help the elderly to feel secure and take a balanced attitude to own life situation and also to death.

 

Reading is one important spiritual supporting method. Older people listen willingly to memories, life stories, spiritual books and the Bible. The texts can activate to conversation of own experiences and thoughts. Singing and listening to spiritual songs, hymns are also important. Arranging spiritual (graces) situations or taking the elderly to church are important supporting methods. Saying farewell to the deceased may help in processing the fears of death. Death is part of our life and discussing it is an essential part of the supporting of the spiritual functional capacity. Often the fears concern the life that has not been lived or the fact that the life left behind cannot be changed. The anxiety concerning death is related to the life history. Older people who have succeeded in dealing the crises of their  lives successfully or experienced little changes may react to life and death positively. Sometimes even satisfied elderly may be anxious with the thought of giving up life. If the elderly has sickness and pains she / he may think that death is a liberation. In discussions the elderly can express own wishes of funeral arrangements and of the last will.

 

It is a part of good professionality that the carer is able to recognize when it is time to discuss death with the elderly. Empathy and discretion are required from the carer in these situations.