| Forward-looking long term care
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| | e.g. in the theatre when an endearing
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| administrators have long pondered how to
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| | character dies we may cry and feel
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| eliminate the dejection and malaise that
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| | hopeless; if our parents continually told
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| infests their facilities. They have
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| | us how stupid we were, we may grow up
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| heard about culture-change and tried
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| | actually feeling stupid. THE SAME
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| various solutions: staff wearing regular
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| | SITUATION can be perceived differently by
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| clothes, pleasant bird cages, providing
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| | different people based on the story of
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| more resident options and meetings about
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| | themselves that was internalized by
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| communication skills with the staff.
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| | repetitive pervasive conversations.
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| However, nothing seems able to generate
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| | One person is treated for cancer and
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| the meaningful changes needed for a
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| | describes the therapeutic experience as
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| pleasant and more optimistic environment.
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| | miserable and the worst time in my life.
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| How Do You Transform Long Term Care from
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| | Another describes it as just a difficult
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| Being A Festering Incubator of Malaise
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| | challenge.
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| and Hopelessness to Becoming an Uplifting
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| | Both had almost identical experiences and
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| Gallery to Resident Achievement and
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| | walked away with vastly different
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| Accomplishment?
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| | interpretations, stories and feelings.
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| I have practiced clinical psychology for
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| | We learn thru repetition. Repeated
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| 30 years and treated hundreds of elderly
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| | suggestions and conversational themes
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| patients for depression and anxiety. I
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| | associated with emotionally charged
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| have concluded that insidious
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| | experiences are powerful in crafting a
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| communication patterns within long term
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| | certain role for a resident in a
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| care facilities themselves are often at
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| | particular story.
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| fault.
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| | The residents internalized story can
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| These, combined with the out-dated
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| | change over time because it is contingent
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| techniques used by the mental health
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| | on the type of consistent interactions in
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| providers they use, inadvertently create
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| | which s/he is engaged. Interactions or
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| the conditions which cause residents to
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| | conversations need not be verbal, but are
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| be even more depressed and dejected.
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| | often composed of nonverbal components.
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| There is a growing concern that the only
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| | A nurse who is gruff in manner is sending
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| mental health care residents often get is
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| | the suggestion that the resident is a
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| from geriatric psychiatrists who often
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| | pain or perhaps inept. Every interaction
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| miss the feelings they experience about
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| | with a resident should be seen as
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| their plight. Just write a prescription,
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| | resulting over time in a better or worse
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| maybe tell them how their thinking
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| | outcome for the residents felt sense of
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| processes are distorted, check in
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| | self.
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| occasionally and see you later.
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| | Strength-Embedded Psychotherapy starts to
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| The use of medication is often the only
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| | treat resident depression and anxiety by
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| treatment a resident receives, even
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| | using asset mining, a method of
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| though the research literature clearly
| |
| | sensitively, yet tenaciously, unearthing
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| and consistently emphasizes that it must
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| | any improvements, large or small, that
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| be combined with psychotherapy to achieve
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| | can be credited to the resident. Then s
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| optimal outcome.
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| | he implements the skillful use of
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| However, many psychologists use
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| | conscious conversation: manifesting
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| pathology-driven psychotherapy in their
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| | attention, imbuing constructive meaning
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| treatments. They build and expand on the
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| | and significance to resident suffering
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| problems and repeated complaints of the
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| | and replacing problem-saturated
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| resident thereby encouraging their impact
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| | conversations with strength and progress
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| on his/her awareness. They often
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| | saturated ones.
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| contribute to the lack of significance
| |
| | These techniques are reinforced by the
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| and de-humanization residents feel
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| | long term care staff and are used over
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| because their approaches are often too
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| | time with repetition and consistency.
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| impersonal, mechanistic and dismissive.
| |
| | The therapist then incorporates them
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| Consequently, resident losses continually
| |
| | deftly in the residents internalized
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| loom larger in consciousness.
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| | story, occasionally over his/her
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| They generate impersonal case histories,
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| | objections, so that the new plot can be
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| which fail to illuminate each
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| | internalized and eventually changed from
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| individual's experience in the struggle
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| | one starring resident victimization to
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| to survive illness. Residents, too,
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| | one showcasing mastery.
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| increasingly complain about this crisis
| |
| | Throughout the process, the resident will
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| of having no meaning-nothing to live for.
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| | often tenaciously attempt to revert to
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| This underscores the need for a
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| | saturating conversations with problems
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| cutting-edge mental health program that
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| | and references to victimization. The
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| addresses meaning obtained by the
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| | resident craves continuity of the
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| resident from his/her travails and his
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| | problem-saturated story which s/he has
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| her strengths and successes, no matter
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| | internalized.
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| how small. This dignifies him/her.
| |
| | After all s/he has depended upon it,
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| After all, that is what culture-change is
| |
| | often at great emotional cost, for a
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| all about!
| |
| | consistent sense of identity. However,
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| What Most Mental Health Providers Do Not
| |
| | with consistency and over time, the new
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| Know about How Residents in Long Term
| |
| | trance starts to take effect with the
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| Care Become So Depressed
| |
| | resident experiencing him/herself as
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| Conventional mental health providers miss
| |
| | masterful and potent, rather than
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| the point that the resident makes sense
| |
| | miserable and hopeless.
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| of his/her world by creating a coherent
| |
| | Compare SEP-strength-embedded
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| facility persona by subconsciously
| |
| | psychotherapy with the usual
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| crafting a particular story and role for
| |
| | pathology-focused techniques of most
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| him/her in it. We have all seen the
| |
| | mental health providers. Talk to a
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| abandoned residents, betrayed residents,
| |
| | resident for 15 minutes; just write a
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| and the ostracized residents. When we see
| |
| | prescription and follow-up occasionally.
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| no objective verification, we conclude
| |
| | If you are a psychologist, tell them how
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| that they are the result of internal
| |
| | their thinking processes are distorted.
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| dramas that the residents are really
| |
| | Then over-use empathy to the point that
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| feeling and living which have been
| |
| | the resident is repeating the same
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| created by inadvertent, though insidious,
| |
| | miseries and complaints over and over to
|
| hypnotic processes taking place in the
| |
| | the point that they loom ever larger in
|
| facility itself.
| |
| | consciousness.
|
| Just like the stage hypnotists subject
| |
| | These pathology-driven treatments
|
| really feels like and becomes a barking
| |
| | continue to infest long term care with
|
| dog, the facility resident becomes and
| |
| | dire results. They build on the problems
|
| feels like a victim drowning in his/her
| |
| | of the resident and build their impact on
|
| own tragedy. Therefore, the residents
| |
| | his/her awareness. They often contribute
|
| hopeless story, though not necessarily a
| |
| | to their insignificance and
|
| FACT, becomes one.
| |
| | de-humanization because they are
|
| And unfortunately the screaming misery
| |
| | impersonal, mechanistic and dismissive.
|
| that results becomes the biggest FACT of
| |
| | Consequently, resident losses continually
|
| all!
| |
| | loom larger in consciousness.
|
| Implications For Your Facility:
| |
| | The train to culture-change is moving
|
| This insidious waking hypnosis is induced
| |
| | faster. Not changing your mental health
|
| by repetitive problem-saturated
| |
| | provider to one who emphasizes strength
|
| conversations taking place in the
| |
| | and success-based approaches can put you
|
| facility. THAT IS Right! The CNAs,
| |
| | in danger of being perceived as an
|
| nurses, therapists, families, doctors and
| |
| | uncaring dinosaur later. On the other
|
| residents themselves unknowingly collude,
| |
| | hand, enthusiastically adopting it now
|
| by their use of various interactions and
| |
| | can position you as a forward-looking
|
| words, to create a reality which is
| |
| | pioneer who is contributing to the
|
| catastrophic, demoralizing and futile.
| |
| | historic changes taking place in the long
|
| We undergo waking hypnosis all the time
| |
| | term care industry.
|
