Need for more meaning

The older we get, gerontologist William Randall (2011) says, “the more meaning we require in order to cope with, and grow through, the losses and challenges (physical, financial, emotional) that later life can bring.”

Yet Yang, Wilhelmi and McGlynn (2018) recognize that clinicians who work with older adults might struggle to help clients find meaning and satisfaction in life when confronted with serious declines in health and related losses.

What helps?

Randall (2012) suggests “narrative care.”

Narrative care is a comprehensive way of listening to, listening for, and listening behind the stories patients tell. And, he says that narrative care ought to run through everything we do in health care, especially when caring for  older adults.

This is important because, as Randall and McKim (2008) said, “just at that stage in our lives when we might most benefit from the company of others to nudge us toward greater narrative developments, the more likely it is that our narrative environments will be starting to shrink, often suddenly and dramatically. Loved ones die, friends fall ill, and our social network contracts, due in part to our own deteriorating health and diminishing mobility.”

Therefore, narrative approaches to health care can help push back against “master narratives” embedded in institutional and societal cultures, including the “narrative of inevitable decline” (Gullette 2004), and “narrative foreclosure” near the end of life (Freeman 2011).

Specific interventions

Yang, Wilhelmi and McGlynn (2018) suggest a variety of specific interventions to help older adults enhance meaning:

• Reminiscence therapy and life review
• Discussing end of life issues and decision-making
• Enhancing relationships to address social isolation and loneliness
• Engaging in creative projects
• Addressing spirituality and religion
• Acknowledging the development of wisdom and legacy-leaving
• Encouraging mindfulness and meditation practice

Additional interventions

Additional interventions that focus on narrative and the body include:

• Dance movement psychotherapy
• Ecotherapy
• Labyrinth therapy

And then there are standard approaches of

• Grief counselling
• Listening

My own research has focused on the power of listening and the meaning it can provide to others in need. It is never “just” listening.

What does it feel like when someone really listens to you?

Participants in my current study (Mundle 2018) talked about how they felt

• moved to tears
• relaxed
• settled
• confident
• empowered
• joyful
• embraced
• loved

What could be more meaningful than that?

These findings support Randall’s practice of narrative care in gerontology.

And they add to Yang et al’s (2018) focus on enhancing meaning for older adults facing  losses and challenges in later life.

Finally, they affirm Penn’s (2007) view in general that “listening is perhaps the most profound source of healing therapists have to offer.”

Freeman, M. (2011) Narrative foreclosure in later life: Possibilities and limits. In G. Kenyon, E.  Bohlmeijer, & W. Randall (eds), Storying later life: Issues, investigations, and interventions in narrative gerontology (pp. 3-19). New York: Oxford University Press.

Gullette, M. M. (2004) Aged by culture. Chicago: University of Chicago Press.

Mundle, R. (2018) Learning from experiences of feeling heard: A qualitative study of hospice volunteers. Illness, Crisis & Loss. http://journals.sagepub.com/doi/abs/10.1177/1054137318764682

Penn, P. (2007) Listening voices. In H. Anderson & D. Gehart (eds), Collaborative therapy: Relationships and conversations that make a difference (pp. 99-107). New York and London: Routledge.

Randall, W. (2011) Memory, metaphor and meaning: Reading for wisdom in the stories of our lives. In G. Kenyon, E. Bohlmeijer & W. Randall (eds), Storying later life: Issues, investigations, and interventions in narrative gerontology (pp. 20-38). New York: Oxford University Press.

Randall, W. (2012) Beyond healthy aging: The practice of narrative care in gerontology. In L. English (ed), Adult education and health (pp. 178-192). Toronto: University of Toronto Press.

Randall, W., & McKim, A. (2008) Reading our lives: The poetics of growing old. New York: Oxford University Press.

Yang, J. A., Wilhelmi, B. L., & McGlynn, K. (2018) Enhancing meaning when facing later life losses. Clinical Gerontologist. https://doi.org/10.1080/07317115.2018.1432735