Month: March 2014

Getting older and better?

Posted on by kathleenmc1953@sbcglobal.net

Getting older and better

Assumptions about aging

For those of us approaching retirement age and beyond each birthday brings new revelations about aging. We can “age well”, “age gracefully” or “look good for our age” . These are the positive connotations, of course, while the negative image of aging is implied. It is assumed that we are trying to keep up appearances and that it is all downhill from here. Lip service is paid to “honoring our elders” but the reality is usually much different. In a youth-obsessed culture aging is not valued. At best we are seen as glorified babysitters and, at worst, as aged children to be controlled and managed.

Could there be another reality for us as we age?

Losing our identity

As it stands today, many adults over 55 are facing a reality far different from our parents. Some of us have saved and are secure but a great number of us are facing no pensions, depleted retirement accounts and chronic health problems. We may have had to retire early due to lack of employment opportunities. We may have acquired a chronic illness and have had to leave our career due to a disability. Whatever the case may be, this is a time of transition when most adults lose, either voluntarily or otherwise, their primary identity.

Your work pretty much dictates your social circle, the neighborhood you live in and the general financial security of your family. The question is: who are you without it?

Rediscovering ourselves

The rub is not to be LESS of a person as we age but MORE. We can become more than a number or an afterthought in a marketer’s arsenal. We can find true satisfaction as we age. How can we accomplish this?

  • Well, above all, we have time. Allow yourself to use this time to rediscover what is important to you.
  • Review your expenses with an eye toward what you can live without. Having more things means using your time and money to maintain those things. Less is more.
  • Utilize your wise self. You know a lot. Find a part-time or volunteer position where you can impart this knowledge.
  • Allow yourself to daydream about the things in your life that you would still like to do. It could be travel, writing a book, starting a blog, learning a language, taking up painting or re-building an engine. You might pursue a hobby that you didn’t have time for when you were younger, become fully involved in something that you dabbled in when you were working or begin a totally new endeavor.
  • Have a serious talk with your family and friends about how you would like to be treated as you continue to age. Challenge them to see you as a vibrant individual who will still contribute. Require respect. Have this talk as often as you feel it is necessary.
  • Revisit your understanding of your higher nature. Prepare to be your best self now that you have the time. The way you do this will be unique to you and could include participating in any kind of spiritual pursuit that calls to you. Or not.

After all, if you’ve made it to this age, this is the time to get it right. Have fun. Make mistakes. But don’t let it pass you by. You have so much to give and so much to learn………..still.

Change versus bureaucracy in mental health

Posted on by kathleenmc1953@sbcglobal.net

Why things don’t change

If you’ve been alive long enough you may be getting an uneasy feeling in the last few years that modern civilization is not working too well. Where the turning point came is somewhat hard to determine but the gears seem to be grinding to a halt as more and more problems go unrecognized and unaddressed. My observation is that this is true in virtually all sectors of society but, since my experience of things is in the mental health and public health fields, I notice this phenomenon more in these spheres.

For practitioners in the mental health field who want to practice effectively the bureaucratic red tape and redundancy is fairly overwhelming. It is discouraging for seasoned professionals and new practitioners alike to face these roadblocks limiting our effectiveness especially if you keep in mind the original reason why many of us went into the field in the first place – to help people.

What is the bureaucratic brick wall?

Simply put, it is the red tape that we must struggle through every day to serve our clients. This includes all kinds of documentation requirements that are handed down from the federal, state, and local levels. The intentions are good. This paperwork is meant to help us understand the client, provide the appropriate treatment and maintain safety for the client. It often works at cross purposes, however, since all the questions and answers often place the client in a diagnostic box which, frankly speaking, the client is unlikely to be allowed to emerge from.

Because documentation requirements are overwhelming, many clinicians tend to not have the time to assess the client without depending on the old paperwork. Documentation supports a diagnosis which follows the client everywhere. Documentation makes a “case” for a diagnosis. It’s ironic that to “get better” a client needs to escape the past in fundamental ways but this proves to be virtually impossible when they carry the weight of a diagnosis and a mountain of paperwork to support it on their shoulders.

Solution anyone?

How can we do a better job of assisting clients without putting them in an impossible bind? From my experience here are a few things that might help.

For administrators

*Standardize and simplify required assessment forms across settings.

*Involve clients and direct service professionals in the development and roll out of any new clinical paperwork requirements.

*Require that every new piece of documentation replace a pre-existing from or be incorporated into a pre-existing form.

For direct service professionals

*Invite the client to be a partner in the assessment and diagnostic process.

*Assess the client without prior documentation or diagnostic information initially. If necessary review prior documentation after the face-to-face assessment.

*Provide the client with a copy of the documentation for review and possible amendment before finalization.

For the client

*Be proactive about wanting full participation in the process with access to the resulting documentation.

*Ask to review the factors involved in diagnosis if this is not clear.

*Challenge any inaccuracies in the assessment or the previous documentation.

Many of these recommendations are in place now, in my experience, but are poorly implemented in many settings. This is primarily due to time constraints and staffing levels. Improving things would require better funding to lengthen the assessment process. More time and money spent on the front end would result in better outcomes on the back-end as the focus would be on current problems and possible solutions. After all, wouldn’t this be a start to help clients emerge from the diagnostic stranglehold? How can people change when the bureaucratic tangle weighs them down?