Aging and Wellness Series
Lesson One: Landmarks ACT Step Two
1. “Clinical experience in palliative care reveals that the end of life can be a time of remarkable opportunity and a time of profound richness and depth for the patients and families. . .Through the skillful, effective management of symptoms, opportunity is preserved and through skillful, sensitive counseling, growth can be facilitated.” – (Ira Byock and Yvonne J. Corbeil “Caring When Cure Is No Longer Possible”)
“Developmental Landmarks” fall into four categories: Completion of Worldly Affairs, Focus on Relationships, The Role of Meaning, and The Transcendent Dimension. How can caregivers provide “sensitive counseling” in any of these categories? What specific questions might be asked and opportunities might be encouraged? List at least one example from one of these categories. What potential roadblocks prevent this type of “counseling” as a part of the healing process?
2. “A very helpful tool in the dimension of meaning is the , Spiritual Health Assessment Form developed by the Sacred Art of Living Center. Using this tool on a daily basis, caregivers can engage older adult clients or family members about these important dimensions of life.” – Soul & Science Lesson.
Reflect on specific ways this Spiritual Health Assessment Form could be incorporated as a part of your caregiving practice. How might this practice support a care receiver’s awareness of meaning? How might it increase a sense of trust and relationship with you, as a care provider? How might it give space for “sensitive counseling” and give important insights to an individual’s emotional well-being?
3. “The existential questions about the human condition can be ignored during many phases of life, but are brought into acuity at the end of life. For those who can find answers to the questions via ritual and/or belief, life can resonate with joy until death . . . However, for those for whom the existential questions remain unanswered, the end of life can reverberate discordantly with despair and anguish.” – (Anna-Leila Williams “Perspectives on spirituality at the end of life: A meta-summary” )
Knowing the Transcendent Dimension of Life is an important landmark in Life Completion work, how can a caregiver or healthcare institution encourage spiritual well-being? What in your caregiving environment supports this type of work? What problems might arise or concerns might need to be considered? How have you seen care providers successfully incorporating transcendent growth and spiritual well-being into care?
4. Dr. Ira Byock teaches the simple exercise of saying “The Four Things” that matter at end of life – “Forgive me. I forgive you. Thank you. I love you.” He states, “In acknowledging the inevitable loss that approaches, continued time together with friends and relatives often reflects a poignant, loving, solemn and yet celebratory quality.”
In what ways can you model these four sayings in your role as caregiver, as well as in your personal relationships? Which is hardest to incorporate in daily practice? Which is the easiest for you and why? How might you encourage this practice in others? As a caregiver, how can you create a space for meaningful closure?
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