Wednesday, 25 June 2014

Carepartner Wednesday-- Well-being



What makes life worth living?

(If you answered "coffee in the morning" I'm with you on that, but we're going a little deeper here.)

What are the essential elements that make you feel complete, fulfilled, contented, whole?

Guess what?

They don't change if you are elderly, or have dementia.

The Eden Alternative identifies seven domains of well-being that are universal. Anyone of any age could relate to these, but several of them can be absent in the elderly, especially those who are living in institutions. People with dementia are often not able to communicate their feelings as well as they used to.  If they are missing some of the domains of well-being, they may communicate that loss through actions.  In an institutional setting, we call these actions "behaviours." Aggression, anxiety, wandering are part of a long list of (undesirable) behaviours, and often the solution is psychotropic medication. Problem solved, right?

If you've read anything I've written in the last several months, you know that's not right. But, aside from the side effects of psychotropic drugs, and the fact they don't work, there's another problem.

We're treating the wrong problem.

If I am anxious or wandering or aggressive because I am insecure, and you treat me with an anti-anxiety medication, I will still be insecure. I may or may not still exhibit the behaviour, but something in the core of my being will be missing. Nothing but discovering what I need and looking for ways to supply it, will help.

Problem is, that's hard. It's not an exact science.

But when it happens, it's magic.

Here are the seven domains of well being:

* Identity
* Growth
* Autonomy
* Security
* Connectedness
*Meaning
* Joy 1

What do they mean? What does it look like (or feel like) when we have them, and what might happen, especially to someone with dementia, when one or more is missing?

We're going to explore these in the coming weeks, because this is key to our discussions about culture change and using as few psychotropic drugs as possible.

Think about this. What would happen, if every time an elderly person displayed a difficult action, we asked, "what domain of well-being is missing?" And when we identified what was missing, what would happen if we asked, "how can we restore (identity, security etc.) to that person?

Well-being would happen.
Fulfilment.
Quality of Life.

Life. Worth. Living.

1. http://edenalt.org/wordpress/wp-content/uploads/2009/06/EdenWell-BeingWhitePaperv5.pdf


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