“What is the meaning of my life?” and “What allows me to feel my life on this planet is meaningful in some way?” are the questions driving that willingness to change, according to Daniel Ellenberg, Ph.D., a Novato, CA-based therapist and co-founder and co-director of Relationships that Work, an organization dedicated to communication skill improvement for relationships.

The fact that some of a person’s friends and loved ones may have passed on by the time a woman is 50 may actually encourage her to improve communication with others. “The power of death adds meaning to life, and gives the opportunity to drop old ego stuff in our ego-driven culture,” Dr. Ellenberg said.

“Pretense is gone,” agreed Barbara Bartlein, R.N., C.I.C.S.W.,  an expert in relationships and organizational culture located in Milwaukee, WI, and author of Why Did I Marry You Anyway?: Overcoming the Myths That Hinder a Happy Marriage. “We can share experiences and really talk.”

‘Purposeful Introspection’

Purposeful introspection paves the way for connecting with others. Dr. Ellenberg provides clients with his “V.I.P.P.: strategy: 

• Vision: what you want.
• Intention: why you want it.
• Plan: how to create it.
• Practice: what specifically will you do.

“V.I.P.P. offers an opportunity to create common ground, or find out what is not so common,” he said.  “It is important to find out what you want in relationships…to understand what drives us, and our core beliefs about who we are.”

Regardless of age, some form of communication problem brings most clients into the Berkeley, CA, office of marriage and family therapist Elayne Savage, Ph.D.  

“Misunderstandings lead to anger, hurt feelings, and resentment, and there is no room for connection,” said the author of Breathing Room and Don’t Take it Personally.  “Communication means learning to be clear and specific. Don’t leave room for others to fill in the blanks.”

Bartlein calls this scenario the “glass head mentality”–we think others can look inside us and know what we want and think. “We have to get clearer in saying what we want and need,” she stressed.

Self-examination is best combined with push for personal growth. “Our worlds can start to get narrow,” Bartlein noted. “We need to stay up on what’s happening in technology, trends, and music to communicate across generations. We need to follow the news and the politics of other countries.  Being well-read is critical.”

Mindful Marriage Renewal

Familiarity can breed complacency, and it is possible to feel undervalued in our closest relationships. 

“Communication patterns we fall into are comfortable, but comfort can be routine and even boring,” Bartlein said.  She emphasized the need for married couples to renew shared interests, especially after grown children leave home. “That gives you things to talk about, she said. “It’s like glue for long-term marriage.”

Equally critical is the need to make daily time to connect with a partner through conversation. Dr. Savage said it’s time to “hit the reset button” on the relationship when children move out. “This is a great new opportunity,” she noted.

Even with common interests and shared time, there may be bumps in the relationship. “It’s OK to disagree,” Bartlein affirmed. “Some things we will never agree on, and we can choose to agree that we will never agree.” Bartlein says most marriages harbor two or three of these “perma-arguments.”

 “If you agree most of the time, you are in good shape,” she continued. “If you agreed on everything, that would be boring.  You can have fun with the differences.”

Avoid the Parent Trap

Common interests also build bridges to communication and connection during the changing parenting role that results when children reach their early 20s. “You move from parent to mentor-coach, and wind up friends,” Bartlein said, noting that she continues to share activities such as golf and skiing with her children.

“You let go of the job description of ‘Capital P Parent,’” Dr. Savage confirmed. “You don’t have that job anymore. You build a new relationship.”

Methods of creating strong communication bonds with grandchildren vary with their ages. Younger children love receiving letters and packages, and seeing a grandparent while using a webcam with Skype can be more effective than faceless telephone chat. Busy older grandchildren are not inclined to write or phone. “I recommend grandparents learn to text,” Bartlein said.

Work It Out Respectfully

Workplaces are multigenerational in nature and require respect for generational style differences. “Read online about Generation X, Y and Z,” urged Dr. Savage, who blogs at http://www.tipsfromthequeenofrejection.com. “Understand Twitter, Facebook, and LinkedIn, even if you don’t use them. Respect for the major style differences is really important. Differences are not a threat.”

Bartlein regularly confers with younger colleagues to tap into their generational expertise. Her effort shows interest and provides connection. “Feel comfortable with the team approach and working in teams,” she said. “Enjoying the differences and not being judgmental can go a long way.”

Misunderstandings require a willingness to address the situation in a direct and positive way. When a conversation sparks a critical or defensive reaction, Dr. Ellenberg instead advises a “reality check.”

Start by asking “if it is a good time to talk, then say, ‘I have an impression and I want to check in with you,’” he said. Respectfully indicate discomfort with a situation and a desire to make things better. “We fill in blanks and tell ourselves stories about others’ behavior, but we are not always correct,” Dr. Ellenberg continued. “This spans all relationships. If you want a clearer relationship, you need to speak up. And if a person matters to you, it is never too late to have a conversation.”

New communication skills can be learned through seminars, books, and counseling. “People these days have to realize we are pioneers,” Dr. Ellenberg said.  “This is the first time in history when we can learn more about ourselves. We live in an amazing era of resources.”

“The starting point is to look at ourselves,” said Bartlein. “We can’t change anyone else. My best piece of advice: work on listening skills. We view communication as talk, but all of us need to hone in on watching body language and listening. That’s 90% of communication.”

–Monica M. Walk

Resources:

• Barbara Bartlein, R.N., C.I.C.S.W.: http://www.thepeoplepro.com/#
• Dr. Daniel Ellenberg:  http://relationshipsthatwork.com
• Dr. Elayne Savage: http://www.queenofrejection.com/

There are some who may consider it to be the adventure of lifetime, while others find that they were not so well prepared as they had imagined. 

Over the past century, life expectancy has increased 30 years. But how do we prepare for all that extra time?

Being Realistic

“There is a gap between what we want retirement to be and what it actually is,” said John T. Cacioppo, Ph.D., and director of the Center for Cognitive and Social Neurosciences at the University of Chicago.  Dr. Cacioppo, an expert in social psychology, is a public speaker and a contributor and blogger for Psychology Today.   

Common problems are:               

• Self-esteem: Self was tied to position and work.
• Isolationism: Loss of social network.
• Ageism: Unexpected age discrimination.
• Disorientation: Loss of structure and purpose.
• Unrealistic goals: Not understanding all sides of questions.
• Family: Increasing demands from family.

Retirees often move to another location, but then may find that their social network is gone and that after six months or so the idyllic retirement setting does not seem so wonderful. Or in starting a second career, the retiree may find he or she is not as respected as at the last job. Without a work schedule, some retirees do not know how to organize their time. And some retirees find that the family expects them to be a baby-sitter or helper now that they “have the time.”

Susan D., a retired health care professional, moved from the suburbs to Chicago, expecting excitement and fun.  What she discovered was that high-rise living was an isolating experience. With the dense population and anonymity, the lakefront view was not enough to offset the lack of companionship.  She eventually transitioned to a smaller city.

“This is not uncommon” said Dr. Cacioppo. “The network we leave took years to build and is not easily replaced. Numbers are not important here, however. A person needs only one or two quality relationships to give life meaning again.”

Dr. Cacioppo said that women generally have an easier time with retirement or being laid off, because they can spend more time with family and friends, specifically female friends. 

The question to ask is, “What exactly do I want in this part of my life?”

Assessment and Experience

Maria Malayter, Ph.D., director of the Center for Positive Aging at National-Louis University in Chicago, wrote a book entitled Boomers: Visions of the New Retirement. From her research, she concluded that three key questions can put a person on the road to a happy retirement.

• What gives your life purpose?  To what are you committed and what do you get excited about?
• Where do you get your mental stimulation? What exactly gets you interested and excited among various types of mental stimulation such as volunteer work, formal education, on-the-job training, teaching, etc.?
• What kind of companionship would you like?  Who are the people with whom you would like to spend time?  What are your networks?

“These three are intricately linked and hard to separate,” said Dr. Malatyer.

“My transition from healthcare required that I look honestly at myself and forced me to discard ideas that no longer worked,” said Susan D. It led me from corporate life, to consulting, and finally to owning my own business.

“The journey was neither easy nor quick,” she said noting she had to be her own cheerleader and just “pushed through” with the help of supportive friends. 

Susan D. also had reared her four children and had been a caretaker for her sister and mother, both of whom recently had died.  She decided she no longer wanted a caretaker role.

“I still babysit occasionally, but I guess I began my businesses to avoid the family calls,” she admitted.

Now, after seven years of owning a business, Susan D. would like to move into something more meaningful that would incorporate her previous healthcare experience. To that end, she now volunteers with a group that serves children who are being raised by their grandparents.

Ageism not only comes from others, but can come from retirees themselves, as when they opt to associate only with others their own age with similar interests. Not only can that result in stagnation and a lack of being open to change, but it also can be depressing as the members of one’s social circle die off.

Dr. Cacioppo suggested socializing, working, and volunteering with younger people. For example, the organization Experiences Corp provides an opportunity for retirees 55 and above to teach children to read. Such activities provide an opportunity to share knowledge with youth, which can be meaningful and rejuvenating, and the mere act of getting involved with an outside organization can keep retirees moving physically.

Nurturing Networks

“Nurturing networks is essential,” said Marci Alboher, senior fellow at  Civic Ventures, a San Francisco-based think tank engaging boomers as a force for social change.  Alboher has written the book, One Person, Multiple Careers, A New Model for Work Life Success. She also created the Shifting Gears column and blog for the New York Times about work/life transitions and career diversity. 

“If there are no support groups, then create them yourself with the people from your employment or friends,” said Alboher, “Cheerleaders are important.”

Alboher offers several strategies for an enjoyable and meaningful retirement:

• Begin research on your interests before you leave your employment.  Ask for a “phased retirement,” although it may not be possible with all employers. This will give you a chance to explore new areas with a bit of structure in place.
• Learn new skills. It isn’t necessary to go back for formal education; there are classes offered through a variety of venues, such as continuing education courses at universities, professional organizations, and aging support centers.
• Volunteer. Volunteer opportunities may provide an idea of where your talents can be used, and also be a good option for learning new skills and providing a sense of purpose.
• Create a day-to-day schedule and long-term plan. Having a plan and strategy from which to work will help you realize what will and will not work. You can even “test drive” a move to a new location as part of your long-term plan by spending time there before you actually retire.
• Stay flexible. Opportunities come from various places and sources, so it is vital to listen and be ready for change.
• Open dialogue.  Look for opportunities to be in and promote dialogue in intergenerational settings.
• Take risks.  Growth comes from moving out of one’s comfort zone.

“It’s not customized,” said Alboher. “You will be finding more and more people identifying new pathways for living”.

When Susan D. asked why some elders are happier than others, she discovered that “the trip depends on you,” she concluded.

–Susan Fong

Resources:

• Marci Alboher: http://www.heyMarci.com
• Alboher, Marci. One Person/Multiple Careers: A New Model for Work/Life Success. Business Plus, 2007: http://www.amazon.com/One-Person-Multiple-Careers-Success/dp/0446696978
• Dr. John Cacioppo: http://psychology.uchicago.edu/people/faculty/cacioppo/index.shtml
• Cacioppo, John; and Patrick, William. Loneliness: Human Nature and the Need for Social Connection. W. W. Norton & Co., 2007: http://scienceofloneliness.com/?q=homepage
• Civic Ventures: http://www.civicventures.org
• The Intergenerational Center at Temple University: http://templecil.org
• Dr. Maria K. Malayter: http://www.docmaria.com
• Stanford Center on Longevity: http://longevity.stanford.edu
• Southern Illinois University Year of the Engaged Older Adult: http://www.law.siu.edu/GenServeGen/home.html
• Mather LifeWays: www.MatherLifeWays.com

Our culture tells us that we should fight hard against age, illness and death: “Do not go gentle into that good night,” the Dylan Thomas poem says. “Rage, rage against the dying of the light.” And holding on to life, to our loved ones, is indeed a basic human instinct. However, as the end of life approaches, “raging against the dying of the light” often begins to lose importance, and “letting go” may instead feel like the right thing to do.

This Fact Sheet discusses the shifting emotions and considerations involved in “holding on” or “letting go.” Addressing these sensitive issues ahead of time will allow a person with a chronic illness to have some choice or control over his or her care, help families with the process of making difficult decisions, and may make this profound transition a little easier for everyone concerned.

The opinions of the dying person are important, and it is often impossible to know what those beliefs are unless we discuss the issues ahead of time. Planning ahead gives the caregiver and loved ones choices in care and is kinder to the person who will have to make decisions. First, this Fact Sheet will present the principal concerns. Then it will discuss planning ahead, and some of the related matters that come up during chronic illness. Finally, it will present some ideas on actually making the decisions when the time has come.

Holding On

As people, we have an instinctive desire to go on living. We experience this as desires for food, activity, learning, etc. We also feel attachments to loved ones, such as family members and friends, and even to pets, and we do not want to leave them. We do not so much decide to go on living, as find ourselves doing it automatically. Robert Frost said once, “In three words I can sum up everything I have learned about life: It goes on.” Even in difficult times, it is our nature to hold on for better times.

When we realize that the end of life may be approaching, other thoughts and feelings arise. The person who is ill will want to be with loved ones, and may also feel a sense of responsibility towards them, not wanting to fail them nor cause them grief. He/she may have unfinished business. For example, the person may want to reconcile with estranged family members or friends and will find it both easier and more important to do. Fears arise, and may be so strong that they are hard to think about or even admit: fear of change, of the dying process, of what happens after death, of losing control, of dependency and so on. Both the person who is ill and the caregiver might also experience resentment, sadness and anger at having to do what neither wants to do, namely face death and dying.

In one way or another, hope remains. The object of hope may change. As death comes closer, the family may hope for a restful night, or another visit with a particular friend, or just a quiet passing from this life to whatever we hope follows it. Often, as the end of life nears, we keep two incompatible ideas in our minds at the same time. The Jewish prayer of the gravely ill puts it well for both the person who is ill and the loved ones caring for him/her: “I do not choose to die. May it come to pass that I may be healed. But if death is my fate, then I accept it with dignity.”

Letting Go

As death nears, most people feel a lessening of their desire to live longer. This is not a matter of depression. Instead, they sense it is time to let go, perhaps as in other times in life when one senses it is time for a major change. Examples might be leaving home, getting married, divorcing or changing jobs. Some people describe a sense of profound tiredness, of a tiredness that no longer goes away with rest. Others, who may have overcome many adversities in their lives, reach a point where they feel they have struggled as much as they have been called upon to do and will struggle no more. Refusing to let go can prolong dying, but it cannot prevent it. Dying, thus prolonged, can become more a time of suffering than of living.

Family members and friends who love the dying person may experience a similar change. At first, one refuses to admit the possibility of a loved one dying. Then one refuses to accept the death happening. Lastly, one may see that dying is the better of two bad choices, and be ready to give the loved one permission to die. As mentioned, the dying are distressed at causing grief for those who love them, and, receiving permission to die can relieve their distress. There is a time for this to happen. Before that, it feels wrong to accept a loss, but after that it can be an act of great kindness to say, “You may go when you feel it is time. I will be okay.”

Other Concerns

Letting go gets mixed up in our minds with a person wanting to die, although these are really separate situations. There are various reasons a person may want to die, reasons quite separate from those for letting go. Depression is one response to finding life too painful in some way. Some people cannot tolerate losing control, so they want to take control of dying. It can be unpleasant to be disabled, or in a place one does not want to be, or isolated from the important people and things in one’s life. Very often, a severely ill person feels like a burden to family and friends, and may wish to die rather than let this continue. Fears of the future, even of dying, may be so great that a person wants to die to get away from that future. Inadequately controlled pain or other symptoms can make life seem unbearable. For many of these problems the right sort of help can make a great improvement, and replace the desire to die with a willingness to live out this last part of one’s life.

Chronic Illness

So far, this Fact Sheet has been about the very end of life. Many, or even most, people go through a period of chronic illness before they die. Along the way there are numerous choices to make. Caregivers and people they care for have to decide whether or not to get a particular treatment or procedure. How long can one keep trying to do usual activities, including work, and when must they admit that that phase of their lives is over? Most of us have things we have dreamed of doing, but never got around to. Now may be the time to do that thing, no matter how difficult, or it may be time to let it be just a beautiful dream. Chronic illness brings up one situation after another where caregivers and care receivers must decide either to hold on or to let go.

Planning Ahead

Planning ahead means thinking about what is important, and what is not. It also means talking about this with those close to us. Even though we think we know what someone else thinks and believes, we really do not know until we ask. You cannot read other people’s minds.

When we think about the last part of our own or someone else’s life, consider these questions: What makes life worth living? What would make it definitely not worth living? What might at first seem like too much to put up with, but then might seem manageable after getting used to the situation and learning how to deal with it? If I knew life was coming to an end, what would be comforting and make dying feel safe? What, in that situation, would I most want to avoid? Some matters to consider would be: being able to talk with people, activity, physical comfort, alertness, the burden of care on others, being at home (or not being there), how much distress it would be worth in order to live another month, what medical procedures are not worth enduring, what I think is the best way for a person to die, how important it is to be in control of how one lives and how one dies, whose opinion should be sought in making choices about end of life care. One especially important matter is to complete the Advance Health Care Directive for both the person who is ill and the caregiver, so that there is an official spokesperson when one is too sick or too confused to speak for him/herself.

If, as caregivers, we haven’t had the necessary conversations—whether due to reluctance, dementia, or a crisis—we might have to think about the issues raised above without a lot of information. Some questions that might help in thinking about this are: What has that person actually told me? How can I find out for sure about her or his wishes? Turning now to myself as the caregiver, what would be important to me? What would I especially like to know about that person’s wishes? What would be the limits of what I could do? Could I take time off work? How much? What physical limitations do I have? What kinds of care would be just too much emotionally for me? Am I willing to accept the responsibility of being someone’s official spokesperson? If that person has relatives who would be especially difficult to deal with, how would I manage being the official maker of decisions?

All of these questions may sound very difficult to discuss now, when the time for decisions is still in the future. However, they are harder to discuss when someone is really sick, emotions are high, and decisions must be made quickly. Dementia soon takes away the ability to discuss complicated issues. The earlier everyone sits down to talk, the better. The best way to start is simply to start. Arrange a time to talk. Someone else’s death or illness may offer a good opportunity to bring up thoughts you had about their choices. Perhaps you could say you want to talk about things that might happen in the future, in case of serious illness. Have some ideas to bring up. Be prepared to listen a lot, and to ask questions. Do your best not to criticize what the other person says. If you know the other person will not want to talk much about this topic, have just one or two important things to say or to ask about. Be prepared to break off the conversation, and to come back to it another time. Write down the important things people say. Eventually, you can use your notes to prepare a statement of wishes and make this statement part of an “advance directive” about health care decisions, whether or not the formal document has been completed.

Making the Decision

Is it time to let go? Or time to give a loved one permission to die? There are three ways to help decide. First, look at the medical situation. Has the illness really reached its final stages? When it has, the body is usually moving on its own toward dying, with strength declining, appetite poor, and often the mind becoming sleepier and more confused. Treatments are no longer working as well as before, and everyday activities are becoming more and more burdensome. In a sense, life is disappearing. Second, talk with people you trust. Discuss the situation with the family members and friends who seem to be able to see things as they are. You might also talk with people who are not personally involved. Choose the people whose judgment you trust, not just those with an official role of giving advice. Most importantly, what does the dying person think? Third, listen to your heart. Try to see beyond your fears and wishes, to what love and caring are saying to you. What is really best for the one who is dying, and for the others around? Given that death is unavoidable, what is the kindest thing to do? It might be holding on. It might be letting go.

Credits

• Albom, Mitch, Tuesdays with Morrie, Doubleday, 1997.
• Byock, Ira, Dying Well, Riverhead Books, 1997.
• Dying Unafraid
  Fran Johns
  Synergistic Press
  3965 Sacramento Street
  San Francisco, CA 94118
  (415) 387-8180
  www.synergisticbooks.com
• Kubler Ross, Elisabeth, Death, The Final Stage of Growth, Prentice Hall, Inc, 1975.
• Levine, Stephen, Who Dies, Anchor Books, 1982.
• Handbook for Mortals
  Joanne Lynn, MD and Joan Harrold, MD
  Americans for Better Care of the Dying
  4200 Wisconsin Ave. NW, Suite 418
  Washington DC, 20016
  (202) 895-2660
  www.abcd-caring.org
• Malcolm, Andrew, This Far and No More, Times Books, 1987.
• Nulland, Sherwin, How We Die, Alfred A. Knopf, 1994.
• Rabbi Nosson Scherman, The Complete Art Scroll Siddur, Mesorah Publications, 2000.
• Shannon, Thomas and Charles Faso, Let Them Go Free, Sheed and Word, 1987.
• Thomas, Dylan, “Do Not Go Gentle Into that Good Night”, The Collected Poems of Dylan Thomas, New Directions, 1957.
• Webb, Marilyn, The Good Death, Bantam Books, 1997.

Resources

Family Caregiver Alliance
180 Montgomery Street, Suite 1100
San Francisco, CA 94104
(415) 434-3388
(800) 445-8106
Web Site: www.caregiver.org
E-mail: info@caregiver.org

Family Caregiver Alliance (FCA) seeks to improve the quality of life for caregivers through education, services, research and advocacy.

Through its National Center on Caregiving, FCA offers information on current social, public policy and caregiving issues and provides assistance in the development of public and private programs for caregivers.

For residents of the greater San Francisco Bay Area, FCA provides direct family support services for caregivers of those with Alzheimer’s disease, stroke, head injury, Parkinson’s and other debilitating disorders that strike adults.

Compassion & Choices
PO Box 101810
Denver, CO 80250-1810
(800) 247-7421
www.compassionindying.org

Hospice Foundation of America
2001 S St. NW, #300
Washington DC, 20009
(800) 854-3402
www.hospicefoundation.org

National Hospice Foundation
(800) 338-8619
www.hospiceinfo.org

National Hospice and Palliative Care Organization
A Pathway for Patients and Families Facing Terminal Disease
1700 Diagonal Rd. Suite 625
Alexandria, VA 22314
(703) 837-1500
www.nhpco.org

Finding Your Way and Talking it Over
Sacramento Health Care Decisions
10540 White Rock Rd, Suite 135
Rancho Cordova, CA 95670
(916) 851-2828
www.sachealthdecisions.org

Five Wishes
Aging with Dignity
PO Box 1661
Tallahassee, FL 32302
(888) 5-WISHES
www.agingwithdignity.org/5wishes.html

Five Wishes is a document that helps you express how you want to be treated in the event you become seriously ill and unable to speak for yourself.

Prepared by Family Caregiver Alliance. Reviewed by John Neville, MD, Spiritual Care Coordinator, Pathways Hospice. Funding provided by the Older Americans Act, administered by the San Francisco Office on the Aging. ©2003 All Rights Reserved.

Deborah Forbes of Tierra Verde Salon & Spa in Tierra Verde, FL.

Dim lighting. Soothing wall color. The smell of lavender lingering in the air. Warm bed sheets. And most important of all, a massage therapist, like a healer from the mythic past, using skillful hand movements to revitalize a motionless body.

Sound good? Massage therapy can provide a peaceful oasis isolated from the stress of modern society.

“Our current lifestyles have us in a fight-or-flight pattern for much of the day,” said Deborah Forbes, a massage therapist and the owner of Tierra Verde Salon & Spa in Tierra Verde, FL. Forbes noted that in a fight-or-flight stage the body releases adrenaline and cortisol. These hormones are vital when fighting for survival; however, excessive quantities and prolonged presence of adrenalin and cortisol may be poisonous and negatively affect a person’s emotional and physical states. 

“As we continue to create stress on a daily basis, we feel the need to slow things down,” Forbes said. “Massage pulls the mind and body back into one entity, instead of being disassociated.”

An Ancient Art

Massage is one the oldest forms of medicine, and its traditions are found all around the globe. 

In 2100 BC in the Sumer Empire, a healer inscribed a remedy on a clay tablet advising that a diseased body part be healed by “rubbing” it.  The Huangdi Neijing, or Yellow Emperor’s Classic of Internal Medicine, was written in 200 BC in China and is considered the first book of traditional medicine; it recommends massage for certain ailments. The traditional Indian medicine system Ayurveda, the practice of which reaches back as far as the fifth century BC, also prescribes massage to treat numerous illnesses. The ancient Greeks and Romans would not pass on a chance to get a soothing and relaxing massage. Alexander the Great, who otherwise was busy conquering the world, had his personal triptai or massage specialist, who would help the great warrior to relax with massage and calming baths.

Paul Myer, Campus President, Cortiva Institute Chicago

The list of massage therapy benefits is a long one: it helps to enhance immune system; increases blood circulation, thus helping to heal wounds faster; eliminates toxins from the body; improves nutrition distribution to the tissues; has both stimulating and sedative effects on the nervous system; and many others.

For the last couple of decades, massage therapy has experienced a renaissance in the Western world.  “It is a growing industry based on increased consumer requests,” said Paul Myer, president of the massage therapy school the Cortiva Institute in Chicago. “Once consumers experience massage, they incorporate it into their routine to improve their quality of life,”

Robert King, Educational Consultant, Cortiva Institute

Increased interest in a wellness philosophy and alternative medicines has renewed interest in massage therapy. “Western medicine frequently addresses just symptoms of the illness, but not its causes,” said Robert King, author of numerous publications and cofounder and past president of the Chicago School of Massage Therapy. “For example, instead of taking aspirin for headache, people may consider taking a massage, especially if they really have a tight neck, scalp, or upper back muscles, all of which could be a causal factor for the headache.” King serves as an educational consultant for the Cortiva Institute and conducts advanced myofascial training (soft tissue therapy) throughout the country.

In the U.S., people have increasingly become interested in massage therapy as the level of stress in society has increased. “Stress exacerbates every disease,” King said. “If a person has a wound, illness, or psychological disorder, then excessive stress makes the condition worse. Alleviating stress is a very powerful component that helps the person’s health overall.”

Captives of a Stressful Routine

The human body’s response to environmental triggers shifts between two stages: “fight-or-flight” or “rest-and-digest.” When we feel threatened, body systems shift to fight-or-flight mode and prepare to fight for survival. This mode shuts down blood supply to the muscles, and increases blood pressure as well as heart and breathing rates. When there is no potential danger, the nervous system shifts to rest-and-digest mode: the body restores energy, maintains blood pressure at low rate, and ensures proper functioning of the digestive systems.

Bobbe Bermann, Director of Education, Cortiva Institute

During a massage session, the nerve endings in the skin send signals to the brain to relax and release tension. The body increases production of serotonin, a natural mood enhancing chemical, and endorphins, natural pain killers. “Endorphins combat the cortisol that is released in the body due to stress. If the body is less stressed, then its systems are able to work better and an individual experiences a sense of well being,” said Bobbe Bermann, director of education at the Cortiva Institute.

A study done by the American Massage Therapy Association’s Immediate Past- President M.K. Brennan indicates that chair massage reduces stress perception.   “Even the way we view things as being stressful can be changed,” Brennan said. Although more studies need to be done, recent findings indicate that massages enhances stress perception skills, Brennan noted.

M.K. Brennan, Past President, American Massage Therapy Association

“One of the benefits of the massage is taking time for oneself in a quiet environment, where you do not have to do anything and just be,” Brennan said.

Even entering a massage room and just lying with closed eyes, listening to soothing music, and being where everything is designed to be relaxing, sensual, and peaceful helps to calm the nervous system. General relaxation has been proven to help those who feel depressed, anxious, or angry.

Releasing Suppressed Emotions

A good massage therapist may help to release emotions and traumatic memories carried in the body for a long time. The late Austrian-American psychoanalyst and psychiatrist Wilhelm Reich, M.D., stated that the human body, by suppressing negative emotions or defending itself from outside stressors, starts building “neuromuscular armor.”  This “armoring” process can start as early as in childhood.

“Unexpressed anger often causes tension in the muscles of the back and arms that would have been used to strike out,” wrote Patricia J. Benjamin, Ph.D., in explaining Reich’s theories in Tappan’s Handbook of Healing Massage Techniques, based on earlier work by Frances M. Tappan, Ed.D. “Or, unexpressed grief may result in shallow breathing and stiffening of muscles used in crying.”

“Sometimes a trauma lingers in the body for years and people are not even conscious of it,” King explained. “When a massage therapist works on the area which was tight or tense for decades, the area begins to be freed-up and emotions and feelings may be released.”

Miraculous Healing Powers of Touch

It is not surprising that masterly manipulation, rubbing, stroking, and caressing of the skin have always been part of traditional healing methods, since a touch in itself is invaluable to every human being. “In the absence of touching and being touched, people of all ages can sicken and grow touch-starved,” writes naturalist Diane Ackerman, Ph.D., in her book A Natural History of the Senses. “In fetuses, touch is the first sense to develop, and in newborns it’s automatic before the eyes open or the baby begins to make sense of the world. Soon after we’re born, though we can’t see or speak, we instinctively begin touching,”

Numerous studies indicate that babies who are in consistent physical contact with their mothers or caregivers grow and develop faster, their emotions are more controllable, and they are calmer.

“People do not lose the need to be touched when they grow older,” Bermann explained. “A compassionate touch gives a body a sense of belonging, a sense of well-being, and more self-awareness.”

However, hectic daily routines, isolated hours spent in a car stuck in a traffic, friendships created in cyberspace, and rules and regulations defining the amount of touch allowed in a public and/or work environment often push a friendly, caring human touch into peripheral field of human communication. “I feel in this computer age, the interaction we have with other people is cerebral, which makes the human need for touch even more important,” said Forbes.

To benefit most from a massage it is important to have a trusting working relationship with a massage therapist, otherwise the whole potentially healing and relaxing experience may become irritating and stressful. Bermann and Paul Myer of Cortiva suggested verifying a massage therapist’s credentials–see if he or she has a license and liability insurance, belongs to a professional organization, and continues to obtain national certification.

“It is also important to talk to your friends and network to find out whom they would recommend,” Myer said. 

Since every human being is unique and every body responds to massage techniques differently, also it is important to discuss with the massage therapist one’s troublesome body areas and expectations, the Cortiva experts concluded.

–Gabija Steponenaite 

Resources:

• Dr. Diane Ackerman: http://dianeackerman.com
• American Massage Therapy Association: http://www.amtamassage.org/
• Benjamin, Patricia J.. Tappan’s Handbook of Healing Massage Techniques: Classic, Holistic, and Emerging Methods. Upper Saddle River, N.J.: Prentice Hall, 2009.
• Cortiva Institute: http://www.cortiva.com
• Deborah Forbes, Tierra Verde Salon & Spa: http://www.tierraverdesalon.com                                
• Tim Noonan: http://www.timnoonan.com.au/maspap98.htm

What are some of the most common financial mistakes women make, and how can I avoid them?

Mistake #1:  Relying on Someone Else To Manage Your Finances

Life can get crazy, and sometimes without realizing it, you have handed over the purse strings.  By not engaging in the family finances, women set themselves up for potential hardships.  When one spouse controls the finances, the other spouse can be left in a vulnerable position (especially if the marriage ends).  This can also lead to losing your financial identity.  Merged accounts and shared credit cards in your significant others name may lead to lack of an active credit history.

Solution:  Attend meetings together.  Joint investments or property should be held in both names.  Make a list of all bank and brokerage accounts and insurance policies and keep it with other important documents, such as wills.  Maintain some individual accounts.  Yours, mine, and ours will allow for each to maintain credit identity.

Mistake #2: Not Saving and Investing Enough

Outliving your retirement income is one of the biggest risks any retiree faces, especially women.  According to the National Center of Health Statistics, a woman who reaches age 65 can expect to live until at least age 85. However, because women typically spend less time in the workforce (and may earn less for the same work than their male counterparts), women’s retirement savings and benefits are often shortchanged.

Solution:  Be diligent with your contributions.  Resist the urge to cut back on retirement saving to meet other expenses or accommodate other goals.

• Increase contributions to your Simplified Employee Pension (SEP), SIMPLE or company 401(k) plan.
• Annually review and adjust your saving and investing goals and managing your asset allocation to stay aligned with your long-term goals, even during periods of market uncertainty.
• Consider consolidating your retirement plan accounts from previous employers, making it easier to track and manage your investments

Mistake #3: Underestimating Your Need for Insurance

On average, women outlive men by 7 years (mortality for women is 79 years vs. 72 for men).  Many women are faced with caring for their husbands later in life, but after his death they may be left with no one to care for them. Because of this, women’s health care needs will likely be substantially higher than men, making it much more expensive for us to live longer.   What does this mean?  It means we may not only need to consider products like Long-Term Care Insurance, but we also need to have much more money in the retirement pot than men in order to not outlive our funds.

Solution:  Research your options regarding insurance.  Long-Term Care Insurance helps cover the cost of care you may need.  It gives you the flexibility to participate in making choices that impact your care, about the services you receive, where you receive them and who provides the care.  Life insurance can’t protect your family from losing you, but may help your family financially should you die early. This applies whether you are the primary wage earner or not. 

*Do you have a personal finance question for Jean? Click Here to submit a question via email for her to answer in the next posting.

Jean B. Muldowney, Financial Advisor, Wells Fargo Advisors, LLC, Member SIPC

As a Financial Advisor, I am dedicated to developing financial and investment strategies that are in line with your needs and goals. Making sure your wealth continues to work in support of the goals you have established takes careful planning. Such preparation is not a single event – it is a process. Backed by the vast resources of Wells Fargo Advisors, I focus on delivering personal service that surpasses client expectations. I hold all the requisite securities registrations and insurance licenses as well as a Bachelor of Arts degree in Communications from John Carroll University, Cleveland, Ohio. I take pride in working for a firm that puts you first.

The modern world can make life feel like nothing but excess, with its fast pace, technology, and constant change. Women face extra pressure from shifting hormones that leave them more vulnerable to stress and from a stress load that’s often higher than men’s because of more intense time demands for family obligations.

The good news is that women in their 50s and beyond have an important advantage in overcoming stress and restoring balance.

“By 50, you recognize problems and how to deal with them from experience,” said of Eva Ritvo, MD, associate professor of clinical psychiatry at the University of Miami in Florida and co-author of The Beauty Prescription. “That can give you confidence.”

Joyce Scott of Austin, TX, agreed. The 50-plus Scott is a business consultant, public speaker, and founder of Superb Speakers, a firm that supplies experts on a wide variety of topics. By the time a woman has reached 50, Scott said, she most likely has raised a family, developed a family schedule and routine, and mastered time management. She has negotiated deals with plumbers, contractors, and hired help. She has researched medical diagnoses that have affected family members.

In essence, Scott said, she has “what she needs to know to be a chief executive officer of any corporation”—and has all she needs to manage her own life, too.

Make it easier to succeed

Women can make it easier to succeed at balance by paying attention to fundamentals. For example, Ritvo noted women 50 and above must be mindful of their health to keep life in balance. “You’ve got to have proper nutrition,” she said. “You have to exercise.” She added that younger women can ignore these needs, but women over 50 can’t—their bodies won’t let them.

Also, give yourself regular quiet time. Scott’s first recommendation: “Turn off the TV.” Idle entertainment for hours at time, she explained, drains a woman’s ability to think for herself, analyze her situation, and develop solutions to problems.

Be in the moment

Judy Harrison, a Virginia-based life coach and woman past 50, believes that, if you make good choices that make sense in the present moment, you can bring harmony into your life.

“I think we tend to get out of balance when we think about the future and think about what I need to get done for this, or what I need to get done for that,” Harrison said. Instead, the real question should be, “What do I need right now to be more harmonious?”

When the unexpected happens, or life becomes overwhelming, Harrison recommended women concentrate on “what in this moment is really important.” For example, you may have an inventory of errands or a long to-do list, but if something important occurs, say a call from your grandchild, just let the schedule go, Harrison said.

“It’s all about knowing what you personally need,” she continued. “We tend to overcomplicate things.”

Make a plan

For many women, Harrison’s flexible, intuitive approach may be enough to achieve balance. Others may need a more structured approach, however.

For 67-year-old motivational speaker and author C. Leslie Charles of East Lansing, MI, “balance isn’t something that happens accidently. It’s something that’s planned” so you can do the things you love without guilt or reservation.

Charles developed the four-point PLAN program to integrate work, family, and spirituality so her life remains in balance:

● Play

● Leave time for you

● Amplify your attitude

● Nurture yourself

Many of us have been taught to behave, be quiet, and work hard, but “by the time you are 50, you have license to play,” Charles said. To embrace point one of her program, she suggested flirting with your spouse or partner, being silly, and looking at the world with awe and wonder like a child.

For point two, she urged women to resist overscheduling themselves so they have time for the things they enjoy. Point three, amplifying your attitude, means having a sense of humor, being enthusiastic, and smiling. For point four, she recommended “indulgences such as a bubble bath, or time with a good book,” or other self-nurturing. “Be willing to do something for yourself,” she said.

Live your dream life

In Scott’s case, this kind of strategic approach made all the difference in achieving balance and living the life of her dreams.

Married 39 years and the mother of two, she grew up “a poor black girl,” she explained. “I moved up from the projects and into the ghetto. When I first had the right to go into a restaurant, I was 14. In third or fourth grade, I was picking cotton in Louisiana. I was cleaning houses.”

She developed her plan as a teenager and has followed it ever since: she and her husband paid their way through college, raised their sons, achieved individual success in their own fields, and stayed connected to their religious community throughout their life journeys.

“I knew I could be in charge of my life,” she said. “I understand how to show people how to be successful.  It’s substantial planning. You plan balance in your life.”

Try something new

For Scott, part of life’s equilibrium is always pursuing a new skill or taking on a project that scares her. She hated public speaking as a younger woman, but with her sons’ help and prodding, she now does it for a living.

“If I have a fear, I research it and find a plan of attack,” she added.

Charles, like Scott, believes strongly in life-long learning. “I recommend you try something you have never done before,” she said. “It’s never too late. It actually balances your brain.”

A longtime equestrian who competed in dressage for many years, Charles had to give up competitive riding as she got older. She wanted to stay active, though, so she took up disc golf, which uses golf’s rules but is played with a Frisbee.

“I was lousy at it,” Charles said, laughing. 

So she worked at it and got better. She joined a women’s disc golf league and eventually broke a distance record. Then she won a national championship.

“It’s just never too late,” she said.

–Mary Voelker

Resources:

• C. Leslie Charles: http://www.lesliecharles.com/
• Judy Harrison:  http://www.judyharrison.com/
• Eva Ritvo, MD: http://psychiatry.med.miami.edu/About-Department/Faculty28/Eva-Ritvo.aspx
• http://www.thebeautyprescription.com/
• Joyce Scott:  http://www.superbspeakers.com

Assessing Your Home-Care Needs

A number of options are available for finding help at home. It is often best to start by assessing both your needs as a caregiver and the needs of the person you are caring for. There are a variety of checklists to help you evaluate what types of help are needed. In general, consider the following areas:

• Personal Care: bathing, eating, dressing, toileting
• Household Care: cooking, cleaning, laundry, shopping
• Health Care: medication management, physician’s appointments, physical therapy
• Emotional Care: companionship, meaningful activities, conversation

It is also important to evaluate the values and preferences of the person receiving care. He or she may be more comfortable with a home care worker who shares his or her cultural background and/or language. The care recipient may also have a preference between male and female caregivers, particularly if the worker will be helping with personal care. (For more information, see the FCA Fact Sheet Making Choices About Everyday Care.)

This assessment may also enable you to include alternative (and possibly less expensive) approaches to care such as adult day care, friendly visiting services, home grocery delivery, pharmacy delivery services and meals-on-wheels programs. (For more information on these and other services, see the FCA Fact Sheet Community Care Options.)

Writing a Job Description

Once you have identified the types of help you need, writing a job description can be fairly straightforward. In addition to including the tasks you have identified from your assessment, be sure to include the following when and if appropriate:

• Health care training (what level and what type – CNA, LVN, RN)
• Driving (car needed or only valid driver’s license)
• Ability to lift care recipient and/or operate special equipment
• Experience with people with memory impairments and/or other disabilities
• Language skills
• Any other special skills needed

At this point, you have the option of hiring an individual or going through a home care or home health care agency. In some states, publicly- funded programs may allow you to hire another family member to assist you in providing care at home. In making that decision, consider the following:

Developing a Job Contract

The job contract is based upon the job description. It formalizes the agreement between you, the employer, and the employee, and is signed by both of you. Should questions or problems come up later, either party can refer to the written agreement. A good work contract should include the following:

• Name of employer and”household employee”
• Wages (including tax withholding—see section on Employer’s Responsibilities) and benefits (e.g., mileage, meals, vacation, holidays)
• When and how payment will be made
• Hours of work
• Employee’s Social Security number
• Duties to be performed (i.e., the job description)
• Unacceptable behavior (e.g., smoking, abusive language, tardiness, etc.)
• Termination (how much notice, reasons for termination without notice, etc.)
• Dated signatures of employee and employer

Finding the Right Home Care Worker

Set aside some time as you approach this critical next step: finding the appropriate person to fit the job description. One of the best ways to find a helper is to get a personal recommendation from a trusted relative or friend. Churches, synagogues, senior centers, Independent Living Centers and local college career centers, especially those which have nursing or social work programs, are good places to advertise for in-home help. Listings for these places can be found in your local phone book.

Most communities have attendant registries that can be an excellent resource for finding in-home help because they typically provide some initial screening of applicants. When calling an attendant registry (generally listed under Nurses and Nurse Registries in the phone book), it is important to inquire about their particular screening process and/or training requirements as well as about any fees charged. While some are free, fees for using a registry can vary greatly. It is a good idea to shop around and obtain the best service at an affordable. There are also nonprofit community agencies (generally listed under Social & Human Services for Individuals & Families in the phone book) that maintain lists of individuals available to perform all kinds of household tasks, from cleaning and laundry to repairs and gardening.

If all of the above sources fail to produce an in-home worker, you may choose to advertise in the “Help Wanted” classified section of a community college, local paper or neighborhood newsletter. The advertisement, at the minimum, should include hours, a brief description of duties, telephone number and best time to call, e.g.: “Home Care Assistant needed to provide supervision and companionship to older adult with memory loss. Must be compassionate, reliable and able to assist with bathing, dressing and eating. References required. Call to apply.”

Interviewing the Applicant

You do not have to hold a face-to-face interview with every person who applies for the job. Some screening over the telephone is appropriate. In screening applicants over the telephone, caregivers should describe the job in detail and state specific expectations listed in the work contract as well as information about the hours and wages. At this time, it is also important to ask about the applicant’s past experience and whether he/she has references. If the applicant sounds acceptable, then an interview should be scheduled. Consider having another family member, the care recipient (if appropriate) or friend sit in on the interview to provide a
second opinion.

In preparation for the interview, the caregiver should have a list of questions pertinent to the job description and a sample work contract ready for the applicant to read. The following are some suggested questions for the interview:

• Where have you worked before?
• What were your duties?
• How do you feel about caring for a disabled person? Or a person with memory problems?
• Have you had experience cooking for other people?
• How do you handle people who are angry, stubborn, fearful?
• Do you have a car? Would you be able to transfer someone from a wheelchair into a car or into a bed?
• What days and hours would you be available? How many hours per week?
• Is there anything in the job description that you are uncomfortable doing?
• Can you give me two work-related and one personal reference?

Consider what qualities/skills you require and what you can train a good candidate to do.

Be sure that you have a chance to watch the interactions between the in-home worker and the family member for whom he or she will be providing care. You may want to do this at the end of the interview with individuals you feel are good candidates, or you may want to invite the top two candidates back to meet with your family member. If your family member is able, he or she should be included in the interview process and in making the final decision.

Immediately after the interview, it is important for you to write down first impressions, and if possible, discuss these with another family member or friend. Consider the person most qualified for the job and with whom you feel most comfortable. Always check the references of at least two final applicants. Don’t wait too long to make an offer, as good applicants may find another job. If the job offer is accepted, you and the in-home helper should set a date to sign the contract and begin work. Both employer and employee should keep a copy of the contract.

What Are the Employer’s Responsibilities?

As an employer of a “household employee,” there are several legal considerations. First, household employers should verify that their household insurance (renter’s or homeowner’s) covers household employees in case of an accident. It is also imperative that the employer be fully informed of the legal responsibility of paying taxes for household employees.

As the employer, you may also be responsible for withholding Social Security taxes, Medicare taxes and/or federal unemployment tax and filing them with the Internal Revenue Service annually or quarterly. Social Security taxes are owed by both the employer and the employee. Rules governing the amount(s) to be withheld and payment schedules can change annually. For information on paying federal taxes for household employees, call (800) TAX-FORM and ask for Publication 926 or view it on the web at www.irs.gov/formspubs/index.html [Scroll down to publication number 926.].

There are also state regulations. Some states require that employers pay state tax and/or state disability insurance. To find out the regulations in your state, call the state employment department listed in the government section of your local phonebook. The penalties for not paying taxes on household employees include paying the back taxes and paying interest and penalty fines.

There is one other requirement that every employer should know. Each employee is required to fill out an Employment Eligibility Verification form I-9 and a record of this should be kept on file. This form verifies that the person is legally entitled to work in the United States. The form can be downloaded from the web at www.irs.gov/formspubs/index.html or ordered by calling (800) TAX-FORM.

FCA advises that household employers and employees stay informed and comply with state and federal tax laws. There are often local services available to seniors who need assistance in filing tax statements for household employees.

Making Your Home Care Situation Work

The relationships between the family, the person who requires assistance and the in-home worker are very important. Consequently, it is imperative that you take the time to go carefully through the selection process. Good communication is essential for a good relationship. Schedule regular times to meet and discuss concerns, problems and/or changes. It is also important to make expectations clear and to provide adequate training to meet those expectations. If you hire a home care worker on your own, it is important you feel comfortable both providing training and firing the worker if necessary. If the person you have hired is doing a great job, be sure to tell him or her. A smile and well-deserved praise can make a big difference. None of us likes to feel to feel that our work is not appreciated.

Additional Resources:

• Consumer Reports Complete Guide to Health Services for Seniors by Trudy Lieberman and the Editors of Consumer Reports, (2000), $19.95.
• Homecare: The Best! How to Get It, Give It, and Live With It by Jo Whatley Cheatham. ProSoPress (1999), $14.95.
• The Caregiver Helpbook, Powerful Tools for Caregiving by Vicki L. Schmall, Ph.D., Marilyn Cleland, R.N., Marilynn Sturdevant, R.N., M.S.W., L.C.S.W., Legacy Caregiver Services, Portland, www.legacyhealth.org, (503) 413-6578, $20.00.
• The following two booklets were written specifically for individuals with spinal cord injuries, but they contain valuable information and resources for anyone hiring in-home help:
• Hiring & Management of Personal Care Assistants for Individuals with Spinal Cord Injuries. It is available on the web at www.tbi-sci.org/pdf/pas.pdf.
• Managing Personal Assistants: A Consumer Guide written by the Paralyzed Veterans Association available on the web at www.pva.org by calling (888) 860-7244.

Organizations:

Family Caregiver Alliance
180 Montgomery Street, Suite 1100
San Francisco, CA 94104
(415) 434-3388
(800) 445-8106
Web Site: www.caregiver.org
E-mail: info@caregiver.org

Family Caregiver Alliance (FCA) seeks to improve the quality of life for caregivers through education, services, research and advocacy.

Through its National Center on Caregiving, FCA offers information on current social, public policy and caregiving issues and provides assistance in the development of public and private programs for caregivers.

For residents of the greater San Francisco Bay Area, FCA provides direct family support services for caregivers of those with Alzheimer’s disease, stroke, head injury, Parkinson’s and other debilitating disorders that strike adults.
 

American Association for Homecare
625 Slaters Lane, Suite 200
Alexandria, VA 22314-1171
(703) 836-6263
Website: www.aahomecare.org

American Association of Homes and Services for the Aging
901 E Street NW, Suite 500
Washington, DC 20004-2001
(202) 783-2242
Website: www.aahsa.org

Children of Aging Parents
1609 Woodbourne Road, Suite 302-A
Levittown, PA 19057
(800) 227-7294
Website: www.caps4caregivers.org

National Association for Home Care (NAHC)
228 7th Street, SE
Washington, DC 20003
(202) 547-7424
Website: www.nahc.org

United Seniors Health Cooperative
409 Third St, SW, Suite 200
Washington, DC 20024
(202) 479-6973
Website: www.unitedseniorshealth.org

Visiting Nurses Association of America
11 Beacon Street, Suite 910
Boston, MA 02108
(617) 523-4042
Website: www.vnaa.org

Prepared by Family Caregiver Alliance and funded by the Archstone Foundation. Revised November, 2001. © All rights reserved.

“Basically, women are much more capable of positive thought and action than they realize,” said New Jersey-based Barbara Becker Holstein, Ed.D., an author and private practice psychologist for more than 30 years.

Herself a woman over 50, Dr. Holstein has found in her studies how to tap into that “positive zone.” She has developed a system to find what’s positive in a woman’s life and have her build on that feeling for better well-being.

“When you are thinking positive, you are feeling positive,” said Donald Dossey, Ph.D., of the Stress Management and Phobia Institute in Asheville, NC. “When you are thinking good thoughts, then your immune system is more highly activated,” he added.

In addition, relationships improve and you have better interactions with your family and coworkers, Dr. Dossey explained. Conversely, he noted, when you are entertaining negative feelings, or are experiencing a stressor, such as fear, “The immune system shuts down. When you are in fear, under stress, or thinking negatively, it’s the same thing.  Your memory is poor, you are irritable, your relationships suffer.”

A March 2009 study authored by a team led by Hilary Tindle, M.D., assistant professor of medicine at the University of Pittsburgh School of Medicine, followed nearly 100,000 post-menopausal women as part of the Women’s Health Initiative  research funded by the National Institutes of Health. The research found that optimists had lower rates of death and fewer cases of some chronic conditions, such as heart disease, compared to pessimists.

 In addition, Suzanne C. Segerstrom, Ph.D., professor of clinical psychology at the University of Kentucky, was part of a team that authored a 1998 study of optimism and the immune system, which appeared in the Journal of Personality and Social Psychology.

Optimists cope better

“Optimists cope differently with stressors, experience less negative mood, and may have more adaptive health behaviors– all of which could lead to better immune status,” Dr. Segerstrom’s study concluded. “Optimism has been shown to mitigate the effects of stressors on psychological functioning.”

Optimists have higher T-cell counts, which protect the body from infection, and have delayed “flight or fight” responses to stress, which can tax the body, the research determined. That study cited past research which provided the groundwork for the Segerstrom team’s work.  In 1989, a group led by Michael F. Scheier, Ph.D., professor of psychology at Carnegie Mellon University, found optimism was tied to better physical health. 

In addition, two more studies found optimism induced successful coping with health challenges. Among them, research by Charles S. Carver, Ph.D., professor of psychology at the University of Miami, and colleagues established in a 1993 study that optimists adjusted better to health challenges.

The Segerstrom study “contributes to a growing body of evidence that elucidates the relation of optimism and other psychosocial factors to biological processes associated with physical health,” the study said. “The investigation thus indicates that beliefs about events, appraisals about events, and associated affective changes are important.”

Effects of stress

There also is research that ascertains that prolonged and intense stress, even among optimists, can tread on the immune system. Aside from immunity, negative feelings also may cause relationship problems.

David Gilbert, Ph.D., professor of psychology at Southern Illinois University, said negative feelings and attitude could translate into relationship problems and breakups. In addition, stress causes the release of a hormone called cortisol, which suppresses the immune system and leaves the body vulnerable to viruses and infections, he explained.

Optimism and positive thinking may be hard to come by these days, but Dr. Holstein said women can reach a plateau of positive thinking, and she developed a way to do it. She formulated the positive psychology method called “The Enchanted Self,” designed to promote happiness. She developed what she called “gateways to happiness” as stepping stones to emotional health. They include the following recommendations:

●Discover and honor your talents, strengths, coping skills, and potential.

●Love the story of your life and find ways to fall in love with who you are.

●Learn how to get your needs met.

●Take time to replenish, to enjoy life, and to find meaning and purpose every day.

●Belong and don’t isolate.

●Be a mentor and find mentors.

●Live generously. Do positive actions and good deeds.

“If a woman practices the first gateway, whether 23 or 83, she is going to get better in touch in what she has to offer society,” Dr. Holstein said.

The second gateway is important in finding your unique accomplishments, and giving yourself credit for what you have done. For example, were you the first person in your family to graduate from college? Respect that accomplishment, Dr. Holstein suggested.

The third gateway is designed to help women achieve what they need. Even women over 50 may require training or learn a new skill, Dr. Holstein added.

The fourth step is focused on renewing.  “We need to recognize we tend to run on empty because we are helping others,” she said. “It’s very important to replenish ourselves.”

The last three points are directed at staying connected and sharing with friends, family, colleagues, and people you come in contact with during your life’s journey, she said.

“All the research shows, when we give, we feel better,” she pointed out.

Pamela Johnson of Texas, founder of the Secret Society of Happy People, a decade-old organization dedicated to spreading good feeling, said, “When happiness is a part of your life, you express it. It’s kind of a ripple effect.”

“There are numerous studies that show you have physical health benefits from happiness,” Johnson said.

Although she advocates optimism and good cheer, Johnson doesn’t dismiss the fact that we all will confront disappointment, sadness, and even tragedy in our lives. Don’t ignore the pain, she advocates, but try to coexist with it.

“They quickest way to be happy is feel the pain,” she said. “There are still positive things in an unhappy moment.  You don’t need to be consumed by it. You can start coming up with ideas.  You can move into a more creative zone instead of hitting a wall.”

Unfortunately, if you tend towards sarcasm and criticism, you will tend to surround yourself with people who share the same negative feelings, and it becomes harder and harder to break free from the grip of despair, Johnson explained.

Women over 50, who may be confronted with career and life changes, can face these issues with confidence, Johnson added.

“I think women are resilient,” she asserted. “They trend and move with the times. Embrace the attitude of what’s next.  Don’t get stuck on what was.  There are a lot of people who have been empowered at 50 plus.”

She cited Martha Stewart and Georgia O’Keefe as role models who came into their own later in life.

“Instead of an end, it is a beginning,” she concluded.

—    Mary Voelker

Resources:

• Dr. Charles S. Carver: http://www.psy.miami.edu/faculty/ccarver/
• Dr. Donald Dossey: http://www.drdossey.com/
• Dr. David Gilbert: http://www.psychology.siu.edu/faculty/david_gilbert.htm
• Dr. Barbara Becker Holstein: http://www.enchantedself.com/
• The Secret Society of Happy People: http://www.sohp.com/
• Dr. Michael F. Scheier: http://www.psy.cmu.edu/people/scheier_vita.pdf
• Dr.  Suzanne Segerstrom:
• http://www.as.uky.edu/academics/departments_programs/Psychology/Psychology/faculty_research/ faculty/suzannesegerstrom/Pages/default.aspx
• Dr. Hilary Tindle: http://pmbcii.psy.cmu.edu/tindle/index.html
• Women’s Health Initiative: http://www.nhlbi.nih.gov/whi/

The studies:

Scheier, M. F.; Matthews, K. A.; Owens, J. F.; Magovern, G. J.; Lefebvre, R. C. Sr.; Abbott, R. A.; and Carver, C. S. (1989). “Dispositional optimism and recovery from coronary artery bypass surgery: The beneficial effects on physical and psychological well-being.” Journal of Personality and Social Psychology, 57, 1024–104.

Stanton, A. L.; and Snider, P. R. (1993). “Coping with a breast cancer diagnosis: A prospective study.” Health Psychology, 12, 16–23.

Carver, C. S.; Pozo, C.; Harris, S. D.; Noriega, V.; Scheier, M. F.; Robinson, D. S.; Ketcham, A. S.; Moffat, F. L. Jr.; and Clark, K. C. (1993). “How coping mediates the effect of optimism on distress: A study of women with early stage breast cancer.” Journal of Personality and Social Psychology, 65, 375–390.

Tindle, H.A.; Chang, Y.F.; Kuller, L.H.; et al (2009). “Optimism, Cynical Hostility, and Incident Coronary Heart Disease and Mortality in the Women’s Health Initiative.” Published online 10 August 2009.

 Question:

“Each January, I set personal goals for myself. With everything going on in the economy, what are some New Year’s financial resolutions that I should consider?”

 Answer:

Every year lists are created, promises are made, and we start out with the best intentions.  Week one is outstanding, week two is going great, week three needs a pep talk, and let’s face it…..at week four we have issues.   Sometimes it’s a matter of setting unrealistic objectives. When it comes to financial resolutions, some small goals can yield some amazing results.  Begin with this:

• Clarify Goals  Many women don’t begin to plan for retirement because they have not set any long-term personal goals.  You wouldn’t set out on a trip without first having a destination in mind, right?  Steps you take should be based on what you are trying to accomplish.  For instance, if you want to retire at 60 to travel, it is necessary to make sure your needs, such as health insurance and living expenses are covered by your retirement income.
• Determine Your “Time Horizon”  Having a clear idea of your goals is important because they will help determine your time horizon. For example, if you want to save for a child’s education, your time horizon will probably be shorter than if you are saving for your retirement.
• Learn One New Thing About Investing This Year  If you want to learn to cook, you read cookbooks. So what can you do when you have a question about finances?  Register for a class, join an investment club, pick up a book or do research from a credible source online.  Your local library or college can also be a great resource.

 Question:

“My colleagues tell me I should save more.  The only problem is I have personal loans that need to be paid off.  Which is more important?  How will I know when its time to change my approach?”

 Answer:

• Establish Your Starting Point  Once you’ve clarified your objectives and time horizon, you need to determine where you are today. In other words, is your financial house currently in order? For example, if you’re carrying a heavy debt burden, especially high-interest credit card debt, you’ll probably need to reduce it before you start investing. A financial advisor can help by evaluating your current financial situation and create a plan-of-action for you.
• Get a Yearly Financial Check-up  Everyone dreads check-ups, but we still go see the doctor every year for our “annual”.  It is very important to review your plan each year.  Over time, it is easy to get off course.  Make sure you evaluate your direction to see if changes are needed to keep on your financial course.

 Do you have a personal finance question for Jean? Click Here to submit a question via email for her to answer in the next posting.

Jean B. Muldowney, Financial Advisor, Wells Fargo Advisors, LLC, Member SIPC

As a Financial Advisor, I am dedicated to developing financial and investment strategies that are in line with your needs and goals. Making sure your wealth continues to work in support of the goals you have established takes careful planning. Such preparation is not a single event – it is a process. Backed by the vast resources of Wells Fargo Advisors, I focus on delivering personal service that surpasses client expectations. I hold all the requisite securities registrations and insurance licenses as well as a Bachelor of Arts degree in Communications from John Carroll University, Cleveland, Ohio. I take pride in working for a firm that puts you first.

Holidays are perhaps the toughest times for those who have suffered the death of a beloved spouse or partner.

A succession of holidays coming back-to-back–Thanksgiving, the Christmas season, New Year’s, and Valentine’s Day—only serve to heighten the sense of loss. With a loved one absent on those occasions, we need to know we are not alone. Help can range from counseling one-on-one, to joining a group of people with similar losses, to proactively using coping strategies recommended by experts.

Eileen “Ellie” Meindl O’Hagan, a Chicago artist, in 2009 experienced her first holidays without her husband of 25 years due to his recent death. She said she managed with the help of a therapist and by forcing herself “to smile during family dinners,” and will manage future holidays with the aid of her counselor as well.

Understanding that you are going through what almost everyone who suffers a similar loss goes through is a start.

“I think losing a spouse must be one of the hardest things in life,” right up there with “losing a child also,” said Rhonda Borman, a psychotherapist, social worker, and grief expert based in Nashville, TN.

Evolution of Emotions

“For someone who is newly widowed, the emotions can run the gamut,” Borman said. First, there’s numbness. Then anger. Then learning to cope without your beloved. The worst is a feeling of desperation.

“I had a great husband,” O’Hagan said. “We were friends and lovers and companions. We had plans.” Some times, she climbs into her car and drives around in tears.

After losing her husband to a heart attack in July, the 60-year-old widow had to sell his business, look for a less-expensive apartment, and make plans to move out of an art studio. She is living with her daughter until tenants vacate the upstairs of her daughter’s two-flat.

“Everything I had is gone or going,” O’Hagan said. “I am beginning all over.”

O’Hagan is looking forward to the New Year, when she expects to settle in her new home and resume painting abstract art. She expects the pain of losing her husband to ease in a year or two. “There is no rush,” she said. “I am going to lick my wounds for a while.”

The grieving process takes time, said Suzy Yehl Marta, founder and president of a not-for-profit grief-coping advising organization called Rainbows, based in Rolling Meadows, IL. Marta is an expert in grief resulting from death or divorce.

“First and foremost, people need to allow themselves time to grieve,” Marta said. “It does not stop with sobbing at the cemetery. It takes a number of years.”

In the first year, grieving people should tune into their feelings and take care of themselves, Marta said. The second year also is very painful. A lot of the support system eases away, often causing grieving people to feel isolated.

Avoid Isolation

How you deal with your loss depends on your personality, Borman said. “Some people prefer to grieve alone, but it is important to not isolate yourself; stay connected,” she noted. Borman suggested that the grieving person make time for others and be somewhat more “assertive” in scheduling time with family and friends.

O’Hagan had seven brothers and sisters; her husband was the eldest of eight. She sees a lot of her siblings, in-laws, her own two children, and numerous nieces and nephews.

“Find a good therapist,” Borman said, and “a support group that is run by a reputable agency. Grief-support groups exist in many cities, even for the families of victims of violent crime, Borman said. Check around if you believe you need a group.

Also, “one of the best things to do is to get some books on grief and loss,” Marta said.

Both Borman and Marta recommend volunteer work as a way to heal. “Reach out of yourself and help someone else,” Marta said.

This time of the year is almost perfect. At the holidays, many of the “helping organizations” are short on staff, Borman noted. She suggested simple things such as offering to drive for Meals on Wheels or helping children in hospitals.

Coping Exercises

Borman offered several self-help strategies:

●Be sure you get enough sleep. Count down from 100 by seven. If still are not asleep, just start over. If the countdown does not work after trying a few times in a 30- minute span, try chamomile tea or reading. Or, try sleeping in a different room or on a sofa until you accept our loss.

●Allow “worry time.” Six to eight times a day, lie down and imagine standing outside a bank vault, opening the vault, and opening a box containing all your worries. Let the worries float out and permeate you. After nine minutes, put the worries back into the box. Tell yourself, “I can’t worry until the next period.”

●Combat low energy and difficulty motivating yourself. Make up a schedule with quarter-hour increments. Fill in every 15-minute period and follow the schedule. Find something to fill up the schedule, even if it’s only watching a particular TV show.

Try New Traditions

Holidays are especially hard because of your traditions as a couple, Marta said. Consider what traditions you want to change. Involve your children in discussions about changes. “Be honest with the kids,” Marta said. “Tell them what you need. There’s something very healing in talking about it.”

O’Hagen will visit her son and his wife in London after Christmas. “When I come back, it will be a new year and I will have put the holidays behind me,” she said. “I would love to be in suspended animation and wake up in the spring.”

“The whole grief process involves making time for yourself,” Marta said. “Ask yourself, ‘Who am I today?’ You are a different person now than before marriage.”

O’Hagan is working on that. She quit painting after her husband’s death. “There is so much going on now that I don’t have the focus, but I’m not worried about that,” she said. O’Hagen plans to resume painting next year in the spare bedroom of her new apartment, and expects her experience to show in the new abstracts. “I know when it breaks through it is going to be big in my art,” she said.

“I am so lucky I can sit here and let the grief have its way,” O’Hagan said. She still sees her counselor. “She really helped me a lot. I still see her to make sure I am not going off the deep end. I am not.”

“It is a journey,” Marta said, noting the journey has “a lot of phases of ups and downs. “Move forward through depression to recognize life does go on.”

Acknowledge that what you are going through can actually be a sort of “positive process,” concluded Borman. “Grief is nature’s way of reminding us that our time with that person was real.”

–Susan S. Stevens

 Resources:

• Rhonda Borman, www.rhondaborman.com
• Susy Yehl Marta, www.rainbows.org