By Oran Aviv
“People who have no repertoire for facing losses are stuck” Naomi Feil
We must develop coping mechanisms earlier in life so we can deal with loss and changes later in life. In this way we may prevent cognitive decline and withdrawal.
Physical Losses and Dementia
According to Naomi Feil, who developed the Validation Method of communicating with people who are living with dementia, suffering losses can lead to cognitive decline, disorientation, regression, and withdrawal
Depending on our genetic background and lifestyle, we may suffer various physical losses as we age. Many older people develop sensory changes (see my blog Dementia and Sensory Changes) These and other physical changes can lead to cognitive decline if the person is not able to accept and cope with change.
Physical changes and losses include:
· Decline or loss of hearing
· Changes or loss of vision
· Loss of speech
· Memory change/loss
· Loss or change in smell and taste
· Loss of movement and range of motion
· Changes in appearance (i.e. hair loss, wrinkles, facial hair)
· Impotence
· Incontinence
· Pain
· Illnesses
When an older adult is in denial and does not accept these changes and losses, they will not look for a coping mechanism to deal with the loss. This can cause them to retreat into their own world where they don't have to face losses they have suffered.
“With little or no stimulation from the outside world, people vegetate and die.”
Naom Feil
Many of us know of an older person who does not accept their hearing loss and refuses to get hearing aids. Instead they become angry at others for not speaking clearly or they blare the TV at a very high volume making their behavior intolerable to everyone near them.
Sadly, this type of behavior will lead to social isolation because no one will want to be around them. This, along with not being able to understand what people are saying, will cause the person to slowly disconnect from their environment and withdraw, (see Does Everyone with Dementia Withdraw?)
Naomi writes in her and Vicki de Klerk’s book Validation, The Feil Method:
“Physical deterioration helps the very old person who has unfinished life tasks to accomplish the final task; restore the past in order to resolve it.
Naomi believes we should accept our changes like wrinkles and hair loss to help us accept that we are aging and that eventually we will need to deal with unfinished business so we can die in peace.
Today the over $60 billion global anti- aging industry has convinced us to shun old age and do everything we can to remain young. This causes many of us to be in denial that we are aging. What happens when that serum and filler no longer works, and we suddenly discover that we are very old? We have no coping mechanisms that we could have developed in middle age to help us get through our later years. This can lead to regression and withdrawal because we cannot accept that we are old.
Social Losses and Dementia
Social losses can be as debilitating as physical losses.
Social losses include:
· Death of a loved one
· Loss of job
· Loss of status
· Loss of parenting role
· No longer contributing to society
· Loss of relationships
· Loss of unconditional love (to love and to be loved)
How does one deal with these losses? Do they find a way to cope, or do they deny what has happened and hide their emotions?
Often people are taught to hide their feelings. One of my Validation teachers, Hildegard Nahum, explained that during WWII in Austria, many parents lost children, but had no time to grieve because they had to deal with helping their family survive.
People may have been able to hide their feelings all these years, but when they get to be in their 80s or older, all these feelings come surging out like a Tsunami.
These locked up feelings can cause outbursts and difficult behavior. If the person is not able to express their feelings to someone who will listen, the person will most probably regress and withdraw.
Naomi encourages all her students who study Validation to not hide their emotions and to learn how to cope with change and loss.
While studying Validation, we learned about the importance of developing coping mechanisms early in life and this line has stayed with me:
If the white keys on the piano stop working, learn how to play on the black keys.
Pivoting
How do we react to change or loss?
In one of her recent dharma talks about pivoting, my meditation teacher Stephanie Noble discussed how can we adapt when, for whatever reason, we can’t keep doing what we love doing.
I was amazed when Stephanie gave this dharma talk a few weeks ago because pivoting is exactly a coping mechanism, we need in order to accept loss and in so doing. prevent cognitive decline and regression when we suffer from loss later in life.
Stephanie’s personal journey is inspirational. She suffered many losses over the years and yet each time accepted them and found a new way of coping.
Besides telling her own personal stories about how she had to pivot so many times due to physical changes, Stephanie also shares a story about her aunt who went blind.
Stephanie tells of the difficulty of this change, but also the positive sides including that her aunt ended up finding the love of her life.
Do take 10 minutes to listen to Stephanie's dharma talk about pivoting. You will be inspired.
Even this dharma talk is the result of Stephanie pivoting!
Stephanie wrote and read her dharma talks each week and then published them on her website. However, recently she has had some eye issues that make it difficult for her to read and write.
By pivoting, Stephanie now records her dharma talks rather than write and posts the audio recoding of her talk on her site. This was the first dharma talk that she recorded.
What is even more amazing, is that Stephanie also finds the positive side to this change and every change. By not having to concentrate on reading her dharma, Stephanie finds she is more engaged with her audience because she doesn’t have her eyes on reading her text. Learn to pivot to deal with change and losses.
How to Cope
It is not always easy to learn to cope with change and loss, but with practice and patience you can learn how.
Change for me has always been difficult:
As a child I supported my mother and didn’t let my father buy a color TV because we were happy with our black and white set and color seemed dangerous.
My oldest son still laughs at how adamant I was to not let my husband add a CD rom player to our home computer.
I never wanted to change phones because I feared having to learn a new system.
I still look backwards when I park in reverse because I’m not willing to depend on the car’s reverse camera.
And yet – over the years I have learned to deal with the punches life throws my way in the form of changes and losses.
There are many ways to learn to cope with loss and change. Here are some of the methods I have used. Please a feel free to learn more about each and if you have a coping mechanism that works for you, please share in the blog comments below.
Accept Impermanence
When we can accept that nothing is permanent it is easier for us to accept change and even loss.
Impermanence is a fact of life, and how we are in relationship to it,
to a great extent, determines our ability to be happy.
Stephanie Noble - Cultivating With the Core Insights
Meditation
Learning how to bring our thoughts to the moment can help us cope better with change. Read c For your Brain’s Sake, Stop Thinking to learn how to meditate.
Reflexology
Reflexology reduces stress which can help us cope with change and loss. You can find reflexologists all over the world. Search for the Reflexology Association in your country or in your area. You can also try some hand reflexology on yourself. This is my favorite hand reflex point for reducing stress:
Practice Gratitude
When you find yourself only having negative thoughts, try to focus on something that you can be grateful for. Try to find and write down 3 things that you can be grateful for, even when you are in one of your most low moments.
Every time I watch Louie Schwartzberg's Gratitude film, the colors of the world seem much brighter and I notice much more that I am grateful for.
https://www.youtube.com/watch?v=4115qFsdWKQ&t=38s
Tell Someone how You Feel
Find someone who you can talk and who will listen. This can be a friend, family member, religious leader or professional. This is what a Validation worker does – listens with empathy. Read The Importance of Empathy to learn more.
Exercise
For some. physically moving can help release stress and the feel-good endorphins can help us cope better.
Read Exercise for Brain Health to learn about the importance of and how to start an exercise program.
Volunteer
By helping others, you can help yourself. Knowing we have helped another human being (or animal) is uplifting. It makes our life more meaningful and helps us cope with the difficulties we are facing.
World Health Organization’s Guide
You can also download the WHO’s illustrated stress guide to learn some coping tools. The guide is offered in many languages.
In summary
Learning how to deal with change and loss may help prevent cognitive decline and regression
Learn coping skills early in life.
Don’t be in denial. We all age and many of us suffer from age related, physical and social losses.
Don’t hide feelings. They will eventually come out at a later age.
Find ways to pivot so you can accept and live with the changes
Learn some coping skills now.
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