Walking …

WALKING THE WALK … HAND IN HAND

As a licensed counselor practicing for the past 20 years, I have never seen an issue press so many hot buttons as end of life care. All the ‘should haves’ and ‘would haves’ now come to a head and seemingly reach a point of no return.

Specifically for elderly persons with chronic issues, after a period of time, things will exacerbate. Planning, if done at all, needs to be updated to the current reality, which many times presents itself abruptly through crisis. The question of who gets to make these decisions and when can cause much confusion and anxiety.

Individuals or families who were going along moment to moment suddenly need to consider more variables. Doctors chime in their assessment and advice, and rabbis consulted will provide halachic guidance. The patient is going through her/his own experience and often finds this hard to convey in words particularly if hearing, speech or cognition is dimmed.

Finances are usually a consideration, and then there is a search to find ‘the best care.’ This is tricky because the obvious question is: according to whom? Each person’s own values about health, medicine and quality of life are called to the fore. Is it most important to deal with issues of physical pain and safety, or is thought given to emotional well being and the need for interactive stimulation? If a person is living on his/her own or with an also aging spouse, how can it be assured that prescriptions will be taken and procedures followed? Are the medical personnel at all levels from PT, OT to primary doctor to specialists to nurses’ aides in open communication with one another? Is there an overall plan, and who monitors this?

Concerns multiply, and much of this is placed on the aging spouse and/or other family. Not only are they consumed with their own activities of daily life but many are now confronted with the dynamics of their relationship to one another and to the chronically ill person, generally a parent. Feelings that may get stirred include: confusion, helplessness, resentment, anger, fear, guilt, sadness, all resulting in overwhelming anxiety. Given our human proclivity to survive, many people adopt the flight response, ie, denial. We run away from admitting our feelings yet continue to act them out all the same.

This is a tough time on many levels, and those of you immersed in this do not need anyone to tell you so. You probably also have been offered a plethora of services provided by agencies and individuals purporting to aid during this aging, sickness and dying process. Many are sincere and offer real help. Unfortunately, others promise but greatly disappoint and, in some cases, cause injury.

The problem I have found in my engagement with individuals and families is that coordination often falls short, and the dots are not connected. People’s values and decisions may be acknowledged and supported on one level but not throughout. Much of this can be bewildering to the patient and continue to fan anxiety for the family.

I am now taking my years of training and practice as a mental health and expressive arts therapist and as a previous wellness coordinator for a village of seniors and creating an offering that I believe can bring a more comprehensive and hopefully saner approach to these issues.

“WALKING THE WALK….HAND IN HAND” intends to provide:

–1:1 engagement and sensory stimulation for the patient, whether at home or in facility

to determine the correct activity level and interventions to increase comfort

–training of family members and surrounding staff in how to also provide this

–emotional support and counseling for family decision making

–information gathering, navigation of systems, advocacy with medical providers

–regular communication with family of patient’s status and treatment protocols

–monitoring of patient’s treatment by paid in-home staff and institutions

–facilitating end-of-life realities: honoring patient’s wishes in conjunction with

those empowered to make decisions

Some comments from institutions about my work include:

Levindale: “Joyce impresses me as a very genuine and caring person who has good clinical skills for providing support and therapy to elderly persons.”

Tudor Heights: “Joyce brought expertise, care, enthusiasm and professionalism in both helping to better train care staff along with interactions with our Memory Care residents.”

And from families: “Joyce is a very compassionate and gifted professional who contributed greatly to my father’s quality of life. And she has a remarkable knowledge of eldercare resources.” “My husband has Alzheimer’s…Joyce’s biweekly treatments have helped him become more responsive and expressive of love and appreciation.” “In the nursing home, Joyce was a valuable extra pair of eyes and a natural advocate for assuring that my mother-in-law received the best care possible.”

My rates are primarily out-of-pocket, yet there may be some circumstances in which commercial insurance will pay. I am committed to working out a reasonable plan with each consumer. My fervent hope is that together we may create a rite of passage imbued with dignity and deep reverence for the human soul/spirit

Joyce Wolpert, LCPC, R-DMT
Licensed Counselor, Expressive Arts Therapist
410 358-0977  –  JBdance8@yahoo.com

Joyce’s listing on Psychology Today

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