Learned Helplessness
The fastest growing segment of the US population is those over 85. The country with the fastest rate of rise in healthcare costs is Japan, and the reason is their aging population. Mary Jane Koren of the Commonwealth Fund testified before congress 15 Feb on the issue of Caring for Aging America. She cites impressive statistics on the magnitude of the problem and urges us to think about this population in terms of their medical needs rather than chronological age.
Certainly someone needs to think creatively about our current practice of warehousing the elderly en route to the mortuary. Certainly, as Dr. Koren suggests, people meed more help with anything as they get older. However, some of this we do to ourselves--or rather, to our parents. That which we get help doing today, we will no longer be able to do tomorrow. It is easier to dress a child than watch him try to dress himself. However, the penalty for doing it for him is that he never learns to do it himself. The same is true, in reverse, for the elderly. When you hire someone to mow the lawn or clean the house, you soon give up the ability to do those things yourself. As we push the elderly to their meals in wheelchairs, we deprive them of the ability to walk. We also obligate our healthcare system to pay someone to push the wheelchair. And that, of course, is the tie with efficiency. We use fewer resources caring for those elderly who mostly take care of themselves, but it takes great patience and planning to make that happen.
This concept of learned helplessness applies also to the mind, to the decisions we make every day from what to wear to what to have for breakfast. Many studies suggest that mental exercise preserves mental function, but our general approach is to do the mental work for them, thus pushing them into the spiral of learned mental helplessness.
Health should mean more than just survival. As we consider how to deal with our elderly citizens, we should enable them to take care of themselves. Their lives will be better, and the rest of us won’t have to pay the bill. That’s a win-win.
Certainly someone needs to think creatively about our current practice of warehousing the elderly en route to the mortuary. Certainly, as Dr. Koren suggests, people meed more help with anything as they get older. However, some of this we do to ourselves--or rather, to our parents. That which we get help doing today, we will no longer be able to do tomorrow. It is easier to dress a child than watch him try to dress himself. However, the penalty for doing it for him is that he never learns to do it himself. The same is true, in reverse, for the elderly. When you hire someone to mow the lawn or clean the house, you soon give up the ability to do those things yourself. As we push the elderly to their meals in wheelchairs, we deprive them of the ability to walk. We also obligate our healthcare system to pay someone to push the wheelchair. And that, of course, is the tie with efficiency. We use fewer resources caring for those elderly who mostly take care of themselves, but it takes great patience and planning to make that happen.
This concept of learned helplessness applies also to the mind, to the decisions we make every day from what to wear to what to have for breakfast. Many studies suggest that mental exercise preserves mental function, but our general approach is to do the mental work for them, thus pushing them into the spiral of learned mental helplessness.
Health should mean more than just survival. As we consider how to deal with our elderly citizens, we should enable them to take care of themselves. Their lives will be better, and the rest of us won’t have to pay the bill. That’s a win-win.
Comments
I agree whole-heartedly with your post. We are quick to find an assisted-living facility for our parents so they will have to do less for themselves. We pay the home health aid to come and help them bathe and dress.
Possibly the idea of assisted living is not so bad, but the training for the home health assistant should be to encourage independent activity under supervision, not rush through just to get it done. It will take 10 minutes longer to walk them to the dining room instead of use a wheelchair, but every minute is worth it.
Posted by: Rose Girard | February 27, 2007 10:44 AM