Interview With an Older Adult, Essay Example

Introduction

Mrs. Harley is the interviewee in this particular interview. She is 70 years old and is of Caucasian origin. She is originally a mixed caste as her mother is German and her father was French. Presently she is living with her husband in a well-furnished duplex in Trafalgar Square. She did her graduation in painting education and masters in clinical nutrition services. Currently she is physically not very stable and is suffering from muscular degeneration and a generative eye condition. Being aged she receives disability compensation and her 72 year old husband is working. The characteristics and features of Mrs. Harley perfectly match her present age.

Face to Face Interview

I wanted the interview with Mrs. Harley to be very smooth and make her feel comfortable and thus I began with the conversation casually. As soon as I saw Mrs. Harley I could make out how aware she was about her looks as she was dressed in a well-fitted grey color mid-length dress, a scarf in her neck, comfortable slippers and very light make-up lighted up her face. Her frail body complimented her dressing. Seeing her I could make out that she had accepted that she was growing old. Being intelligent and practical she believed that growing old is just a natural phase of life but still was disheartened by her physical changes and degenerating vision. It was a simple task for me to get friendly with Mrs. Harley as I had some acquaintance with her from the club where her paintings are generally exhibited as I also work there. I knew she had noticed me and trusted me as she willingly drove with me to Houston where we began with the conversation.

What are the usual activities and responsibilities?

Mrs. Harley seemed comfortable as we started conversing and told me what keeps her busy. She said that her usual activities involve receiving phone calls as people call her to seek advice regarding what nutritious food is all about. She hardly gets time to watch television or read books as phone calls from her friends and relatives keep her busy. Also her major responsibility was to take care of her 90 year old ailing father whom she loves a lot.

I could feel how people relied on her for advice regarding staying healthy as she received a number of calls while we drove to Houston seeking advice.

What are the favorite foods?

This question seemed quite appealing to Mrs. Harley as she jumped with happiness to answer me with ‘ice-cream’. Being old had not prevented her from having her favorite ice-cream all the way from Tiffany. She also said she loved having bacon with some fresh salad and it reminded her of her grandmother who used to cook it for her the perfect way in their small backyard.

What are your hobbies?

This question seemed quite appealing to Mrs. Harley as she jumped with happiness to answer me with ‘ice-cream’. Being old had not prevented her from having her favorite ice-cream all the way from Tiffany. She also said she loved having bacon with some fresh salad and it reminded her of her grandmother who used to cook it for her the perfect way in their small backyard.

What type and amount of exercise do you get on a regular basis?

Looking at her I could make out that she was not exercising presently and this is was she also told me. This was because of her degenerating vision which did not perm it her go for morning or evening walks which she loved going to when she was younger. Now that she is physically disabled she cannot even think of driving to the gym which she used to go in company of her husband few years back. However, with a faint smile she said that sometimes she gets involved into in-house gardening and takes a small walk in the garden of the club she visits on weekends. The only exercise she can recall is moving up and down to her attic which is her painting workstation. The attic is on the top floor and whenever she desired to paint she would climb the stairs to the attic and climb down back again when she was tired.

Do you have the physical and financial resources to accomplish their usual activities and responsibilities?

I felt a little apprehensive while asking this question to Mrs. Harley but her smiling face made me confident again. To this she replied that yes, physically she was not sound anymore to carry out her usual activities and responsibilities in the best manner. Her degenerating vision and muscle strength did not permit her to be very active throughout the day. About her financial resources she said that she was managing her expenses with her reservations and disability compensations. Like any individual she also had hidden desires to buy things which fancied her but somehow she was never left with any savings to go for them.

Do you have the same educational and employment opportunities that you had when you were younger?

Mrs. Harley said that when she was younger things were different with her. She was the only second child in her house to attend college and pursue a career. She used to travel both by car and by bus easily to spend a day out with her friends and to meet her relatives. She was physically more active and joyful. With age, physical disability has over-powered to zeal to be in an employed condition. This is because when she was young she had the job of giving private painting lessons to the neighborhood children but now due to her degenerating vision and shaking hands she can no longer concentrate on paintings and cannot drive to the club as well. Thus, both educational and employment opportunities are no more the same for Mrs. Harley.

Do you follow any special cultural or religious practices? If so, have those practices changed overtime?

Mrs. Harley specified that she still follows traditional religious practices but believes that being so traditional sometimes can be problematic. Her religious beliefs and cultural practices have won her the award of being called boring by her friends and relatives. A part of Mrs. Harley holds on to spiritual notions and another part of her realizes its pitfalls also. There is a belief that widowed women refrain from visiting church and other religious practices. This practice was also practiced by Mrs. Harley after she had lost her first husband in an accident. However, with time as she was happily married again these practices have become meaningless for her.

Is religion important to you?

Not practicing some of the religious practices does not prove Mrs. Harley to be non-religious, she is still quite religious and a principled person who maintains certain principles set by her in her daily life. She along with her husband visits the local church with her husband on Sunday’s after her painting exhibition is over and also takes part in any religious activities and events that take place at the club during festivities and New Year. The fact that she got a good life partner after losing one makes her faith in god quite stronger.

What are you most proud of?

Mrs. Harley said that her proud accomplishment lies in her daughter who she was able to raise single-handedly amidst lot of stress and turmoil. The death of her life partner leaving behind a small daughter and lack of financial security was very distressing to her. But however she was able to bring up her daughter in the best way possible which makes her proud of herself.

How have you handled the losses in your life (e.g. limited mobility, change of residence, death of friends, family or pets)?

Mrs. Harley responded to this question with a deep sigh and said that for the most part of her life depression has been her best friend. Initially, the first face of depression she experienced was the death of her spouse when she was very young which both physically and mentally strained her, she took enough time to recover and hold another man’s hand. Another phase of depression for her was to see her daughter getting married which left her with loneliness in her old age. She again took lot of time to recover but again limited mobility due to physical and vision degeneration enveloped with her depression. The fact that her health was deteriorating and the fact that she would soon lose her vision further made her depressed. Another reason why she continued to be depressed was the reason that now that she was ageing her paintings no longer had the zeal to attract admirers and limited exhibitions made her feel cut-off with the outside world. However, Mrs. Harley stood strong and accepted the changes as they came.

Do you have any regrets in life?

Mrs. Harley paused to recall after I asked her this question. After a long pause she replied that she would be very regretful only if she had not taken the steps she actually had taken in her life. She would have regretted if she would have not married again because Mr. Harley loved her well and had brought life to her depressed life. She would also regret if she would not have focused on higher education and if she had not developed any hobby in life. The only regret she could recall was the way her daughter was brought up. Her daughter could not get the love and care she deserved from an intact family. Even before her husband’s death things between them were not very good but were full of abuse and anger which prevented her daughter from being loved by her father which she greatly regrets.

What was life like for you when you were my age?

Mrs. Harley said that when she was younger her life was a blend of adventure, romance and events. Even though things were not that good she was happy with her first husband. Like normal couples they went on vacations, had a small happy family that lived, ate and slept together. These were some of the happy moments of her life that made her smile.

What are some of the challenges of being an older adult in America today?

Being an older adult in America exposed Mrs. Harley face many unknown challenges. Firstly, she was discriminated because of her age and physical disability at public places which made her feel challenged. Secondly, the fact that older Americans generally lose their jobs even before it is time for them to retie which deprives them of pension and thus some fixed income. Thirdly, cutting down of the bus lines is also a major concern as older adults are unable to drive and depend on public transport for their outings. She expressed that she desires major changes in the community resources and treatment options for the elderly as they suffer from lack of family support sometimes.

What are the greatest concerns related to your present or future health?

For Mrs. Harley her biggest health concern is her degenerating vision and muscle strength as mentioned by her several times before also. She can sometimes enjoy painting with her glasses on but soon she will not be able to and this is what worries her. The fact that being a woman she will soon be unable to do her daily personal and household chores, will not be able to care for her husband, father and daughter upsets her well. She said that she is now being focused on accepting things as they come and believe in god who will provide her with the strength to handle situations as always before.

What would you like to pass on to the next generation? Any advice?

It is well-known that elder generations are a bundle of experiences, wisdom and imagination. Similarly, Mrs. Harley had sufficient advice for me as well as the next generation. She elaborated that today’s generation lacks imagination as she can make out from her painting class students. She feels an urgent need for children to concentrate on outdoor games which helps them to mingle with the humbleness of nature. She dislikes the computer age as she feels it is spoiling the nation’s youth.

Mrs. Harley also believes that our planet Earth is not only for exploitation. Every individual must take some step to give back to earth. She had special advice for me to take part in promotion of advocacy for elder patients and encourage proper healthcare facilities for them.

Recommendations to Improve Mr. C’s health

On the basis of this interview and the time I spent with Mrs. Harley, I reached a conclusion to administer ‘The Modified Care Giver Strain Index (CSI) and The Geriatric Depression Scale’. I decided to govern the CSI because she had mentioned about the time she spends providing care to her mother, shifting her to the nursing home and the phone calls received by her from friends and family to ask her advice many times while we were conversing (Thornton, 2002). I read aloud the questions mentioned in the CSI as I was sure that she will find it difficult to read them and it is also apt to read out the questions when it is the question of a self-report instrument. Mrs. Harley recorded 10 points out of 13 (Basford, 2004).

Positive screening which is more than 7 positive items on CSI is an indicator that an in-depth assessment is required to boost suitable interventions (O’Neill, 2002). Also, a number of domains which must be addressed while conducting a comprehensive assessment of the entire caregiving procedure have been identified. It is important to study the problematic behaviors and cognitive status of her mother and Mrs. Harley’s perception of deprivation of role overload in important relationships, activities and goals. The complete caregiving experience is based on crucial variables like family conflict, caregiver social support and family conflict (Picariello, 1988).

I suggested her to make use of the community resources like home healthcare, meals-on-wheels, housekeeping services and Companion services to help her with caring for her mother so as to make her life simpler. I provided her with some telephone numbers also for availing the community resources so that she can select the ones she finds suitable to her (Association, 2009).

The Geriatric Depression Scale (GDS) is a self-report assessment having 30 items which are used to realize depression in older adults. This scale was developed by J.A. Yesavage in 1982 (Melillo & Houde, 2010).

I realized that GDS will be a suitable assessment for Mrs. Harley on basis of her acknowledgement of dejected feelings in association with her loss of functioning and vision. On GDS she scored 4 points out of 30 points (Cram101, 2012). The GDS questions have to be answered with either a yes or a no rather than a 5 category set of responses. This simplistic nature of this scale makes it suitable for moderately cognitive impaired and ill individuals. This scale is usually implemented as a regular part of Comprehensive Geriatric Assessment. 1 point is subjected to every answer and finally the cumulative scores are rated on a typical scoring grid. As per the grid, the 0-9 range is normal, the 10-19 range is mildly depressed and 20-30 range is severely depressed (Davis & Tommy E. Davis, 2008).

The GDS reports are not enough to diagnose clinical depression. This test is well-established for validity and reliability for evaluating other diagnostic criteria but the responses must be considered against the results of a very comprehensive diagnostic work-up. A smaller version of the GDS having 15 questions have been developed and its scale is made available in different languages other than English (Cress, 2007).

It is quite normal for elder adults to experience depression. An individual who scores 6 falls in the category of depressed and requires follow-up accompanied with detailed assessment. Since, Mrs. Harley scored below 5; she was not subjected to further assessment. I suggested her to share her depressed feelings with her spouse. To enhance her mood, I told her to focus on relaxation techniques to combat her caregiving strain (Powell, 2007).

Summary

Mrs. Harley as a woman was very inspiring to me. In spite of the difficulties and setback she had experienced, she kept a positive face living by faith in wise teachings. I admire her quality to be able to counsel others and spend a large part of her time to care her ailing father. I did not face any difficulty while conducting the interview as Mrs. Harley turned out to be welcoming and open to the questions. The most difficult and crucial part was to select an assessment tool. I appreciated the fact that she gave her precious advice to my ability and profession so that I can make some improvements in the health-care system.

References

Association, B. M. (2009). The Ethics of Caring for Older People. London: British Medical Association Publishers.

Basford, L. (2004). Caring For The Older Adult. London: Nelson Thornes.

Cram101. (2012). e-Study Guide for: Handbook of Geriatric Care Management by Cathy Jo Jo Cress, ISBN 9780763746421. London: Cram101 publishers.

Cress, C. (2007). Handbook of Geriatric Care Management. Chicago: Jones & Bartlett Learning.

Davis, T. E., & Tommy E. Davis, J. (2008). The Effectiveness of the Geriatric Depression Scale to Distinguish Apathy from Depression in Alzheimer’s Disease and Related Dementias. London: ProQuest.

Melillo, K. D., & Houde, S. C. (2010). Geropsychiatric and Mental Health Nursing. London: Jones & Bartlett Publishers.

O’Neill, P. (2002). Caring for the Older Adult: A Health Promotion Perspective. London.

Picariello, G. (1988). Practical Geriatric Assessment. Cambridge: Cambridge University Press.

Powell, S. K. (2007). CMSA Core Curriculum for Case Management. London: Lippincott Williams & Wilkins.

Thornton, M. E. (2002). The Measure of Reliability and Validity of the Modified Caregiver Strain Index. Charlotte: University of North Carolina at Charlotte.