Table 1 Narrative Geriatric Loss Simulation Exercise
On a piece of paper, write the following: • Your name • Your type of residence (apartment, condominium, house) • Your occupation (current or “dream job”) • Three people who are important in your life (family, friends) • Three treasured possessions (pet, photos, boat, jewelry, family memento, car) • One favorite hobby or pastime |
Instructions to facilitators: After asking participants to record the information above, and distributing paper “money” to simulate personal finances, read the narrative below. |
Imagine you are 60 years old. You have a full-time job that you enjoy and you have an active lifestyle. Your monthly income is sufficient to meet your needs with some additional cash for retirement savings. You like the neighborhood in which you live, and most of your family and friends live within a 30-minute drive. Your health is reasonably good– you have high blood pressure and mild diabetes, but they are both controlled with medication. You wear bifocal glasses for help with distance vision and reading. You are getting a little hard of hearing, but you can determine what people are saying if they face you when they talk. Because of dental problems, you recently had dentures (partial plate) made. Today you heard that someone very close to you is moving to another state 1,200 miles away. Due to the distance and the cost of air travel, you don’t expect to be able to visit them. Cross one person off your list. |
You are now 64 years old and you notice you have been increasingly short of breath and very fatigued for the past several months. You visit your doctor and are told you have had a heart attack. After some time, you decide to cut down from full to part-time employment. You find yourself enjoying the additional time off. You have more free days to enjoy your hobbies. You had hoped to travel, but with the reduced income, you can no longer afford big trips. Tear up one-third of your income. You are content with trips to the beach in the summer and the Poconos in the fall. |
At 66 you decide to retire– cross off your occupation. You begin receiving social security checks and draw money from your pension, but the income is still less than when you were working. Tear up half of your income. |
Last week you turned 70 and your family had a surprise birthday party for you. You had a wonderful time at the party, but it made you think about many things. It is hard to believe you are 70; in your head you feel like you are still 21, but your body won’t do what you think you can do. Your heart disease makes your activity limited because of chest pain and shortness of breath. You have been told that your family is concerned about you. Since you no longer work, you find it hard to tell one day of the week from another, so sometimes they think you are confused. Your hearing loss is worsening, but this is embarrassing for you and rather than tell someone about the problem, you pretend you understand what people are saying when they speak to you. Your responses do not always make sense to others, and this further confirms your family’s belief that you are confused. One night, on the way to the kitchen, you slip on a small rug in the dark and you fall, breaking your arm. Your family decides it is no longer safe for you to live alone so they insist you live with one of them– cross off your residence. Instead of having an entire home to yourself, you will only have one bedroom and not much room to store your things– cross off two possessions. |
Time goes by and you are adjusting to your new living arrangements. Others in the home seem so busy, but there is not much for you to do. You are 73 years old and no longer very active. No one asks for your help or your advice. You often think back to your youth. You did some exciting things when you were younger and had great success in your work, but your family and friends have already heard these stories several times and they don’t seem interested in them now. Since there is not much excitement in your life these days, you have little news to share with others and not many people call you anymore. You are no longer able to drive so you don’t get out unless someone takes you where you need to go, which most often is to the doctor. Yesterday, someone close to you passed away– cross one person off your list. |
You are now 75 years old and have been hospitalized with a stroke. You have severe right-side paralysis; you cannot walk and cannot use your right arm (you are right-handed). It is hard to remember the names of all the staff. They all look the same, wear the same clothes, and there are several different people taking care of you every day. They wear name badges, but you cannot see them because your glasses are in the bedside table on the other side of the room. To get the staff’s attention when you need help, you wave at them as they walk by your room. Some ignore you as they rush off to complete their tasks. Others smile, wave back and keep on walking. Many staff members do not call you by your name, instead you are called: (Provide names to the participants such as Pops, Grandma, Dear, Honey, Sweetie, Sugar, Cookie, Sweetie Pie, Room 12 bed 1; Room 5 bed 2, the CVA, or no name at all). Cross off your name and replace it with the nickname given to you. |
Your meal tray has arrived. The stroke has made it difficult for you to swallow and you are given pureed food. You try to feed yourself with your left hand and usually make a mess of the tray and your gown. You don’t get much food to your mouth, but it doesn’t matter; you’re not very hungry most of the time. Your health care team decides you need rehab and long-term care. Arrangements are made for you to go to a nursing home. Cross off one possession and one hobby. Hand over your remaining income. |
Instructions to facilitators: Direct the discussion to include addressing issues including independence; dignity; making a contribution/feeling valued by society and family; identity. Review the debriefing questions (below) with participants upon activity conclusion. Debriefing Questions: 1. How did this feel? 2. Did you feel like you were being treated unfairly because of your age? When? 3. Which was the hardest loss to endure? 4. At what point did life seem to be very difficult? Why? 5. Is there anything that would have been a help for you? 6. What are the most important take-away messages to apply to your work as a CCT/nurse/pharmacist/student professional? |