Study counselling and care for older people by distance learning

• Learn about services and care requirements for older people.
• Understand geriatric care and counselling.
• Understand the psychological support needed by elderly people.
• Develop your capacity to work more effectively as a carer, counsellor or support worker with older people.

As a person gets older things change in their life: everything from lifestyle to health and their capacity to do things, through to those activities which they choose to pursue.

This course helps you understand these changes, and the ways in which a counsellor, carer or anyone else might interact with and support an older person. 

This course is suitable for anyone working with older people or who would like to work with older people. For example -

• paid carers
• those caring for family or friends
• geriatric services workers
• support workers
• social workers
• counsellors
• foster carers
• supported housing workers
• nurses
• nursing assistants
• doctors
• volunteers
• charity workers.

Lesson Structure

There are 9 lessons in this course:

1. Understanding Ageing
   • Gerontology, What do we mean by Ageing? Population Ageing, The Effects of the Ageing Population, Theories of Human Development, Erikson’s Theory of Development, Levinson , Theories of Retirement, Disengagement Theory, Activity Theory, Atchley’s Model of Retirement
2. Lifestyle Changes
   • Relationships, Relationships with Children, Relationships with Partners (Husband/wife), Relationships with Grandchildren, Friendships, Sexuality and Older People, Cognitive Changes, Intelligence, Depression, Determining Type of Depression, Unipolar Disorder, Bipolar Disorder, Causes of Depression, Risk factors for Depression, Men and Depression, Depression in Older People, Symptoms
3. Deterioration of Health
   • Physical Changes -Skin, Hair, Height, Senses, Reflexes, Sex, Eyes,Chronic Health Problems, Osteoarthritis, Rheumatoid Arthritis, Gout, etc. Exercise, Diet, Nutrition, Eating habits, etc. Pain relief, Medication, Stress.
4. Support Services
   • Preventative Services, Occupational Therapists, Physiotherapists, Complimentary Practitioners, Counselling Professionals, Other Support Services (eg. Meals on Wheels, Funeral Services)
5. Enablement Techniques
   • Common Risks for Elderly: Risk of Falling, Vision, Hearing, Nutrition, Sexuality. Techniques to maintain Quality of Life: Driving a car, banking, shopping, house cleaning, Gardening, Socialising, Pets, Exercise, Sport
6. Grief and Loss Counselling
   • What is grief, Psychological aspects of Long Term Grief: Family, Work, Financial, Loneliness, Morality after bereavement, Counsellors Response and Intervention, Practical Intervention, Depression
7. Debilitating and Terminal Illness
   • Dementia, Kinds of Dementia (Alzheimer's, Vascular Dementia); Strategies for Counselling the Demented Client; Communication, Daily Activities, Sleeping Difficulties, Hallucinations and Delusions, Wandering, Depression, Terminal Illness: Patients Response, Anxiety, Depression, Guilt & Anger, Defense Mechanisms. Preparing for Approaching Death; Practical Preparations, Emotional Responses, Responses of Friends and Family
8. Losing a Loved One
   • Importance of Loss, Assessment, Role of the Deceased, Death of a Child, Stigmatised Death, Co-Morbidity. Counselling Strategies: Bibliotherapy, Use of Rituals, Bereavement Support Groups. Special Therapeutic Situations: Traumatic, Sudden, and Stigmatised Loss, Ongoing Support, Social Stigmas of Suicide
9. Ethics and Intervention
   • Barriers to Aged Care Counselling, Addressing the Client’s Needs, Common legal and ethical issues with aged care: Decision Making Capacity, Competence, Informed Consent, Confidentiality, Euthanasia, etc

Aims

• Discuss theories of ageing, and to develop an understanding of the different stages of human development.
• Describe the psychological impact of changes which occur as a person reaches old age
• Explain the effect of physical health problems on older people.
• Describe the nature and scope of support services, including counselling, for the elderly.
• Describe a range of solutions that can enable an elderly person to adapt to changed circumstances in order to continue performing tasks or pursuing interests that are becoming increasingly difficult for them.
• Explain how a variety of counselling techniques can be applied to specific Grief and loss situations for counselling elderly persons.
• Develop a strategy for counselling an elderly person who has been diagnosed with a debilitating or terminal illness.
• Develop a strategy for counselling an elderly person who has lost a loved one.
• Determine when and how to intervene in the life of an elderly person

COMMON HEALTH RISKS FOR OLDER PEOPLE

Risk of Falling

When a person ages, the risk of having a serious fall increases. A fall could happen anywhere whether the person is alone or accompanied. Whilst there are some screening tests which can be undertaken by the individual’s doctor, there are preventative measures which can be implemented so that risk of having a fall can be reduced. Hence, the elderly person can continue to undertake tasks such as cooking, gardening, walking to the shops with less fear of a fall.

Solutions include: fist clenching or ankle pumping to combat hypotension: reduced systolic blood pressure. The use of pressure stockings is also helpful. It may be necessary for the individual’s doctor to decrease dosages of medication which are contributing to reduced blood pressure. The counsellor may need to educate the client about correct usage of sedative and hypnotic drugs to aid sleep. Perhaps the client should try restricting daytime naps and weening themselves off the sleeping pills. Strengthening and balancing exercises can help with impairments to gait or balance.

Furthermore, changes to the home environment can be made to reduce risk. Changes could include: installation of grab rails in strategic places, for instance, in the bathroom or on the stairs, avoidance of slippery floors and rugs, and avoidance of sharp or obtrusive furniture around the home. Electric cables should be kept tidy and lighting should be kept bright and in full working order.

Another cause of falling is osteoporosis. Those at higher risk are elderly female clients who have had an early menopause, who are underweight, are white or Asian, drink excess alcohol or caffeine, smoke, use drugs, have a family history, have a low calcium intake, and are physically inactive. The client with osteoporosis may receive a fracture prior to a fall. The counsellor can work with them to reduce the risk factors.

Vision

Elderly clients over the age of 65 years will probably be prompted by their GP’s to take regular eyesight tests. It is estimated that some 70 percent of this age group will have some form of visual impairment. This could be anything from macular degeneration through to cataracts or glaucoma. Changes in vision can cause significant changes to an individual’s life as well as increasing the risk of falls.

Hearing

Approximately one third of elderly people who are in need of a hearing aid actually use one. The most common cause of hearing loss in the elderly is presbycusis. This is the lost of high frequency pitch and affects the ability to communicate. As such, it can increase the risk of isolation and depression in elderly clients. Furthermore, hearing loss can adversely affect physical, cognitive, and emotional health.

A counsellor working with elderly clients who suspects impairments to eyesight or hearing should encourage their client to seek appropriate intervention from a health care professional, or refer them on for assistance.

Nutrition

Malnutrition or simply not eating enough, are common problems amongst the elderly population that often go unnoticed. There are health care screens available which are easy to administer and can be scored by a spouse or relative of an elderly client. They are intended to help avoid dietary problems in at-risk clients which can exacerbate complications during hospitalisation of elderly people.

Many older people remain sexually active. It is estimated that 74 percent of men and 56 percent of women over the age of 60 still practice sexual activities. Problems relating to loss of functional ability are not part of the normal ageing process and must not be treated as such. Reduced duration and intensity are normal in older people. Risk factors affecting the pursuit of an active sex life in the elderly include: arthritis, fatigue, fear of heart attack, and loss of libido through smoking, alcohol, and medication.

One of the problems elderly clients often report is that their GP’s do not wish to talk frankly with them about sex. The aged care counsellor should therefore treat elderly clients with respect when dealing with sexual issues. Providing a warm, trusting, environment, and asking open and direct questions will assist the elderly client to feel like a normal sexual being.