For the last few weeks in this blog we have been exploring the core tenants of well-being as discussed by The Eden Alternative and their transformational effects on creating a person-directed model of care. In our last blog, we talked about the importance of both security and autonomy and why it is vital for caregivers (both professional and personal) to balance the need for creating a safe and autonomous environment that allows individuals to find fulfillment. This week we will be taking some time to explore the concept of meaning making in a person-directed care model.
There can be many definitions for meaning but The Eden Alternative defines it as, “significance; heart; hope; import; value; purpose; reflection; sacred.” This value of meaning expresses itself in care by challenging the “medical model” which,
Think[s] about disability…as a problem that exists in a person’s body. As a consequence, that individual is thought to require treatment or care to fix the disability, to approximate normal functioning, or perhaps as a last measure, to help the individual adapt and learn to function despite the disability.
While this model of care has a certain straight forwardness making it alluring to able-bodied folks, it actually has a tendency to reduce an individual to their disability. The medical model is destructive to the individual because instead of looking at what can be changed about someone’s environment and society to make it more inclusive, it views people with disabilities as a “problem” to be “handled.” When it comes to meaning making in care, the medical model reduces, “the sacred work of care partnering…to a series of tasks and procedures delineated in the care plan. The rhythm of daily life becomes repetitive and numbing, holds no meaning, and inspires little motivation for the individual.” We at Homewatch CareGivers of Crystal Lake reject this medical model, and instead seek to achieve a person-directed care that seeks to promote relationship and wellbeing. One key part to that goal is working to help foster meaning making in our clients.
This, however, begs the question, what does meaning making actually look like in care? To answer this question, we will turn to a research article published in the BMC Geriatrics Journal. In this article, researchers studied what care practices most effectively created a life full of meaning to seniors who were receiving care and they found three areas to be particularly effective in the promotion of meaning: generation of valuable togetherness and aloneness, personally treasured activities, and spiritual connection/closeness. The generation of valuable togetherness and aloneness both involve a caregiver having a personal relationship with their client so they can help facilitate meaningful activities. When someone is alone, they may enjoy reading so someone demonstrating person-direct care might ask them about what they are reading and be willing to help them find books that interest them. When a client is with a caregiver, generating valuable togetherness might look like suggesting they spend some time outside and just talk with them about their lives. These simple activities elevate care from being medically driven, to being person-directed because they encourage care to come from who someone is and not from their disability. Another way discussed in this article to create meaning is through the cultivation of personally treasured activities. This can be something like scrapbooking, writing letters, or anything the client enjoys but may find difficult to do on their own. With the help of a caregiver, a client can have an opportunity to engage again in these personally treasured activities. Finally, the authors suggest that a feeling of spiritual connection/closeness is vital to meaning making. This could look like a caregiver helping set up a livestream of a client’s church service, or simply asking them to talk about their spiritual life (if that is something they want to discuss).
Meaning making in care is a big task, but we at Homewatch CareGivers of Crystal Lake see facilitation of the wellbeing of our clients to be the most significant part of our job. We don’t seek to have care that is merely transactional, like under the medical model, but work to make every client feel seen, embraced, and partnered with toward growth and wellbeing. It is a myth that elder care has to be depressing or uninteresting, and we believe that with the right practices, growth and flourishing is achievable in every stage of life.
 Silvers A. A Fatal Attraction to Normalizing. In: Parens, editor. Enhancing human traits. Washington DC: Georgetown University Press; 1998. pp. 95–123
 Drageset, Jorunn, Gørill Haugan, and Oscar Tranvåg. "Crucial Aspects Promoting Meaning and Purpose in Life: Perceptions of Nursing Home Residents." BMC Geriatrics 17, no. 1 (2017). doi:10.1186/s12877-017-0650-x.