Exercise for Social Fitness

Editor’s note: This is the fifth in the series by Diana Boufford on the well-being of the elder community. She first introduced the Comprehensive Geriatric Fitness model, then discussed Spiritual Fitness, then Family Fitness, then Emotional Fitness. Watch this space for one more article in the series on Physical Fitness. Also check out a separate article with some specific ideas for developing Social Fitness.

When I think of social fitness I think of charismatic, outgoing, exciting people who are able to entertain at parties and make others laugh, people who feel completely at ease anywhere. This is certainly not me, and it is not what this article is about. Instead, I’m focusing on older adults, their families, and their caregivers and how they can build their social fitness to navigate the challenges that arise as someone grows old. It is about applying inner resources and strengths to cope with this challenging period of life.

In earlier articles, I’ve detailed some of the challenges of old age, including lifestyle changes, loss of friends and family, physical illness and impairments, and loss of mobility. Older people may find their worlds shrinking as their ability to get around diminishes. That often means their social worlds shrink as well, unless they keep finding ways to strengthen their social connections.

A Social Trajectory

To illustrate this I will tell you about my mother with her permission. She was a very active young senior who spent her days volunteering to help others who lived in her building, serving as an informal friendly visitor. Before that, she worked as a house mother for a home for pregnant teens, and at another time, she cared for mentally disabled adults. She belonged to a weekly bowling league for decades. She also visited and supported her children and grandchildren in all the ways that loving grandmas do.

However the effects of illness and aging crept up on her at a relatively young age. A medical condition affected her mobility so that she found herself frequently falling. A severe tremor made it difficult to feed herself. She also suffered great pain due to the disorder itself as well as migraines and osteoarthritis. Disabilities often come in clusters. She found herself confined to her apartment, unable to go out alone, and dependent on nurses, personal support workers, and family to come in three to five times per day for meals, personal care, and medical attention.

In the five years that she lived with these debilitating conditions, she became more and unhappy. She felt like a prisoner in her own home. We encouraged her to move into a nursing home to get much needed care, but she refused over and over again. Finally the pain, the frustration of having to wait for help or pain relief, the loneliness, and the isolation got to her. She agreed at the age of 65 to go into a nursing home. It took a bit of adjusting, but after three months, she admitted that she was actually quite comfortable. It was a relief to know that she did not suffer in isolation and that there was a team of people to help her when she was not well.

Today my mom would not live anywhere else. “Even if I became independently wealthy so that I could hire round-the-clock-care, I would not give this up. I would not move.”

You see, today, my mom attends nearly every event and activity in the home. She has a routine that allows her to provide care to others once again. She brings the residents who are unable to make their own way down to the dining room for meals. She gathers all the aprons (Mom thinks it is quite demeaning to call them bibs since they are for adults – I for one do not disagree). She greets each resident in the dining room before each meal and assists with putting on the aprons. She helps plan teas and other activities, and she serves on the Residence Counsel for her unit, bringing up the concerns of her neighbors to the administration and staff.

Moving into care not only restored my mom’s dignity, it has also given her purpose and meaning. She is able to be the social, outgoing woman of service that she once was. She did this through her own resourcefulness, courage, fortitude and yes, stubbornness. These skills reflect some of her social fitness abilities.

For the caregivers as well

Care providers need to develop social fitness as well. The task of caring for an elder along with the demands of one’s own family, work, home, and marriage are often overwhelming. The well-being of the caregiver is easily pushed to the bottom of the to-do list. Over time, this can result in burnout or grow into anger and resentment toward the elder and others. Social fitness is an inner resource that can prevent or lessen these problems. It can actually make the elder years quite fulfilling.

In order to maintain their own social fitness, caregivers need to be willing to reach out to others. This can be difficult. Most people don’t want to be a burden and feel that they are imposing if they ask for help. However sometimes this is one of the greatest opportunities for the development of humility, resilience, building a network, and growing social muscles. Relationships can be meaningful and engaging not only for the asker, but also for the other person, leading to shared attachment, appreciation, and nurturing.

Social Resilience

I initially presented the idea of geriatric social fitness at the International Network for Personal Meaning conference held in Toronto in July of 2012. I had a quick 10 minutes to present my idea about translating the Comprehensive Soldier Fitness model by Seligman and colleagues into a Comprehensive Geriatric Fitness model. Since then, I’ve learned about John Cacioppo’s work on social resilience, defined as “the capacity to foster, engage in, and sustain positive relationships and to endure and recover from life stressors and social isolation.” According to Cacioppo and colleagues, the following features characterize an individual with social resilience.

1. Characteristic ways of relating: agreeableness, trustworthiness, fairness, compassion, humility, generosity, openness
    
2. Interpersonal resources and capacities: sharing, attentive listening, perceiving others accurately and empathically, communicating care and respect for others, responsiveness to the needs of others, compassion for and forgiveness of others
    
3. Collective resources and capacities: group identity, centrality, cohesiveness, tolerance, openness, rules for governance

Researchers working for the US Army developed a survey to help soldiers identify both strengths and areas that needed additional attention for social fitness. They also provided training tools to help military personal to enhance existing strengths and develop new strengths.

I contend that we could improve the quality of life of ourselves as caretakers and our elders if we were able to assess social fitness and provide suggestions for enhancing strengths and addressing areas needing improvement. The VIA character strength assessment is one way to explore existing strengths.

Let’s Look at Mom’s Experience Again

My mom was able to build on her social fitness. She knew that her life was most fulfilling when she was serving others (helping peers with dinner), when she played with friends (bowling), and when she advocated on behalf of others (the Residence Council). She demonstrated the social resilience through her agreeableness, openness, trustworthiness, fairness, compassion, humility, and generosity of time, energy, and spirit. She is always looking for ways to help. Her interpersonal resources include attentive listening, responsiveness to the needs of others, and compassion for and forgiveness of others. Finally she enjoys belonging as a resident of the nursing home, having a group identity, and practicing tolerance for rules for governance.

My mom’s experience is not shared by all, although, many do follow a similar path. What is important is the development of some sort of social resilience skills in order to be well prepared to cope with whatever changes occur. For the care providers, walking this road with the elder(s) is just as challenging. They have a similar need for preparation. These changes can be just as difficult for the care giver as they are for the elder.

Do not walk this journey alone.

There are many resources in your community. Seek them out. There are many books with great, practical ideas that will ease the burden. Avail yourself of them.

One book that is fantastic for the employment of social fitness is called Share The Care by Sheila Warnock and Cappy Capossela. You may also want to read books about resilience, such as the one by Karen Reivich and Andrew Shatté and the one in the Positive Psychology News series book, Resilience: How to Navigate Life’s Curves which is a quick read with many ideas for building resilience.

One more book I would recommend for the caregivers who have siblings is They’re Your Parents, Too! by Francine Russo.
 

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References

Capossela, C. & Warnock, S. (2004). Share The Care: How to Organize a Group to Care for Someone Who Is Seriously Ill, (Revised and Updated).

Maymin, S. & Britton, K. (2009). Resilience: How to Navigate Life’s Curves. Positive Psychology News.

Reivich, K, & Shatt?, A. (2002). The Resilience Factor: 7 Keys to Finding Your Inner Strength and Overcoming Life’s Hurdles. New York: Broadway Books.

Russo, F. (2010). They’re Your Parents, Too!: How Siblings Can Survive Their Parents’ Aging Without Driving Each Other Crazy. Bantam Books.

Seligman, M. E. P. (2011). Flourish: A Visionary New Understanding of Happiness and Well-being. New York: Free Press

Image Credits via Compfight with Creative Commons licenses
Diana and her mother courtesy of Diana Boufford
Nursing home activities courtesy of theps.net
Canine companionship courtesy of bridges&balloons
Sharing pleasure courtesy of Josh Janssen
Strong hands courtesy of UppyPhoto