Learning as a Way of Living: The Pursuit of Eudaimonia in Long-Term Care for the Elderly Submitted by Professor Lucia Knoles, Department of English Proposal Summary I propose to spend a one-semester sabbatical spread over two semesters during the 2018-2019 academic year fostering the creation of an active learning community among the residents of Eisenberg Assisted Living by offering a core reading/writing intensive seminar supplemented by workshops and field trips. Viktor Frankl’s classic Man’s Search for Meaning will serve as the starting point for a year-long inquiry into the question of how human beings can use the arts and humanities, involvement in community and service, and experiences of the transcendent to explore meaning in life. In order to develop a twelve-month schedule of intellectually, aesthetically, and spiritually stimulating events for Eisenberg residents, I am planning to develop collaborations with a network of area educational and cultural institutions. Because so many organizations like the Worcester Art Museum, the American Antiquarian Society, Music Worcester, and the Worcester Public Library already have numerous interactive programs for school children, I expect to be able to work with them to develop a parallel tier of more sophisticated but equally interactive programs for the elderly. Thus, after my sabbatical is over, I am hoping that this network will continue to produce a lively calendar of events for the seniors at Eisenberg and elsewhere. I also plan to produce a qualitative study of the impact of this project. Working with the directors of the Jewish Health Center (JHC) and Eisenberg Assisted Living (EAL) as well as Josephine Fitzgerald, the Eisenberg social worker, I hope to use the results as a basis for articulating a humanities-based paradigm for culture change in long-term care institutions. This project will build on the extensive work I have done over the past ten years teaching literature and life-writing courses to residents at a variety of assisted living facilities, as I will detail later in this proposal. During this same period, I have also been doing extensive reading in gerontology, a field which has been variously described as interdisciplinary, multi-disciplinary, and integrative. (Alkema and Alley 2006.) I have investigated various models of “successful aging” and “perceived wellbeing.” I have collected studies that evaluate the impact that living in a long-term care institution has on residents’ satisfaction with life. I have examined the reports produced by occupational and physical therapists to document the value of “purposeful activities” in promoting health and healing. I have explored the experiments made by professionals in a wide variety of fields to use “reminiscence therapy” and “life writing” to address physical pain (for example, arthritis), emotional pain (including bereavement and PTSD), age-related problems (such as dementia) as well as to contribute to quality of life. And I’ve followed with great interest the evolution of the “medical humanities” and “narrative medicine,” noting in particular the central role played by stories in those enterprises. The dynamic nature of this field, while
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daunting, is also inviting. In a time when researchers have begun to question the limitations of the biomedical model of aging and many doctors are embracing the value of the medical humanities, there is clearly room for a committed humanist to contribute to the ongoing conversation about how to promote “successful aging” (Rowe and Kahn 1987, 1997, 1998) and “eudemonic well-being” (Ryff 1985, 1989 a., 1989 b, 1995; Ryff, Keyes, and Hughes 2003, Ryff and Singer, 2008). What I have to offer that distinguishes me from most others working in this field is my training and long experience as a teacher of writing and literature. That background gives me the expertise and perspective that I believe will enable me to make a distinctive contribution to this important conversation. I have also trained in Dignity Therapy with Harvey Chochinov, the founder of the Dignity Therapy movement and have trained members of the JHC hospice staff to use interviews as the basis for composing autobiographical narratives that hospice patients can pass on to their loved ones. I’ve been invited to report on my writing groups for seniors as the keynote presenter at a number of conferences for professional and familial caregivers. Last April I was featured as a plenary speaker at a conference on Arts, Humanism, and Caregiving sponsored for medical professionals by St. Vincent’s Hospital, the Worcester District Medical Society, and the Reliant Medical Group. My work connecting the humanities and medicine also earned me the opportunity to teach a series of “Literature and Healthcare” classes at AbbVie Pharmaceuticals during the fall of 2017, as well as an invitation to teach classes on humanities and medicine for neurology residents at U Mass Medical School. And one of the best assets I bring to this project is the set of collaborative relationships I have developed in the course of my previous work. After attending one of my presentations, Geriatric Nurse Practitioner Melissa Baugham has been assisting me in conducting Life Stories Roundtables, and she has already agreed to collaborate with me in this project. (Interestingly, as a result of our work together, she is about to begin pursuing a certificate in Narrative Medicine.) As part of my last sabbatical project, Dr. Joel Popkin worked with a team of residents from St. Vincent Hospital to conduct a study of the impact of the Life Stories. Dr. Popkin is known for his work as a specialist in internal medicine for Reliant and as a Professor of Medicine at the University of Massachusetts Medical School. He also served for many years as the Director of Saint Vincent Hospital’s Internal Medicine Residency Program. He has already committed to collaborating with me in this upcoming project by conducting interviews and collecting and evaluating data and by using his investigations of the impact of music on the brain to contribute to our classes on music. But perhaps most useful of all will be the relationships I have built with the residents, staffs, and directors of Eisenberg Assisted Living and the Jewish Health Center. I have worked with Vincent Librandi, now Chief Operating Officer of the JHC/Eisenberg campus, since my father first moved into Eisenberg. And I first met the new director of Eisenberg, Suzanne Dionne, when she was instrumental in helping me set up the Dignity Therapy training for the JHC hospice workers. Both of these people are deeply enthusiastic about my proposal and will offer me their full support. They have also indicated their commitment to helping me take my model to a national audience at the completion of this project. The sense of urgency I bring to this project grows out of countless experiences I have had with elderly residents of long-term care residences who believe their lives no longer have meaning. Assisted Living Residences (ALRs) often offer busy schedules of social events designed to
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entertain residents. But it is understandable that those whose lives are entirely spent in the pursuit of hedonia (pleasure happiness or even simple distraction) might feel a kind of emptiness. One woman who found herself in an assisted living residence after spending years as an advocate for the elderly explained to me unhappily: “Until I came here I never played bingo. Now it’s a way to use up the time.” That, I would argue, is the crux of the problem. Too many residents see themselves as “using up” rather than as “using” time. Psychologists in the 1980’s who studied well being did so largely by focusing on indicators of happiness. But in recent years, our way of thinking about well-being has shifted. As Carol Ryff explains: Indeed, the deeper philosophical roots of the new model of well-being resided in Aristotle’s formulation of the highest human good, which in his Nichomachean Ethics he termed eudaimonia. His writings sharpened the significance of this alternative approach to well-beingvia the claim that the highest of all human goods is not happiness, feeling good, or satisfying appetites. Instead, it is about activities of the soul that are in accord with virtue, which Aristotle elaborated to mean striving to achieve the best that is within us. Eudaimonia thus captured the essence of the two great Greek imperatives: first, to know yourself, and second, to become what you are. The latter requires discerning one’s unique talents (the daimon that resides in us all), and then working to bring them to reality. Two centuries later, these ideas flowed naturally into humanistic and developmental conceptions of self-realization. Existential thinking, in turn, emphasized the importance of finding meaning in adversity or an absurd world. From the scientific perspective, the larger point was that research on well-being, if it is to do justice to the topic, needs to encompass the meaning-making, self-realizing, striving aspects of being human. Consequently, they have moved away from asking whether we have happy lives and moved towards asking whether our lives are meaningful. (Ryff 2014) This is why I am committed to creating a challenging schedule of stimulating, interactive, and collaborative projects to complement the existing schedule of social activities at one assisted living residence. It is my hope that participants in this project will experienced the kind of personal growth, positive relations with others, and sense of purpose that have been identified as key elements in “eudaimonic well-being” as defined by Ryff and others. And in the process, I also hope to gather evidence that will persuade directors of other long-term care facilities as well as other gerontological professionals to adopt this new paradigm for culture change. A Crisis of Identity in Old Age My investigations into this field began as an attempt to address a crisis in my own life and the lives of my parents. In the weeks after I helped my parents move from their home in western Pennsylvania to Eisenberg Assisted Living, my father would call me every morning and state simply: “I have no purpose in life.”
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Gradually it became clear to me that my father was experiencing an existential crisis of identity. Aging and the move to assisted living had stripped him of the most important markers of his identity. The stories we tell people about ourselves are not just for public consumption; they also allow us to make sense of our lives. These stories serve as an important sense of health and well-being. Habermas & Bluck, 2000; Habermas & de Silveira, C. 2008; Hammack, 2008; McAdams, 1995, 2001; McAdams & McLean, 2013; McLean, Pasupathi, & Pals, 2007; Pasupathi, 2001; Singer, 2004, Adler, 2015; Lodi-Smith et al., 2009; McAdams, 1995, 2001; McAdams & McLean, 2013). However, when my parents were forced to move to a long-term care facility because of my mother’s dementia, my father lost his narrative identity. His autobiographical stories always celebrated the trajectory of his success. My father had always thought of himself as a man who had used hard work and intelligence to move out of the coalmining town where he’d been born and build a prosperous life for himself, his wife, and his children. One subplot in that narrative was the story about how he won the prettiest girl in the school to be his wife and crown his success. But no one at Eisenberg remembered my father as a successful business executive or as a member of the country club who played golf with other businessmen on Saturday afternoons. And my father could no longer see his own life as a story of success. My father’s loss of his home, his status, and his wife challenged his idea that life was fair and that he was one of life’s winners. In the process, he lost he sense that his life was meaningful. The loss of his narrative identity was an existential crisis that caused him to question the very purpose of his existence. His sense of loss is clearly evident in the notes he typed up in preparation for his first meeting with Eisenberg staff members who would plan his care, as you can see below.
Notes prepared by my father, Joseph Zaucha, in preparation for his first meeting with staff members at Eisenberg to plan for his future care. The final items in his notes offer a clear insight into the impact of all these losses. My father notes that “when time is filled it does not provide feeling of accomplishment” and reasserts his “need for a purpose or feeling of accomplishment.” A few weeks later my father wrote about the sense of bereavement he felt when my mother was moved out of the apartment they lived in together and into the nursing home next door. At the bottom of that story I found the following lines.
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“Life requires a purpose! Your spouses cannot be effective (in helping those they are caring for) if their lives are mt (empty).” My father was not unusual in his reaction to assisted living. No one ever wants to go to a nursing home and very few people are happy to move into an assisted living residence. Instinctively we dread the “three plagues” of nursing home life that were first articulated by Dr. William Thomas: boredom, loneliness, and helplessness. Add to this list one more plague: loss. The loss of home, loved ones, identity, and a sense that life is meaningful. Long-term care facilities were not really designed to help people address these crises. Based on my experience with such institutions, I think most people who direct or work in ALRs aim to make their residents safe, healthy, and happy. An ALR typically offers meals, provides laundry and cleaning service, and provide additional assistance with activities of daily living such as dressing, bathing, or taking medications. There is almost always a social schedule which might include such activities as bingo, trivia games, arts and crafts, and occasional outings for ice cream or lunch. But no one could argue that these kinds of activities are an effective means of addressing an existential crisis. I believe that what my father needed was not the distraction of hedonia but the pursuit of eudaimonia.
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The Pursuit of Eudaimonia through the Life Stories Roundtable Because my father lost his sense of purpose, I found a new purpose for my own life. I’ve always approached reading and writing as a way of exploring the largest questions we face in life. And so, when I felt an urgent need to do something to help my father, I proposed to him that we begin an autobiographical writing roundtable at Eisenberg. In many ways, the experiences I have had leading that group parallel those anthropologist Barbara Meyerhoff describes in Number Our Days, an account of the time she spent listening to the stories shared by the elderly Jewish people in an urban ghetto. Like her, I have come to believe that elders use stories to fight off the “invisibility” of old age and to pass on wisdom. But perhaps most important is the way elders use stories to transform personal experience into a coherent and meaningful whole, work Meyerhoff describes as “essential to the last stage in the life cycle.” (232, life history among the elderly.) This is consistent with Eric Erickson’s theory of personality development which posits that human beings typically experience a crisis in late life arising out of the change and loss that comes with aging. The prospect of mortality prompts us to evaluate our lives, and this is best done as a process of introspection and reminiscence shared with others. The title of Meyerhoff’s final book, Stories as Equipment for Living, is an articulation of the vision she and I share of the value of autobiographical narratives. While my father was one of only two people who turned up for the first session of the Life Stories Roundtable, I went on to teach autobiography writing on a weekly basis at Eisenberg for over two years. Before long the class had a steady membership of over twenty people. Since then, I have employed the same model at Christopher Heights (Marlborough), Whitney Place (Westborough), Christopher Heights (Worcester), Briarwood (Worcester), as well as offering similar programs for bereaved caregivers at Worcester Elder Services and for a group of social workers and teachers. Typically, each hour or hour and a half class includes a reading and discussion of published autobiographical writing followed by a reading and discussion of life writing done by members of the workshop on the same theme. I use “office hours” at each facility to record and transcribe the stories of those whose physical disabilities prevent them from writing on paper or typing. However, office hours are also a time when other writers can drop in to ask for advice on story ideas or drafts. When a workshop has continued for a substantial length of time, I produce an anthology of the writing in book form illustrated with photographs from various moments in their lives. While this is a time and energy intensive endeavor, the book plays an important function. It stands as a physical monument to the accomplishments of the writers. In addition, it provides them with the sense that they have created something useful that can be passed on to future generations of their family. The final component of our Life Stories Roundtable is a public reading that enables the writers to share their stories with an audience made up of their friends, family members, and staff members of their residence. Because the present proposal does not focus primarily on autobiographical writing, I will refrain from offering an extensive report of the results of this project. However, it has been the surprising results of the Life Stories Roundtable that lead me to propose expanding my efforts. Therefore, I will offer a few examples to illustrate the impact of the autobiography writing
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classes on the lives of the participants. I knew people were deeply invested in our activities because of the way they participated in classes. They leaned forward to drink in the words and ideas when I would begin classes by reading poetry, essays, or autobiographical stories. They eagerly commented on one another’s stories. They used their writing to address the most challenging events in their lives. One man, for example, wrote about his thoughts at the bedside of his dying wife just a few days earlier. In some of the writing, residents shared stories that they had never revealed to anyone in the eighty, ninety, or hundred previous years of their lives. One woman told of having been kidnapped, sexually molested, and then told by her parents to go to bed and forget about it. Another woman told of being fed beer as a baby by her alcoholic father and later becoming an alcoholic to show him she could drink too. A man told of entering his mother’s bedroom when he was eight years old and finding her swinging from a rope, unable to face the future as a single parent without enough food to feed her children. A woman told of being physically molested by her father and then sexually molested by her stepfather. When she told her mother, her mother responded: “Don’t say anything that will make him leave.” In other stories this writer told of her attempt to jump off a bridge to protect her children from the effects of her life-long depression. Not all the stories were tragic, but all of them mattered deeply to the writers. One reason I know they matter is because the obituaries of the first three of my students to die all mentioned their membership in the Life Stories Roundtable. In addition, a number of the participants arranged to have their stories read at their funerals. Recently, one alumnus provided a copy of her stories to the nurses, social workers, and volunteers who made up her hospice team. She wanted them to know the person they were working with. And another former student has decorated the walls of his room in a nursing home with posters advertising the public reading that served as the graduation ceremony for his class. Here is how I distill the principles underlying the Life Stories Roundtable when I’m introducing the project to a new group: • • • • • •
Everyone has a story to tell. Everyone deserves to have a story to tell. By writing our stories, we continue to learn. By telling our stories, we gain respect for who we are. By exchanging our stories, we form a community. By passing on our stories, we give an invaluable legacy to our loved ones.
There are, however, two important limits to using this model as the entire basis of culture change for long-term care institutions. First of all, it is just one class, once a week. People deserve more systematic stimulation. Second, I have found it impossible to export my model for the use of other institutions and other teachers. Although a great many people have expressed interest in starting a Life Stories Roundtable after hearing one of my public presentations, most have given up after realizing the challenges inherent in teaching writing. What comes naturally to me after spending over forty years teaching college writing does not come naturally to most people who have the time to volunteer at an assisted living residence.
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Expanding This Model: Pursuing Eudaimonia by Using Learning as a Way of Living It is my intention to use a series of workshops and field trips to foster the development of a learning community at Eisenberg Assisted Living. As I stated in the opening, the core course at the heart of our endeavor will be a reading/writing intensive seminar that uses Viktor Frankl’s classic Man’s Search for Meaning as the starting point for a year-long inquiry into the question of how human beings pursue a meaningful life, one that emphasizes eudemonia rather than hedonia, purpose rather than mere pleasure. Emily Esfahani Smith’s The Power of Meaning: Crafting a Life that Matters, Aristotle’s Nichomachean Ethics, Robert Coles’ The Call of Stories, and a variety of other literary, historical, social science, artistic, and other “texts” will be used to complement Frankl’s work. Even at this early point in the project, it is clear to me that there is a set of recurring themes that will emerge from our reading. Most of the texts seem to reflect a shared understanding that key elements of a meaningful life include a sense of purpose, growth, community, the transcendent, appreciation of the moment, and finding a way to tell our own stories. Thus, the syllabus for the course will invite participants to explore these themes through art, literature, nature, music, performance and dance, religion, tradition, community service, and other domains. Our syllabus for each month will include: meetings of our seminar in order to discuss classic texts and resident writing on the selected theme; one or more field trips or workshops sponsored by one of our partner organizations; and an exhibit, newsletter, or performance that allows participants to share what they’ve learned and accomplished with other residents, family members, and staff. Each session will be interactive with residents participating in discussions, leading tours or making presentations, and perhaps acting in plays. Each module will also be “generative” in the sense that we will produce something to pass on to others. As a further way of promoting growth, I plan to develop a variety of collaborative relationships with groups of people who might bring different experiences and perspectives to our discussions. For example, I have already made preliminary contact with a Muslim homeschooling group in Worcester in the hope of doing projects that are both intercultural and intergenerational. I’ve also reached out to the Intensive English Language Institute at Worcester State University for the same reason. But I believe that one of the best ways to encourage learning will be to include Eisenberg staff as well as residents in some of our classes and field trips. Although the people who live at Eisenberg depend on their aides to help them with the most intimate routines, residents and staff are often separated by differences in class, race, language, and ethnicity. They have the potential to learn a great deal from one another—and in the process, there is a chance they could become a community founded on respect and understanding. Admittedly, the learning community will not appeal to all Eisenberg residents. It is designed to serve the needs of those who do not satisfied by focusing primarily on social activities. However, I believe that this subset will “leaven the loaf” by occasionally attracting people to events even though they are not regular participants, and by sharing the results of our projects with the broader community. In fact, I hope that one tangible result of the program will be that some residents will have new ideas to contribute to the dinner table conversations.
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Because I am trying to create a model that can be sustained without my involvement if need be or even exported to other institutions, I will not be serving as the teacher for all the scheduled sessions. Instead, I hope to teach the core seminar and then arrange a series of collaborative relationships with area teachers and institutions. If I can work with each entity to develop one type of interactive workshop, tour, or event suitable for assisted living residents, then perhaps those organizations can offer the same program for other ALR’s. I’m also hoping that each institution might consider the possibility of offering at least one program a year for Eisenberg Assisted Living, so that the life-long learning program can continue indefinitely. Sample Syllabus Options for a One-Month Module •
A discussion of texts: o Selections from Man’s Search for Meaning in which Frankl describes the role scenes of natural beauty (such as sunsets) played in the lives of prisoners in the death camps. o Poems: William Butler Yeats' “The Lake Isle of Innisfree,” William Keats’ “The Daffodils,” Wendell Berry’s “The Peace of Wild Things”; and a collection of poems from Mary Oliver. o Autobiography: excerpts from Cheryl Strayed’s Wild: From Lost to Found on the Appalachian Trail o Essays: excerpts from Henry David Thoreau’s Walden and Annie Dillard’s Tinker at Pilgrim’s Creek.
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A field trip to the Troiano Brookside Trail at Broad Meadow Brook Sanctuary, which is fully handicapped accessible and offers “wetland vistas and superb wildlife viewers). Alternative: participate in an Audubon workshop. Have participants collect photographs and/or write haiku.
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A discussion of the landscape paintings of David Hockney and a visit to the Worcester Art Museum to select favorite works of nature art to photograph and use as a startingpoint for writing. I also think it would be interesting to begin our visit by inviting each participant to choose one painting for which he or she might serve as the docent— offering questions and comments to guide our group discussion.
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A workshop with Eisenberg’s head chef to talk about the farm-to-table movement and demonstrate cooking with local ingredients. When we put together our exhibit of nature art, photographs, and writing we can invite all residents to contribute statements or pictures about their favorite places in nature.
The Search for Eudaimonia through Participation in a Learning Community For a humanist, the proposition that you can find a sense of purpose by pursuing the biggest
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questions to the deepest levels in collaboration with other readers, writers, and thinkers is selfevident. After all, this is how we find our own sense of purpose. But as psychologists have joined the conversations started by Aristotle about how to define and pursue eudaimonia, they have provided us with some theoretical models that can be used to imagine ways of promoting well-being. For the purposes of this proposal I have chosen to draw upon Carol Ryff’s theories of eudaimonic well-being in part because much of her work involves studies of the connection between physical and emotional well-being in late life. However, perhaps more importantly, Ryff’s way of thinking eudamonia also closely mirrors my own. Like Ryff, I believe that an individual’s sense of well-being is connected to his/her sense of: • • • • • •
Purpose in life—Am I moving towards a goal? Autonomy—Am I living in accord with my personal convictions? Personal growth—Am I developing my talents and fulfilling my potential? Environment mastery—Am I able to manage my situation in life? Positive relations with others—Do I feel connected to a community? Self-acceptance—Am I developing an understanding of myself and an ability to accept my limitations?
By placing us in direct conversation with great thinkers, writers, artists—and one another—the arts and humanities give us a way of addressing the greatest questions in life. And in the process of pursuing these questions, we see ourselves moving towards goals, developing our talents, connecting to a community, learning how to manage our life-situations, and better understanding ourselves and others. In fact, some studies have already suggested that life-long learning can contribute to older learners’ sense of well-being. (Narushima, Liu and Diestelkamp 2018) Thus, I feel real hope that participation in this project will help Eisenberg residents find a deeper sense of eudaimonic well-being in life. Proposed Timeline for Project: Fall, 2018
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Discuss and refine plan with Eisenberg Director Suzanne Dionne, Eisenberg Social Worker Josephine Fitzgerald and other key staff and develop implementation plan.
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Explore the possibility of developing research partnership with a gerontologist, social worker, or psychologist interested in collecting and analyzing quantitative data related to this study.
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Begin meeting with representatives of key educational and cultural organizations and groups in order to explain the project and develop plans for collaboration. I already have a tentative agreement established with the Worcester Art Museum.
Spring, 2019 •
Prepare schedule of monthly topics so each partner organization or group has one or more target dates for programs.
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Finalize the syllabus for the core seminar on “The Search for Meaning.”
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In consultation with Eisenberg Staff, prepare and begin to execute communications plan for this initiative. How will it be presented to the residents and families? As part of this effort, conduct meetings with residents.
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Organize an all-day training workshop for staff members of Eisenberg and our partner organizations. The morning would feature “how to” workshops run by experts in specific fields. Speakers may include: Margaret Cahill, who specializes in working with museums to create art workshops for seniors with dementia; Kayla Daly, a boardcertified music therapist and owner of Worcester Music Therapy Services; and a representative from The Nature Connection, a Concord non-profit dedicated to providing workshops for seniors. The first part of the afternoon would be devoted to break-out sessions, with each partner organization working with one of our consultants to brainstorm lesson plans, and the second part of the afternoon would be devoted to reporting out and putting together the first draft of a master plan for the year’s schedule of field trips. (Note: I plan to work with Eisenberg and our partners in order to identify sources of funding for this workshop.)
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Gather baseline data by administering Ryff’s Psychological Well-Being Scale (PWB) (Ryff 1989, 1995) by working in collaboration with a gerontologist, psychologist, doctor or social worker to administer the PWB, and/or by working with social worker Josephine Fitzgerald and gerontological nurse Melissa Baugham to conduct interviews based on the items in the PWD. Ryff’s scale is widely accepted and especially appropriate in this case as it was based on concepts of eudaimonia articulated in the Nichomachean Ethics. (Ryff & Singer 2008).
Summer-Fall, 2019 through Winter, 2020
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Teach the core seminar.
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Conduct office hours.
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Meet periodically with Eisenberg executive staff to coordinate complementary events.
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Administer course evaluations at a midpoint in the year in order to assess interim results and revise the curriculum based on feedback.
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Meet with Vincent Librandi, Chief Operating Officer of the Jewish Healthcare/Eisenberg Assisted Living campus and Suzanne Dionne, Director of Eisenberg, to explore opportunities for public presentations on project results.
Spring, 2020 •
Complete core seminar and schedule of events.
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Plan and direct a capstone event designed to allow residents to share what they have learned and accomplished with an audience made up of other residents, staff members, friends, and family. The event will probably include a public reading of original work along with exhibits of other work produced (including such things as photographs and art.)
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Begin analysis of documentary evidence including writing by participants and transcriptions of recorded class discussions.
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Conduct a half-day meeting in March, 2010 to begin evaluating the effectiveness and impact of the project and to consider: o ways of following up on this initiative using in-house resources as well as partnerships developed as part of the project. o whether any events should be repeated annually. o whether any additional events, topics, resources, or partnerships would make good additions to the program.
Summer, 2020 •
Conduct exit interviews.
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Analyze and interpret data and write report.
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Submit conference proposals; make presentations.
Potential Benefits for Assumption College In addition to offering the usual benefits that research brings to the college in the form of name recognition, I believe that my project will:
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Enhance the reputation of Assumption College throughout the greater Worcester community. Deepen the collaborative relationship I have already established with the JHC and Eisenberg as a basis for exploring new opportunities for collaboration beneficial to our new P.A. and nursing programs as well as our existing Human Services and Rehabilitation Studies programs. Contribute to my effectiveness as a teacher of writing and literature at Assumption. My work with seniors has already led to several significant changes in my approach to teaching including my shift to requiring one-on-one conferences for every student in every one of my classes at least three times a semester.
Upon my return I would also like to explore the possibility of collaborating with faculty in other departments to develop a course in life writing in long term care of health care settings. This could be offered for students in our undergraduate programs or for health care and social work professionals who need to engage in continuing education in order to maintain their certification. Conclusion: My father was not unusual in his reaction to assisted living. No one ever wants to go to a nursing home and very few people are happy to move into an assisted living residence. Instinctively we dread the “three plagues” of nursing home articulated by Dr. William Thomas mentioned earlier in this proposal: boredom, loneliness, and helplessness. Thomas went on to create the Green House Project, which attempts to address these problems by offering long term care in residential-style small group settings that emphasize privacy, community, and collaboration between the caregivers and the cared for. Similar in some ways is the Eden Project, which brings plants, children, and animals into the daily environment of the residents. Together, these two movements have inspired an enthusiasm for culture change through much of the long-term care industry. Unfortunately, in most cases culture change has amounted to little more than installing new carpeting to create a homey feel, designating each wing a named “neighborhood,” and convening a resident counsel. This may be due in part to the fact that it is impossible to convert an existing facility into homey cottages with a kitchen for each twelve residents. Culture change of this sort is resource-intensive, requiring more buildings and more staff. Meanwhile, governmental regulators and other oversight agencies continue to evaluate facilities primarily on medicalized criteria such as number of falls number of deaths. And family members searching for a placement for a loved one are often more aware of the furniture in the lounge room on the first floor and the smells in the hallways than the institution’s philosophy of patient care. Finally, while the Eden and Green House Movements represent a breakthrough in thinking about the possibilities of long-term care, I’m not convinced that a more homelike environment that included children and dogs would have been enough to resolve my father’s existential crisis. This is why I am committed to creating a new paradigm for culture change that speaks to the human need to find meaning in life. For years my father had been inclined to sing only halfjokingly the lyrics of the Peggy Lee song, “Is that all there is?” He had wondered about whether
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life had a meaning all along. But when age robbed him of his sense of autonomy and competence, he was desperate to find a satisfying answer. Although I believe that the Life Stories Roundtable helped my father find occasional moments of purpose in the final year of his life, I know it was not enough. It is, of course, too much to hope that any program can provide people with a purpose in life. But I believe that all people are entitled to have their questions about life’s meaning taken seriously, and that all people are entitled to have opportunities for personal growth, positive relations with others, and purpose. That is what I aim to do with this project. And if I can provide the opportunity for some people to search for—and perhaps find—the kind of answer that ultimately eluded my father, then that will be his legacy. And mine.
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