What do people feel when they grow up. Being orphaned in adulthood: how it changes us
They say that sooner or later all children grow up. Without a doubt, outwardly we are all growing up, but what happens in the psyche?
The question of when a person matures and what kind of person is called an adult can be considered in different ways.
When can a person be considered an adult?
If you ask different people about what an adult is, you will probably get answers like: "Growing up is when you already think about work, family ...", etc. This is partly correct opinion, but not always. We are accustomed to equating adulthood with some specific attitudes and goals in life, such as the fact that an adult works, creates a family, and gives birth to children. And what, for example, to be with children who are forced to earn extra money, including playing instruments in the street? Or, for example, a very young girl became pregnant through negligence and is now going to give birth and raise a child, although she is not yet ready for this? Of course, in many of these situations, children grow up very quickly, but this is not always the case.
In fact, the question of adulthood is much more multifaceted and complex. Outwardly, the adulthood of a person is manifested in a well-developed figure in terms of secondary sexual characteristics, which indicates that the person is fully formed physically and is ready for procreation. In this sense, adults can be considered, for example, already older teenagers about 17 years old.
Qualities of an adult
However, appearance alone is not enough to recognize a person as a full-fledged adult. It is important to pay attention to the character of a person, his qualities, habits, etc. So, we can single out the most general list of these parameters for an adult:
- In an adult, self-control and reason prevail. Yes, an adult also sometimes wants to give up on everything, make a scandal to an unpleasant person, go to have fun with the last money, not thinking about tomorrow, but an adult understands what this is fraught with, and therefore behaves within the framework of decency and reason.
- Responsibility is a pronounced quality of an adult. He himself takes responsibility for his life, without dumping it on anyone. An adult is able to provide material stability, to arrange a life for himself in the most accessible and comfortable way on his own. He sets goals for himself, plans them, and then achieves them. When an adult understands that he is ready and wants, he can take responsibility for the life of another person - this is how an adult has a family and children.
- Separately, it is worth considering the issue of infantilism - a certain "childishness", lightness of character, capriciousness. There are many adults who can be called infantile. They live one day without thinking about the future, indulge their momentary desires, give themselves up to emotions, like children, behave in accordance with their desires and moods, without thinking about others. But if we talk about the classical understanding of adulthood, then such a person left infantilism behind him - in childhood and adolescence. An adult has certain principles, rules and priorities that he follows, as he already understands who he is now and who he wants to be later.
That is the basis. All other distinctive qualities and features of an adult are either based on it, or are additional and individual.
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“When my mom’s doctor informed my sister and me three years ago that my mom had days to live, not even weeks, my first reaction was, ‘No, no, she can’t! - says 32-year-old Victoria. I was supposed to get married in two weeks. Somewhere inside me, an adult woman who was then experiencing shock, pain, denial, suddenly spoke a confused little girl who had already lost her father at the age of 10, and now simply could not believe that none of her parents would no longer watch with proud of how beautifully she walks down the wedding corridor. Then we decided that life should go on, and the ceremony was not canceled. In these dark days, we so needed at least a drop of some kind of bright emotions. The wedding day was exciting. It was as if I was bathing in the waves of the boundless love of friends and relatives, I felt this warmth without further ado. And yet there were moments when I could barely hold on. For example, in the morning, when all the guests, except for my sister, left for church, and I stood alone in front of the mirror, looking at my magnificent wedding decoration for the first time, and there was no mother nearby who would say: “How beautiful you are!” And later, when we stopped at the exit of the church to take family photos, I physically felt a gaping void in the place where my parents should have stood.
For the first time after a loss, many adults experience an incredibly acute, childish feeling of confusion and defenselessness. “You can be an adult married woman with children, you can have a successful career and be financially independent, but as long as one of your parents is alive, you are still someone else’s child,” explains psychologist Alexander Levy. ), author of The Orphaned Adult (Da Capo Press, 2000). – After the other parent dies, this important component your identity disappears, and with it the illusion of security and permanence that has fed us, even if we didn’t realize it.” There is no longer a worthy defender who would support and encourage you from the side. There is no longer a person who alone remembered all your childhood antics - all those events and actions that made you what you are now. And there is no more shelter in which you can lie low and exhale when reality comes down with all its weight. “No matter how old you are, 17 or 70, but at the moment when you lose the second parent, you finally part with the child inside you,” concludes Alexander Levy.
Exit security zone
“After the death of my father, I became very close to my mother,” Victoria continues her story. “She worked hard despite the onset of rheumatoid arthritis, and we had financial difficulties in the family, but I remember how often she laughed and joked, even at her sore hands. She and I were friends, not only mother and daughter. My husband was ironic that my mother, although she lives in another city, could recognize each of my work colleagues at a glance - she was so involved in my daily life. Now, without being able to call her and discuss some little thing, even just to whine, I feel like I have lost my real home. Where there was my most reliable refuge, today there is emptiness, a vacuum.
Many men and women admit that no matter what age they lost their parents, they felt very lonely at this difficult moment in their lives, they found themselves almost isolated. Those around them sympathized noticeably less than those who lost a partner or other family member. “It's the natural order of things for children to bury their parents,” explains University of South Africa psychologist Matshepo Matoane. “But today, orphaned adults have a very difficult time. Growing disunity, an accelerated rhythm of life, and greater employment make us less sensitive to each other, and the support of acquaintances and colleagues for those who are experiencing grief is no longer as tangible as before. Burying a father or mother, many lose, perhaps the only loved one, which was a moral support for them, and this can increase their isolation, isolation.
Learn to grieve
No clear recognition of loss outside world the process of mourning often takes a long time and is imperceptible to others. Only sometimes does it break through to the surface at some separate, important moments - on family holidays and anniversaries, at the birth of children, in various crisis situations experienced for the first time without parents, and even at the onset of the age at which the father or mother passed away . “Losing a second parent makes you more aware of your own finiteness,” says Alexander Levy. “There is no one else between you and death.” And the emotional experience of mourning the loss of the first parent does not necessarily prepare you for the pain of loss a second time. “It’s common to think that you can gradually get used to suffering of this kind, but studies do not confirm this,” the psychologist notes. “Every time we face a loss, we not only feel the acute grief that has piled up now, but also remember, relive our previous losses.”
As difficult as this experience may be, one eventually realizes that life goes on one way or another. And quite often, life without parents turns out, oddly enough, a step towards inner liberation. “Two years after the death of my mother, I found that I can cope with all the difficulties without her,” Victoria admits. “I realized this when I became a mother myself. After a suspected miscarriage and a painful birth, I was completely unprepared for sleepless nights, I was physically and emotionally exhausted. I faced all the challenges that any new mother has to deal with on a daily basis - and for which I have no doubt my mother would have prepared me. But I survived this test without her support. And I felt much more confident.” The experience of orphanhood in adulthood can certainly push us to personal growth, says Matshepo Matoene. “Losing a parent sometimes brings unsolvable problems, but it also provides an opportunity to re-evaluate them and find a way out. It allows you to overestimate yourself, to discover your true "I", which for the time being was clouded by the presence of the parent, his established view of his child.
Become yourself after loss
For some, the departure of parents can be a great relief, because it will finally allow them to escape from the negative influence of a harsh, critical parent. For many, it only means a change in family roles that have been established over the years. But there are those who experience the death of their father or mother as the loss of their own identity. “The departure of our parents throws us back to ourselves, forcing us to more clearly define who we are,” emphasizes Matshepo Matoene. “This experience can open up opportunities for us that were previously closed to us. “The changes that have taken place in my life turned out to be not only global, but significant,” Victoria admits. – I feel that I have become stronger and more confident in myself. And in some ways - and more vulnerable: I realize that I can lose those I love at the most unexpected moment. But at the same time, I know that I can handle it. It hurts me that my parents will never see my wonderful daughter. This loss will forever be painful for me. But now I know that you end up moving from where memory hurts to where memories bring comfort and strength to face the new, free and independent person you have become.”
Faith in Santa Claus and faith in magic wand that can do anything with just one stroke. And much more. Opportunity to run around. Build a headquarters on a tree. Possibility to play hide and seek between the garages. Run around with a toy gun in the school garden. Loses purity. And off we go. There is no longer that pure naive soul capable of believing everyone. There was a fried crust of the heart and constant attempts to survive in this world of the strong and the weak. He loses the opportunity to be happy, just looking at the child who smiles at him on the street. Many die never becoming happy, many live unhappy. Everyone says that time has changed, but not time has changed, but people. Many people earn money all their lives, losing health, and then lose money, restoring it. They dream of becoming adults, and when they grow up, they dream of becoming children again ...
When a person grows up, his eyes grow dim. Our lies become more refined, misleading words become more eloquent. We grow up ... We are not afraid to take a step, because we know: all our mistakes will not be fatal. We do not believe the heard “love” and we ourselves are no longer sure that we can sincerely pronounce this word. We can calmly let a person close, close to us, but we don’t let him into our life ... We forgive less and less often and more and more often do not pay attention. We speak calmly and with a smile, but few can read our true thoughts.
We know that you can’t push people away - it really hurts. Therefore, we try to protect those few truly loved ones who are close to us. We still hope that love will warm again, and we try to catch the sincere notes in the heard “I love”. We let ourselves close, close, but not everyone. We try to believe that this person can become a part of our life. And although we forgive less often, this forgiveness is sincere, and we never again speak with resentment about what we have already forgiven for.
Aging is a multidimensional process, but in most cases, the focus is on the medical aspect of late age changes. Meanwhile, for family members, the aging of parents is a much more complex problem than the disease itself. Even full awareness of the state of health of an elderly person, of the procedures and medicines prescribed for him, does not save children from the question: how to live next to the elderly, how to help them and themselves in this difficult period of life for everyone.
Written in textbook form, American psychotherapist Joseph A. Ilardo, Ph.D., is one of the few that fills a gap in this area. G. A. Ilardo's advice is based on his many years of practice, but is not medical, but rather psychological character. How adult children cope with feelings of irritation and guilt, how to overcome the estrangement that arises between family members of different generations, what to do when mental abnormalities appear in elderly parents, how to cope with grief caused by their death - these are approximately the range of issues considered in the book.
The Russian reader, perhaps, will find the author's persistent optimism and the classifier method used by him, which allows meticulously laying out all the phenomena “on the shelves”, unusual and somewhat naive. However, in evaluating this work, one must keep in mind both the special nature of American medicine and the clearly expressed instructive nature of the book, conceived not only as an invitation to reflection, but also as practical guide to action.
The author attaches paramount importance to the awareness of family members regarding the very phenomenon of old age, its physiological and emotional nature. Without a rational knowledge of this issue, freed from prejudices and various mythological layers, he believes, it will be very difficult for adult children to build correct, caring relationships with aging parents. Accordingly, the first chapter of the book is a small practical information compendium based on the latest achievements in gerontology and geriatrics.
First of all, Ilardo emphasizes individual character aging, which should not be obscured by the general similarity of the changes that occur with all older people, and requires a thoughtful and heartfelt personal approach in dealing with them. Moreover, in the body and psyche of each person, numerous aging processes develop at different rates and - which is especially interesting - largely independently of each other, and each of these processes can, in principle, be influenced by special methods. Finally, one of the main points underlying the book is that aging is not necessarily associated with degradation and disease.
Modern gerontology distinguishes two levels of aging: primary, including purely physiological, genetically determined processes, and secondary, determined by the lifestyle of the individual, past illnesses and possible injuries. The primary ones are mainly trophic changes (i.e., associated with the functioning of hormonal substances in the body), which lead to a decrease in skin elasticity, a reduction in bone mass, the number of muscle fibers, to a weakening of the senses, etc. To some - insignificant - Medicine has only recently learned how to influence these processes. Secondary aging is another matter. It is not always possible to prevent accidents, but we still choose our lifestyle. It is known that the health of an elderly person to a very large extent depends on the diet, physical activity, tobacco and alcohol use, not only in old age, but also in younger years.
Perhaps the most frightening environment for an aging person is the changes that affect the brain and activity. nervous system. In this regard, the author makes several important distinctions, while at the same time pointing out to the reader a number of common misconceptions. First of all, he notes that it is impossible to identify the brain and thinking. With age, the brain as a physiological organ functions less intensively, however, intellectual skills, strength abstract thinking and his individual traits may still be pronounced. The quality of thought is largely determined by the level of its complexity and how accurately it interprets reality. An older person may process information more slowly, but be accurate and deep in their judgments. In addition, studies have found that a person's mental abilities increase as a result of exercise, similar to his physical strength. From here, as well as from his own practice, the author draws an encouraging, although unexpected for many, conclusion: a person is capable of learning at any age, his intellect is not necessarily subject to destruction. However, a clarification is needed here. We can talk about two components of intelligence: "plastic" (fluid) and "crystallized" (crystallized). The first is included in the work in cases where it is necessary to respond to unexpected events, quickly find a non-trivial way out. This faculty of the intellect develops from constant use and, on the contrary, weakens if it is not used. The second component is “responsible” for the assimilation of information, oral and written expression of feelings and thoughts, it not only does not fade away, but is able to improve with age, for which there are many examples. As for the widespread phenomenon of senile dementia, its author does not hesitate to attribute it to the consequences of brain diseases and does not consider it as an indispensable sign of “normal” aging.
Turning to the consideration of the emotional consequences of aging, sometimes very severe, Ilardo remains true to his methodology, dividing them into two main categories. In the first category, he emotional experiences associated with the bitter experience of previous years: loneliness, loss of loved ones, loss of hope for the future, deprivation of former physical attractiveness, authority, social status etc. To the second - emotional states caused by a sharp narrowing of the circle of a person's physical capabilities.
However, old age brings not only negative emotions. For many people, old age is a time of well-deserved peace, the realization of a well-lived life. Psychoanalyst Erik Erickson notes that a dignified and harmonious old age is highly characterized by concern for the next generation. This care is often non-material: an old person shares his wisdom with his children and grandchildren, wants to warn them against his mistakes.
The first chapter ends with a little practice test. The author gives a number of typical situations that arise in families where there are old people, and invites the reader to mentally put himself in the place of their adult children. Here is one of them, for example. An older person increasingly begins to repeat the same stories from his childhood or youth. There are several types of reactions to this to choose from: a) remind him that he has already talked about it, b) each time pretend that you hear it for the first time, c) reproach him for repeating the same thing over and over. The author himself considers the most acceptable type of behavior a) as the most respectful and honest.
The second chapter focuses on emotional state children, often very acutely experiencing the aging of their parents. As we grow up, our parents appear to us as omnipotent, omniscient people who can be relied upon for everything. The loss of confidence in parental "infallibility" always deals a serious blow to the feelings of other family members, makes them reconsider a lot in their attitude to life.
Ilardo breaks the material he has collected into several blocks. First, he describes how adult children experience a time when their father and mother are before their eyes, more recently full of life, gradually lose physical strength, intellectual security and self-confidence. The natural reaction of children to all this is anxiety and sadness. And only with a lack of love and mutual respect in the family, children develop anger, irritation and even hatred towards their parents. Ilardo lists the typical emotions experienced by children whose parents begin to grow old before their eyes.
At first, unexpected signs of aging surprise and amaze those around you. So, the mother of one of Ilardo's clients, who until recently carefully monitored her appearance and made caustic remarks about the outfits of other women, for some time began to appear in public sloppyly dressed and unkempt, which led her daughter to extreme confusion. As a rule, such indifference is explained not by the fact that a person loses observation and ceases to be aware of his own actions, but by the fact that he loses his taste for life. In this case, ordinary antidepressants helped, the aging lady returned to her previous type of behavior for a long time.
Sometimes children are not able to internally come to terms with the real and bitter fact that their parents have grown old, and then they have a reaction of rejection and distrust - they prefer not to notice the manifestations of old age in their parents and behave as if nothing has changed. Someone stubbornly does not want to admit to himself that his mother is no longer able to arrange family dinners for twenty people and, as if nothing had happened, invites a large group of relatives into the house. Someone refuses to believe that his father, until recently such a healthy man, suddenly fell ill with cancer, and does not come to his hospital. All these reactions appear in the first stages of aging of the parents. Children need time to get used to the changes that are taking place.
The next group of reactions occurs after the realization that the parents have indeed moved into the category of old people. A whole fan of negative emotions - resentment, discontent, impatience, a feeling of devastation, etc. - arises in cases where in previous years there was no mutual understanding between parents and children or parents behaved “not like parents” at a younger age. The reaction of “intellectualization” is curious, which consists in the fact that children, unable to withstand the severity of their own experiences, sometimes begin to replace the natural feeling of compassion with an in-depth study of medical and psychological literature about old age.
As a special category, the author singles out the emotions that arise in adult children when they begin to try on the situation of aging for themselves. Looking at their parents, children inevitably think about their own future fate, and the consequences of this are far from always negative. Often they experience fear and confusion in the face of approaching old age and its accompanying illnesses, but sometimes it is different. Ilardo remembers one of his clients. She was a businesslike, purposeful woman leading a rather conservative lifestyle. One of her schoolgirl daughters dreamed of becoming a fashion model, but her mother did not want to hear about it and imperiously directed her daughter on the path of academic study. And only after her own elderly mother fell seriously ill, did the strict lady soften, subjecting her life values deep revision. “Why have I hindered my daughter’s cherished desires for so many years?” she asked herself bitterly, and could find no answer. After that, she allocated a significant amount to hire a photographer and create a portfolio for her daughter. In addition, she significantly changed her lifestyle, which from now on could be called moderate hedonism. The tragic event gave a new dimension to her life, which became much richer and more interesting.
Very often, adult children are unable to cope with their emotions, they experience nervous breakdowns. They may begin to yell at their aging parents, treat them dismissively or even aggressively. Quarrels arise between younger members of the family, they begin to have troubles at work, headaches, and other painful somatic manifestations - the consequences of prolonged depressive states. In such cases, the author strongly recommends contacting a psychologist or, perhaps, some clergyman. To help the reader understand himself, the book contains a small questionnaire, the answers to the questions of which allow us to judge whether our reactions to what is happening are natural or have already acquired a painful character.
So far, the author has talked about how the aging process affects individuals - parents and children. In the third chapter, the object of his attention is the family as an integral organism, as a system that responds in a special way to various “perturbations”, whether internal (such as aging and illness of parents) or external (intrusion into the life of a family by strangers - doctors, psychologists, etc., whose recommendations have to be responded to in some way and whose work must be paid). Any system, while it remains such, tends to maintain equilibrium. Accordingly, Ilardo considers different types of family reactions to new life circumstances as either consistent with this goal (i.e., normal) or as contrary to it (harmful, unhealthy).
The main idea of the author is that in the changed conditions, when the older members of the family cease to play their former role in it, become helpless and often require increased attention to themselves, the sometimes unconscious desire of people to conserve the existing family structure, to preserve role roles in an unchanged form is very detrimental. relationships that go back to early childhood. Long-standing rivalry between children, settling old scores, envy of parental “favorites”, vanity of an “exemplary child” - all this, especially in conditions of stress, financial difficulties, difficult moral experiences, etc., can lead to very sad results, destructive for family. The author, on the contrary, calls for flexibility and openness. It is desirable, he writes, to distribute responsibilities among younger members of the family so that everyone uses their strengths: someone is better at negotiations with doctors, lawyers, psychologists, someone cares for the elderly, etc. However, he is convinced in that truly complex structural problems cannot be solved "from within" the family team and require the indispensable third-party help of a psychologist.
It is important to understand that the aging of parents is not only part of their life cycle, but also part of the family life cycle. In this sense, the situation of aging parents is normal, every family faces it in one way or another, and every family must get out of this crisis - otherwise it will cease to exist. The third chapter of the book, devoted to this problem, in to a large extent formalized, filled with diagrams and tables that detail the correct phases of the evolution of the family as a system and the undesirable course of its development, possible mistakes, an approximate agenda for family councils, etc. The author owns a huge amount of empirical material, presents it professionally and adequately, but it can be assumed that the domestic reader will shake his head in bewilderment more than once, turning over these pages. The notorious difference of mentalities is affecting. Let's leave it to everyone to judge for themselves how applicable to Russian conditions such as the recommendation of the author. If at a large family council, assembled to solve urgent problems, someone begins to clearly dominate, “hammering” the remarks of the rest of the family members, you should choose a chairman and regulate the time of each speech ...
One of the most important problems for family life is the mental health of its older members. In the fourth chapter, Ilardo identifies two types of mental abnormalities in the elderly: mental disorder and nervous disorder.
It should be noted that the concept of the norm itself is ambiguous. Some psychologists give it the meaning of an ideal. They consider normal only those people who have fully realized themselves in life, are happy, active and satisfied with their existence. For others, the term "normal" means a state of predictable reactions. The norm can also be understood statistically and mean the behavior and emotions characteristic of a given social group. From this point of view, memory lapses in people over 65 can be considered normal. In practical psychology, such an approach to the norm is common: the norm is a state that allows a person to live an ordinary life. everyday life, communicate with others, solve everyday and other problems that arise before him.
The author lists in detail the main factors that serve as prerequisites for mental disorders. Firstly, these are physiological causes: brain aging, sleep disturbance and various somatic diseases. (All these phenomena are completely natural in themselves, they only increase the likelihood of mental disorders.) Secondly, these are various changes in the emotional perception of the world, which the author considers even more significant than physical aging. In a society where youth and health are valued primarily, the old person experiences loneliness, bitterness associated with the loss of former authority, power, etc. Both types of factors are closely interconnected. Thus, hearing loss can lead not only to a sense of isolation, but also to excessive suspicion, in some cases even to paranoia. In addition, physical infirmity deprives a person of personal space in which he is the master, and a sense of independence. Therefore, the author advises, when surrounding an elderly person with care, one must be extremely careful not to make him feel helpless. It is impossible to relieve the elderly from all family responsibilities, it is necessary to carefully consider what activities they will be able to do, and thus involve them in common life. Realizing their weakness, older people begin to fear becoming a burden for the family and being rejected by the family because of this.
Social factors are highlighted in a separate section. Retirement is accompanied by a sharp decline in a person's income. Retirees are starting to save on everything they can - on food, telephone conversations, electricity, and often they behave this way, even if the children have enough money to support them - and all for the same reason: for fear of being a burden to the family. Old people are often insulted, they are inattentive. And this happens not so much because of changes in the behavior of the elderly themselves, but because of the fact that children do not want to delve into the needs of their parents. Helping them physically and financially, they often deny them the emotional, human support that they need in the first place.
Regarding mental disorders in general, it is important to understand the following.
These deviations are nothing to be ashamed of. The taboo of mental illness goes back to the time when they were seen as a sign of possession by the devil. Nowadays, many problems can be solved by visiting a psychologist or medication.
The appearance of mental disorders is not a sign of weakness of character. To think so is also to follow an archaic prejudice. Many patients experience shame when they see a specialist, believing that if they were stronger, they could cope with their illness themselves. However, the situation is exactly the opposite: going to the doctor is a manifestation of strength, not weakness. There are diseases that a person, in principle, cannot cope with on his own.
It should also not be thought that prescriptions for medicines are a doctor's unsubscribe or a way to "drive illnesses inside." Today, it is firmly established that many mental disorders are due to malfunctioning of the brain. For example, depression is the result of low levels of serotonin in the body. There are modern remedies that in most cases relieve the problem of depression. However, it is important to remember that you need to treat the cause, not the effect.
With all the positive influence of a favorable home climate, love and care of loved ones, it must be remembered that in cases of mental deviations it is absolutely necessary to consult a specialist.
Turning to a conversation about the elderly who are entering the last phase of their lives, Ilardo emphasizes the need for careful planning for further care for them. In this regard, it is necessary to take into account all possible options further development events, since such options remain, alas, few. When making important decisions, he writes, one must first take into account the wishes of the elderly parents themselves (of course, if their mind remains clear enough). One of the first and cardinal questions to be decided in these cases by American readers of this book is whether to leave the old person in a family where it is very difficult to provide him with proper care, or to place him in a nursing home. Ilardo makes many arguments in favor of home care. For Russia, this issue, apparently, will remain irrelevant for a long time - due to the established tradition, as well as the small number and squalor of our nursing homes.
In most cases, older people want to stay at home as long as possible - their home gives a feeling of confidence, security, everything is familiar and familiar in it. Old people don't handle change well. Very great importance also have relationships with friends and neighbors. In addition, the presence of parents at home, albeit aging and infirm, has a calming effect on children.
The decision to leave an elderly person at home comes with a lot of responsibility. It is necessary to carefully consider everything that can be done in the apartment in order to ensure its safety. For example, a non-slip mat is needed in the bathroom, if possible, thresholds inside the apartment should be removed, when cooking it is better to use self-switching appliances - a microwave oven and electric kettles, the most necessary items should be easily accessible. It is also necessary to make changes related to a person’s personal illnesses: for the hearing impaired, for example, it is necessary to install a loud doorbell and telephone, for the visually impaired, bright light and, if possible, use contrasting colors in the environment. It is impossible to list all the recommendations, but the easiest way to understand what changes need to be made is if you take the place of an elderly person, try to look at his surroundings through his eyes.
Old age ends sooner or later, and a person enters the last phase of his life. life path - last days before death.
Ilardo is a staunch opponent of artificial life extension for hopelessly ill patients. In the seventh chapter, he gives a brief typological description of all the participants in the final drama in the life of an old man. These are, firstly, representatives of the hospital administration, who - out of fear of possible prosecution - use all conceivable and unthinkable technical means to support the physical functioning of the body. These are, secondly, doctors who, from the student's bench, are taught to support the life of the patient "at any cost" and who perceive the death of each patient - the natural end of life - as their own defeat. Further, these are sisters and junior medical personnel. These people, being all the time next to the dying, perhaps, like no one else, feel the senselessness and cruelty of prolonging methods, but they, under the threat of dismissal, cannot deviate one iota from the prescriptions of the attending physician. And finally, the most important thing is the patient and his family. sociological research showed that the medical staff of hospitals prefer "good" patients to "bad", i.e., obedient and weak-willed - independent, inquisitive, interested in the course of treatment and upholding their rights. Meanwhile, practice shows that it is the “bad” patients who go through all the phases of the disease more easily than the “good” ones. The bulk of patients and their relatives obediently follow the instructions of doctors, yielding to their pressure.
The author considers it absolutely unacceptable from a moral point of view that the most important medical decisions are made without taking into account the wishes of the dying person and his relatives. Ilardo himself is a supporter of the "Right to Die" movement, which arose in America as a reaction to several factors. The technical revolution that affected medicine made it possible to maintain the patient's vegetative existence for an arbitrarily long time. Dying has become a very costly, high-tech sterile process, under the complete control of the hospital's medical staff. The number of rumors and stories about the last months, if not years, of agonizing patients has exceeded, so to speak, a critical mass. These stories were passed from mouth to mouth and until the late 1970s, practically did not penetrate into the media. mass media. Meanwhile, their content, without exaggeration, chilled the soul. In the name of “correct medicine”, involving the patient’s relatives and himself in an exhausting competition with death, destinies were crippled, families were ruined and collapsed. Eventually, the medical community came under attack from both ends of the spectrum. Some families, exhausted by the endless agony of a person close to them, initiated criminal cases in the courts against doctors who, in their opinion, ignored the rights of patients and their own, others, brought up modern culture, for whom death is the worst of evils, on the contrary, they were sued for medical errors, due to which the patient was supposedly "lost". As a result, according to many observers, medicine has become more concerned with insulating itself from possible lawsuits than with the welfare of patients. During this tense period, the very concept of death turned into a legal term, and at the same time - through the efforts of ethicists, lawyers, doctors - it underwent significant corrosion and lost its shape. In former, more "simple" times, death was recorded in irreversible cardiac arrest, then the cessation of the brain, then its individual sections, etc. began to serve as an indicator. professionals to hear the voice of the patient, to make sure that in the last days he remains the master of himself and his last hours and not a victim of circumstances and an object of medical manipulation.
In 1991, the US Congress passed the Patient Self-Determination Act, according to which every patient entering a hospital must be informed of their rights. In addition, the patient must be asked if he has a so-called "living will" with him, which would contain the so-called preliminary instructions regarding the subsequent medical measures that should be applied in case of his further incapacity. (A separate clause of the law stipulates that the patient's care and treatment should not depend on the presence of a living will.) many contradictions and pitfalls. Ilardo devotes a dozen pages of his book to a detailed analysis of the possible interpretation of controversial places in the will form itself, as well as recommendations for filling it out.
The last chapter of the book is devoted to how different people experiencing the death of their parents. Ilardo describes in detail the various types of reactions to this tragic event. The quintessence of his reasoning is, perhaps, the following idea: the main condition for the normal flow of emotions is the openness of family members to each other. There is nothing more pernicious than the inability to cry, to sincerely express your emotions. It is very important to internally accept the natural course of things and, on the one hand, not to impose a ban on your emotions and the emotions of other people, on the other hand, not to try to artificially prolong the feeling of bitterness and grief, which otherwise can turn into a chronic mental disorder.
Daria Belokryltseva
Joseph A. Ilardo, ph.d., L. C. S. W. As Parents Age. A Psychological and Practical Guide. Acton, Massachusetts, 1998. Joseph A. Ilardo - Psychotherapist, Ph.D. Heads the Center for Adult Children of Older Parents (New Fairfield, Connecticut).- Presentation on the development of speech on the topic: "Speech games and exercises for preschoolers" (by age) Download presentation speech development of preschoolers
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