Lee Kehoe

When I began my internship for my graduate program, almost two years ago, with a company working within assisted living and skilled nursing facilities, I was excited to immerse myself in counseling older adults. My experiences throughout my internship working with older adults afforded me invaluable opportunities to learn and cultivate my passion for older adults. A great deal of my focus in my own research and writing revolved around the older adult population, and this blog has been driven by my experiences with my older adult clients

Over the course of my internship and now working as a professional counselor within a long term care and skilled nursing setting, I have been learning many strategies for navigating within a larger system. Furthermore, I have found there to be a great deal of need for mental health services; a need that requires mental health counselors within such a system to act as an advocate for our profession.

It is interesting that whenever someone asks me what population I work with, and I mention older adults, in my experiences the first thing many people then ask about has something to do with memory loss or dementia. It seems as though there is a widespread association between older individuals and memory loss. I have also encountered individuals who often assume that all of my clients have Alzheimer’s disease. In addition, in my experiences many people seem to then conclude that individuals with such memory loss, Alzheimer’s disease or other forms of dementia could not benefit from counseling.

Through the major transitions, grieving of losses, onset of loneliness, and perceived loss of control, the relinquishment of roles typical of adulthood and acceptance of roles typical to later life become a great challenge for older adults. As I have worked with older adult clients, another theme that adds to the difficulties of adjusting to later life revolves around learning to navigate new roles. Many older adults worked for up to four decades in the same job, developing an identity that was very connected to that job. I have worked with female clients who identify as a mother before anything else; however, are still learning to adjust to having their grown children act as their caregiver, while they are left with no one to care for. These are just a couple examples of the role changes that I have seen in working with my older adult clients. Such role changes go deeper than simply getting use to a new way of living; they tap into the core identity of a person. When that identity is shaken, feelings of anxiety and depression are common symptoms of the struggle to adjust to the changing roles.

As I’ve gained more experience working with my older adult clients, I believe there is one aspect to the work that is the hardest for me not to take home every day. To be present with another person’s loneliness is one of the most heart wrenching feelings to sit with. Loneliness is also perhaps the most pervasive theme I have seen over my time working with older adults. I felt compelled to share my experiences and thoughts on working with clients who are living with such extreme loneliness because so many of my clients have been bringing it up more recently. The clients’ feelings of loneliness don’t even really have to be said since they are so very much felt as soon as I walk into the room. I personally struggle to know how to help my clients with such extreme loneliness.