The elderly have an increasing emotional investment in familiar items surrounding their daily lives such as pets, familiar objects, heirlooms, keepsakes, photo albums, scrapbooks, and old letters. These objects provide a sense of continuity, help the memory, and provide comfort, security, and satisfaction. They also can help maintain orientation, self-respect, and identity in institutional settings.1
"The possessions are oneself," says de Beauvoir,2 who views ownership as a guarantee of ontologie security. Due to possessions, the older people assure themselves of their identity against those who claim to see them as nothing but objects.
Victoria Plaza is a low-income facility for the elderly that was built to provide suitability for elderly occupants. In her study, Carp3 found that prospective residents who were taken on a tour of this facility immediately began visualizing cherished belongings in the new setting. When some people realized that they would not be able to bring all their belongings, they verbalized feelings of unhappiness at having to let go of their furniture and other possessions that had been part of their lives for so long.
Goffman4 indicated that being admitted to an institution entails a dispossession of property; this is important because people invest feelings in possessions. On being admitted to a mental institution, individuals are likely to be stripped of their identity equipment, thus preventing them from presenting their usual image to others. Although Goffman's main interest is on possessions bearing on self, he also is aware of the importance of other objects because people invest self-feelings in possessions.
Loss of loved ones and loss of familiar objects or surroundings - resulting in helplessness and despair - are related to medicalpsychologic disorders.5 Birren6 found that in general, older people seem to gain satisfaction and support from association with familiar objects and places and from associations with persons living in the same environment.
Millard and Smith7 found that a lack of personal belongings increased the likelihood that the elderly patient would be perceived in a negative way. Similarly, Baltes and Zerbe8 viewed loss of such private possessions as a "loss of reinforcing events" contributing to a deprived environment. Such deprivation places the role of the institutionalized long-term patient who is poor and without possessions upon the individual. Posner9 noticed a lack of personal possessions on special -care floors in a home for the aged. She felt that the spareness of room contents reflected the social isolation of the occupants.
Finally, Gubrium10 described how residents reminisced and wept about the loss of such familiar objects as a chair, a lovely dresser, and a table that they cherished. These objects were, for a long time, part of their lives. Cutting ties with one's home entails not just losing the big items, such as the house itself, but also the little things. The familiar trivia of everyday life are often the hallmarks of solid ties. The presence of these "trivia" assures people that all is basically "as usual." The long-term absence of these items is alarming because it signals change.
Thus, it is clear from the literature that personal possessions are significant in the lives of the elderly. Another aspect of possessions is that üiey serve as a tool by providing a link with the past and allow elderly individuals to engage in the lifereview process and to reminisce about their past.
Personal Possessions as a Tool for Reminiscing
This process of nostalgic remembering allows adults to recapture some of their feelings of youth, competence, attractiveness, and closeness to others. Reminiscing appears to lend continuity to the older adults' self-concept through which they can trace the path of their development through time and can identify moments dial were of central importance to the crystallization of their personal philosoPhy."
Reminiscing then can be viewed as an integrating process with positive value. Ebersole12 describes reminiscing as putting together all one's life experiences to construct a meaningful existence, an integrated contiguous whole, a thing unique and never to be replicated. Reminiscing and the life-review process can be viewed as being preventative and therapeutic for the mental, social, and physical well-being of the elderly.1 Positive applications are thought of in terms of righting old wrongs, making up with enemies, coming to acceptance of mortal life, a sense of serenity, pride in accomplishment, and a feeling of having done one's best.1
Sherman and Newman14 postulated that certain cherished possessions might serve in the life-review process, allowing elderly persons to make positive adjustments and come to terms with old age. Lewis and Butler15 suggest tangible reminders of the past, such as scrapbooks, photo albums, old letters, pictures of reunions, and autobiographies, when available, as useful in remembrance. Butler16 has suggested that cherished possessions provide a vehicle for the adaptive and constructive manifestations of reminiscence in the life-review process.
Rogers17 provides a conceptual framework for the importance of possessions in the lives of the elderly with her theory, "Principles of Homeodynamics." Man is viewed as a complex human field. Behavior is due to change in the state of this field; it is derived from a totality of facts coming into a person at a specified time during a specific event. The human field is a continuum: whatever is done to one aspect will have an effect on the whole. Man is becoming; he is sentient, therefore, he can learn. He is self-regulating within his field, but when interfered with, problems develop.
Change occurs at a point in space/time and depends on the state of both human and environmental systems. It occurs as mutual simultaneous interaction of the human field and the environmental field at any point in time. These two fields are in mutual simultaneous interaction with each other. The human field and the environmental field maintain the elderly person's pattern and organization; this pattern may be altered in any setting where the individual no longer has personal possessions. In the absence of these possessions, dissonance occurs between the two fields and repattermng is necessary.
Man is a highly complex continuum of various life energies contributing to the mutual simultaneous interaction with the environmental field. In a state of health, all the individual's energies should be in harmony. Dissatisfaction or low life satisfaction of the elderly shows a dissonance in the human field. Without possessions, the environmental field is altered, losing its pattern and organization; thus, reorganization of the human field ensues.
Nursing Interventions and Recommendations
By using Roger's17 conceptual framework, nursing intervenes to help achieve harmony between the fields of institutionalized elderly individuals and their environment. This harmony would be accomplished through repatterning of the fields to help the residents adjust to and find satisfaction with their life and environment. Personal possessions help maintain the pattern and organization of the environmental field; they do affect the human field through mutual simultaneous interaction and thus create harmony in these fields that contribute to life satisfaction, his through the nurse' s actual assessment of both fields that holistic health care can be provided. The number and type of possessions as well as their meaning to the owner need to be explored as part of this assessment.
Institutions may have a policy of "allowing" residents to keep some of their possessions. They may have no policy at all. All too often when this policy does exist, maintenance of possessions is not encouraged. It often has been easier to allow a "stripping" of possessions for the ease of institutional care.
To gain recognition for this need of possessions and for implementation of such a policy, support of power sources is necessary - i.e., owner, director, director of nursing, head nurses. They should be approached in an effort to enlist their support and endorsement of such policy.
The nursing home brochure is an excellent means to describe this policy. If the brochure has photographs, a picture of a resident's room with many personal possessions could be shown. Besides using the brochure as a means of disseminating this information, the time when elderly residents and/or their families come to the institution for an orientation also could be used for this purpose. Families may sell or give away the belongings of elderly individuals when they are institutionalized because they believe possessions are not allowed in the new setting. Therefore families and residents should be approached before a move into the institution is made.
Once institutionalized, the need for personal possessions could be brought up for discussion at a resident's council meeting and/or a general meeting of the residents and staff. Some residents may voice fears of loss of possessions in the institutional setting; at that point discussion of the need for respecting other people's belongings could be entertained.
Staff nurses, nurse's aides, therapists, activity directors, and the custodial staff should be included in inservice programs. The staff may tend to arrange the residents' rooms so that they are neat and easy to clean and provide maximum movement or ease. Personal belongings might tend to "clutter" up the space. Again, the benefits of this "cluttering" should be explained. These belongings contribute to creating a more meaningful environment or a "milieu" more conducive to helping the elderly resident adjust to and function in the institutional setting.
Some of the possessions that could be included in the institutional environment include pictures, paintings, photographs, bureaus, bookcases, bedspreads, quilts, blankets, lamps (that are acceptable electrically), and even a bed (if it is not too low and there is no need for adjustment) - or any other "reasonable" item that has some meaning for the individual.
It also is important that those individuals working with elderly residents be aware of the importance and significance of the life-review process and reminiscing by the elderly. Nursing actively can encourage these processes though the use of the resident's personal possessions by questioningresidentsabout their role and meaning in their life.
Nursing has to develop its leadership role and potential; it must act as an advocate for the needs of the institutionalized elderly. Nursing goals should include helping the elderly to adjust to the setting of the institutional environment and making such moves into this setting as acceptable as possible. One important way to do this is by actively encouraging the elderly and their families to bring personal possessions into the setting of the institution. In addition, being close to personal belongings that the elderly have been associated with in their earlier years will help them in adjusting to their stage in life through the life-review process.
Society needs to accept the premise that institutionalized individuals have the same rights and needs as others in our society. Therefore, a "milieu" or environment should be created congruent with the needs of these individuals. Personal possessions constitute one important aspect of this need.
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