What Nursing Home Residents Talk About in Psychotherapy

Have you ever wondered what nursing home residents discuss with their shrinks behind closed doors? Here I solve the mystery, revealing the types of conversations I’ve had with residents over the years.

  • Feelings about leaving home and being ill.
  • Issues around loss of control and being dependent on other people, with a focus on gaining control over what they can.
  • Ways to work with the staff to get their needs met.
  • Roommates, and how to cope with them.
  • The reaction of family members to their placement and illness, including ways to help adult children understand that Mom or Dad can’t be there for them in the same way because Mom or Dad is sick and needs help themselves, and ways to help adult children understand that just because Mom or Dad is sick, it doesn’t mean they can’t go off campus every once in a while.
  • Issues around dying, including concerns about the afterlife and worries about how the family will get along without them.
  • Ways of making the most of the time they have left, including getting more involved in nursing home activities and the life of the nursing home community.
  • Their lives, choices, accomplishments, and regrets.
  • Stuff that interests them that they don’t get to talk about with anyone else, just to be their regular selves again instead of being a patient.

6 thoughts on “What Nursing Home Residents Talk About in Psychotherapy”

  1. This is so enlightening. Your list makes me think of the two key things David Solie talks about in his book, "How to Say it to Seniors". He says the elderly are dealing with 2 developmental tasks, the need for control and the need to be remembered.

  2. Actually, they talk about this with any staff who take the time to listen. I've heard some things that made me laugh for days and some things that made me cry on the way home. Sometimes the best thing you can do for a resident is to sit down and listen to them.

  3. Very interesting, Dale, I'll have to check out David Solie's book. I often think of my eldercare work in terms of Erikson's stage of development, especially Integrity vs Despair, but also Generativity vs Stagnation. I like to think the time in nursing homes can continue to be one of generativity, whether it's participating in the nursing home community, the larger world, or teaching a few things to the psychologist.

  4. K. Tree, I agree about the importance of listening to the residents, and I know many staff members wish they had more time to do this. The nursing home environment is so hurried these days, it seems I'm one of the few who has the opportunity to sit, listen, and be a witness to their experiences, because that's part of my job description. I've heard of other staff members getting reprimanded for spending too much time talking with the residents instead of getting their work done. It's a valid point on the part of the administration, but the residents' need to share their stories should be addressed as well, perhaps through volunteers or a referral for psychological services if the person is distressed.


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