Try to imagine a house that’s not a home. 
Try to imagine a Christmas all alone.
The only things I see
Are emptiness and loneliness
And an unlit Christmas tree.

Songwriters Jeremy Lanning, Michael Chapman, Nicky Chinn. Song by Mud

It is no surprise that for those who experience loneliness in their lives, Christmas can be a particularly difficult time of year.  Everything on the television, in the shops and in the general collective conscience seems to be telling you that this is a time of great happiness, families coming together, huge excesses of food and gifts being given and received.  But what if you have no plans for December 25^th, and the Turkey dinner for one is not looking very appealing?

You can of course experience a sense of loneliness at any age, but many older adults, who have lost their spouses, or whose families have moved away, are perhaps more likely to find themselves spending longer periods of time on their own.

My mother lost her beloved husband living with dementia in a care home over 4 years ago.  She never complains, but she does sometimes admit that when I am leaving after a visit, the house suddenly feels very empty and quiet.  She is grateful for the companionship of the radio and the television, but says that in the winter particularly, the day feels very long when there is nothing in the diary.

Loneliness is not just experienced when you are on your own.  Being alone and being lonely are two very different things, as many people can enjoy great contentment being on their own. Perhaps one of the worst feelings is when you are surrounded by other people, but you have a profound sense of not being particularly connected to them.  You go through the motions of putting on the Christmas hat or pulling a cracker, but your heart really isn’t in it, because it isn’t where you want to be.  John, a man living in a care home told me that Christmas reminds him of all he has lost.  He sometimes says he is overwhelmed by memories of when his children were little and the excitement of opening their stockings together.  He also remembers his own family Christmases when he was small and can picture his mother standing in the kitchen stirring the Christmas pudding.  John says that whilst he wants these happy memories to be a comfort to him, he sometimes pushes them aside, as they leave him feeling the painful contrast of his current Christmases with what he describes as a “group of kind strangers.”  Like my mother, he doesn’t grumble, but there is a sense of sad resignation that this is the reality for so many people as they age.

So, what can be done to make this better?  We cannot bring back people’s younger selves, their lost parents and spouses, and we can’t pretend that Christmases will ever be quite the same.  However, for care teams working in care homes, our role as ‘kind strangers’ is still very important.  We can find ways to lessen the sense of loneliness for individuals we support through moments of affection and laughter.   We can find out what a person’s favourite food, song or film was and surprise them with a treat.  We could help people contact a family member or old friend through the power of technology.  For some individuals, helping them do something for someone else who isn’t having an easy time can help, such as donation to a children’s charity or adopting an animal through the many rescue and wildlife charity schemes.  

But the most important gift we give people at Christmas is our time.  When we stop to sit and chat, or pick up a phone to talk to a relative living alone at home or in a care home,  this is the ‘Gold, Frankincense and Myrr’ of the festive season.  For that small moment in time, at least, we are saying to that person, “I’m here for you. You are not alone.”

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The evidence of ‘lateral violence’ in nursing and care settings remains high. Lateral violence can be understood as bullying or other negative behaviour which can happen as a consequence of the stresses some workers constantly experience. Desharnais et al (2023) indicates workplace trauma is associated with chronic stress associated with the emotional toll on the care team members supporting people in need.  These behaviours are often associated with detrimental consequences for the individual, those people being supported, and the greater health care organization.  This is also a major factor in impeding person-centredness in action (Sköldunger etal: 2020).

A focus on creating a person-centred workforce is an essential consideration for our future.  We know person-centred care starts with self. So, perhaps our approach to resilience, mindfulness and wellbeing should also begin with self.  By improving our response to stress and anxiety in the workplace and recognising our feelings and emotions in times of stress we develop coping mechanisms.  This ultimately enables better communication and the ability to prevent lateral conflict through productive conflict management and accountability.  This creates a positive approach and models human behaviour we wish to see as our norm, improving our own mental health.

I’m certainly not suggesting that we should adopt a confrontational attitude or a conflict-based response. I’m also not saying that we should ’let it go’ in terms of becoming a doormat for bad behaviour. We can’t control other’s behaviour but we can control our behavioural responses to empower peer to peer accountability.

We have bad days, and we have moments where it feels like we are being dumped upon when we are down.  Take the example of the donkey and the farmer which is a story often told to teach us how to turn situations around…

One day a farmer’s donkey fell into a well. The animal cried loudly for hours, the farmer heard this but decided nothing could be done and it wasn’t worth trying to rectify the situation.  He spoke to friends and they agreed despite the donkey’s plight, it was best to leave things as they were as doing something wouldn’t change the outcome. They each grabbed a shovel and began to throw dirt into the well. The donkey realized what was happening and decided that he could accept the circumstances and do nothing or, he could be different and change his way of thinking to resolve the problem. To everyone’s surprise, he quietened down after a few shovelfuls of dirt.

The farmer finally looked down into the well and was amazed at what he saw… with each shovelful of dirt, the donkey was doing something incredible: It was shaking off the dirt and stepping on top of the dirt.

Very soon everyone was surprised to see how the donkey reached the mouth of the well, went over the edge and trotted out…

Here’s the point.  Dirt will be thrown at you, all kinds of dirt…  there is always a choice, accept it and become buried under the dirt or choose to shake it off and use it to step up.  Resilience is facing the problems thrown at us, assessing the situation and choosing to use the circumstances and your resources wisely to step up and out.  

We can get out of the deepest holes if we don’t give up and change the group mindset as a result which causes us to take accountability of the situation and make good from it by changing our approach and behaviour.  This then leads to greater awareness for us all.

References

The Donkey in the Pit – A parable on pain and gain – Chabad.org

Desharnais, B., Benton, L., Ramirez, B., Smith, C., DesRoches, S., & Ramirez, C. L. (2023). Healthy Workplaces for Nurses: A Review of Lateral Violence and Evidence-Based Interventions. Journal of Applied Business & Economics, 25(6).

Sköldunger, A., Sandman, P. O., & Backman, A. (2020). Exploring person-centred care in relation to resource utilization, resident quality of life and staff job strain–findings from the SWENIS study. BMC geriatrics, 20, 1-9.

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I decided it was time for a little social project and set about to interview one hundred people aged sixty and over to ask them four questions…

1. What is your happiest memory?
2. What is one of your biggest regrets?
3. If you had children, what would you do differently if you were to raise them again?
4. What do you know in your sixties, that you didn’t know in your forties?

After dozens of interviews, I was quite surprised at some of the patterns that had emerged, and it’s made me think quite seriously about where I put my time and attention now. Here are some of the lessons I’ve learnt and been reminded of…

Happiness comes from people, not things

When asked about happiest memories, I wasn’t surprised to hear things like “the day my children were born” or “the day I got married”. I was however surprised that the answers always involved people. Not a single person referred to a work achievement, acquiring money or buying fancy luxury items. It reminded me that great relationships can bring so much more joy than possessions can.

How we treat people matters

The statement is perhaps obvious, but I didn’t expect it in these questions. Time and time again people told me their biggest regret was not spending more time with, or doing a better job caring for, their elderly parents. These comments were accompanied by a sadness and a genuine feeling that their actions had not matched up to their love for their parents. I was thankful to hear this lesson while my parents are still alive.

Make the most of the season you’re in

We understand that seasons pass but when you’re experiencing something daily, you can overlook it’s beauty. When discussing raising children, the overwhelming theme was “work less, play more”. People suggested they put too much focus on work and trying to provide things and wish they had spent more time with their children. My three children are aged 12-16 and I’ve realised I have a limited number of years with them to create memories before they leave home and forge their own paths. It’s made me think carefully about the things they’ll recall from their childhood when they’re older.

Worry less and take chances

After dozens of these conversations it seemed clear to me that people in their sixties, seventies and eighties have come to a place where they care a lot less about what people think of them. They often feel like it’s worth giving things a go and failure is just part of the journey. They said phrases like “I wish I hadn’t spent so much time worrying about things that didn’t happen”. I recognise that in my forties I have a greater fear of failure than I did in my twenties. I feel challenged to push past this and to continue to step out and live life to the full rather than settle for safety. That, of course, is much easier said than done.

By the end of this experiment, I came to realise it’s far more profitable to think about the changes I can make today, than the changes I wish I made yesterday. I hope you feel inspired to take stock like I have and make some decisions that will lead you to a happier and more fulfilled future.

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Dreams are integral to life. The not so humble dream that mulls away inside our mind can play a significant role in shaping who we are and where we head in life. They define who we are meant to become and are the essence of our life purpose.    So, what’s the secret? The secret is accepting the fact that it takes a dream to reveal our story and ultimately understand our purpose.

William Wilberforce had a dream, like so many great dreamers, of freedom. It seems that oppression, prejudice and captivity are the breeding ground of hope and dreams; what makes Wilberforce special was that he himself did not experience those things, his dreams were driven by compassion for the captivity of others.

BEING A BUTTERFLY

Being a butterfly is about supporting people to be their best self. It requires a deep commitment and understanding of the nature of humanity and the influencing nature of living life, the good, the bad and the ugly! It’s only when we embrace this that we can start to dream of impossible dreams that make a difference in care cultures for the better. It’s going to take determination, resilience and courage, a strong sense of purpose and unrelenting pursuit of the truth. Then and only then we will have a sense of what person centred care should look, sound and feel like.

The process of turning dreams into reality is achievable. Many dreams don’t progress any further than an ideological phenomenon.  The greatest barrier to dreams becoming real is doubting our ability to make it real. The connection between dreaming, reality and living life in the way we want to live it is the heart and soul of what being person centred is about. This means that in order to become truly person centred, we need to be dreamers.

KNOWING THE OBSTACLES

We also need to understand what will rob us of our dream. These are:

I give up. Feeling comfortable in our world is a reassuring feeling. Feeling safe assures us that everything is okay. Often, however, a good dream pushes us out of our comfort zone and into one that doesn’t feel so great.

I quit. The problem with this can be the regret that inevitably follows. Dreaming requires positive risk taking and a lot of resilience and effort to maintain the momentum.

Work, work, work! Find one person who has achieved something significant and ask them if it was an easy feat. I’m willing to bet on the response to this being a resounding NO! Anything worth achieving requires a lot of effort, sweat and tears.

What if? The fear of trying and failing can hold  us back from starting in the first place. Set backs happen. Flexibility is essential. Changing the end goal along the way does not equate to failure. It’s defining your path..

OUR DREAM OF A HOPE AND A FUTURE

We believe that:

1. Person centredness  is about our individuality and what matters to us.  It is who we are, what we feel, the emotions we experience, our human behaviours.  The core principles of being person centred are
2. Creating personalised experiences;
3. Embracing individuality;
4. Enabling ourself and others, and
5. Putting respect, dignity and compassion in action.

• It’s hard. It has risks, it is always evolving and it can’t be done, it has to be lived. It starts with self. It’s persevering.

• Feelings matter most. Life is about how we feel.  Our thoughts, feelings and emotions shape who we are and what we do. This creates our sense of control –  physically, emotionally, mentally and spiritually. It’s real.

• Identity through Individuality. We each have a story. Sadly, circumstances in life have impact our reality..  We are shaped by our individual circumstances and values Our individual identity is released through nurturing our core spirit.

• Personalised in every way. This principle calls for understanding, what works for one person may not work for another. Personalising our interactions, relationships and communication supports freedom and fulfilment. Nothing about me without me

CREATING YOUR OWN DREAM

it’s time to create your own dream of being a butterfly… you may wish to consider the following:

Feel free to achieve your own dreams

Now is an excellent time to kickstart that dream you’ve been holding onto. Spend time with yourself and let your thoughts flow. An excellent place to start is with a thorough plan of action. One that is clear and concise in covering what you want to do, sets out why your dream is important and lists the steps you will take to reach your goal.

Know yourself to know your dreams

Know thyself. It’s hard to follow your dreams if you don’t know what they are. What do they look, sound or feel like. Think about the qualities to make them real. Seek to make changes starting with self.

The time is now!

If you dream of being a Butterfly, but aren’t  living life in an authentic way, you can  see the incongruence between your actions and your dreams. Start today.

Nurture your dreams

Look for ways to create action daily, learn new skills, practice what you preach and be kind to yourself and others. Dreams don’t just happen they are the result of clarity, many small steps, and commitment. 

REFERENCES

Roberts, G., Morley, C., Walters, W., Malta, S. and Doyle, C. (2015). Caring for people with dementia in residential aged care: Successes with a composite person-centered care model featuring Montessori-based activities, Geriatric Nursing, 36(2), pp106 – 110.

Jennings, J. L. (2022). Dreams Without Disguise: Using Freud’s Case of Dora to Demonstrate a Radically Client-Centered Approach to Dreams. Journal of Humanistic Psychology, 00221678221137032.

Michaels, C. A. (2007). Sustaining the dream: a response to excessive positivism in person-centered planning. Research and Practice for Persons with Severe Disabilities, 32(3), 177-180.

Kunz, L. K., Scheibe, S., Wisse, B., Boerner, K., & Zemlin, C. (2022). From dementia mindsets to emotions and behaviors: Predicting person-centered care in care professionals. Dementia, 21(5), 1618-1635.

Francis, P., & Ivereigh, A. (2022). Let us dream: The path to a better future. Simon and Schuster.

Byrne, A. L., Baldwin, A., & Harvey, C. (2020). Whose centre is it anyway? Defining person-centred care in nursing: An integrative review. PLoS One, 15(3), e0229923.

Lynch, B., Barron, D., & McKinlay, L. (2020). Connecting with others. Fundamentals of Person-Centred Healthcare Practice.

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Learning from adversity

As we get older, it’s natural that we reflect more on our lives: what’s happened to us; people who’ve affected us, for good and for bad.  But in terms of how resilient we feel, what’s happened to us is less important than the way we tell the story of what’s happened to us. Life is a very good teacher. Through many years of working clinically with people, and from personal experience, it’s evident that the most excruciatingly painful times in life are the ones that that can teach us the most. Adversity can have a profound and meaningful transformative effect on us. First you need to acknowledge the trauma. It hurts. Grief hurts. Loss is painful. How do you go on when you are suffering or feel overwhelmed? Allow yourself to feel; to be present; to be kind to yourself and your experience of pain. It can be very dark, but only in the darkness can we see the stars. How do I work with this so it’s transformative, not just another episode of suffering? What can I learn? No experience, however painful, should be wasted.

If you’re going through a tough time right now, be kind to yourself. If you can, try not to resist and fight any emotional pain you are experiencing. Sit with it. Accept this is hard, but you are doing well and will get through this. When a wave of sorrow or anger comes upon you, notice it, accept it, don’t push it away. Try to be as gentle and encouraging with yourself as you can be.

Having a voice and being authentic

Many people, especially women, were brought up to be ‘nice’ and ‘polite’ and have never felt free to be their true, authentic selves for fear of upsetting others by having opposing views or even a voice. One of the wonderful aspects of aging is that we have the ability to grow into our authentic selves as we stop being so imprisoned by worrying about what others think of us. A trap that many people fall into is the fear of being selfish. How many times do we convince ourselves that we should neglect our own needs or wants or fail to take care of ourselves for fear of being selfish or self-indulgent? As carers, this may well be something you struggle with. Part of being comfortable with your authentic self, and thus feeling more resilient, is learning to hold the tension between being kind to others and aware of their needs, without neglecting your own. In order to feel resilient and have a sense of well-being you need to know how you deserve to be treated, build and maintain boundaries and have balance in your life. This will help you to make good, healthy choices – physically and mentally.

Intentionally practice an attitude of gratitude

The great news for us is that psychological research suggests our emotional well-being improves as we age. This is partly due to us learning to appreciate pleasure in the ordinary aspects of our lives and relationships, rather than focussing on achieving, competing and acquiring material possessions. But this doesn’t have to be related to getting older. Psychologists have suggested it is more related to our perspective of time and this can be learned at any age. The more someone (of any age) realises that life is short and fragile, the more their perspective and ability to appreciate it shifts. Gratitude is transformative. We have all made mistakes and have some regrets. Learning from these is part of why we get wiser as we age. Life may not be exactly as you wanted it to be. Well-being is strengthened when we have achievable hopes and goals but we also need to appreciate what we have right now. Lots of human suffering comes from expectation: our lives not measuring up to our blueprint and feeling helpless to change it. Resilience is built when we practise being grateful for what we have. It’s a good idea to write down things we are grateful for. You might decide to write 3 things you are grateful for as a daily practice to focus your mind. Remember,the sun is always shining but sometimes the clouds prevent you from seeing it.

Dr Gemima Fitzgerald bio

It wasn’t until I was in my mid-30s, and going through a really difficult divorce and feeling like a huge failure, that I decided to start again and study Psychology BSc at the University of Sussex in the UK. After I finished that, I embarked on a doctorate in Clinical Psychology at the University of Surrey. Following qualification, I worked for a hospice in their Specialist Palliative Care Psychology Service before becoming the lead for the hospice Bereavement Service. I have always had a strong interest in teaching and empowering others, and my particular expertise is in the area of building resilience. My doctoral research was around the processes involved in developing resilience, and I was invited to do a TEDx talk on this subject in 2015. 

I am now Principal Psychologist in a male prison where I lead the psychology team in the mental health service, which has enabled me to work with the most challenging mental health and behavioural difficulties. As well as my lead role in the prison, I founded my own company and work freelance in a diverse range of settings; from private practice, to working with homelessness, hospices, family carers of people with dementia, and the NHS. I regularly run training courses on building resilience for staff, carers and patients as I love seeing people learn these skills and start to feel a greater sense of well-being. 

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