polioperspectives
polioperspectives “Ageing well is about getting clever in your old age, how to do things smarter.” about feeling unsafe, about having falls, finding health care and the future. “I try to work around helping people to challenge unhelpful thoughts about themselves and get back into activity. There are two cognitive errors – overestimating danger and underestimating coping abilities.” Dr Sinclair said chronic pain is a big issue for people with physical disability. He noted that many patients are not given the tools they need to deal with pain adequately, and psychology has a lot to offer in relation to chronic pain management. “We tend to think chronic pain is a fault with the system and we can fix it. While the medications we currently have can mask pain, they can’t fix chronic pain. Psychological approaches are a useful adjunct to medical treatment to manage persistent pain.” “More than 50 per cent of clients referred to my team are referred for assistance to manage chronic pain. After just two four-hour pain management sessions for polio survivors in Geelong, many reported they now had the knowledge to make change in their lives to enable them to better manage their pain.” The key message is ‘be kind to yourself’ and be a compassionate presence. Handle painful thoughts and feelings more effectively. Dr Sinclair once watched a polio patient cross his waiting room, one leg in a brace. He talked to the man about that leg that the patient described as his ‘bad’ leg, while the other was the good leg. “But I said, ‘Think about that bad leg as the hero – it still got you here!’” Nicola Heath, Provisional Psychologist, at the University of Melbourne, spoke about ageing successfully with a long-term disability, and gave insights from Australian polio survivors. Niki Heath pointed out one in five Australians is living with a disability. Australia has an ageing demographic and people are living longer. “The dominant model of successful ageing states that to age well, older adults must be free of disease and disability, maintain high levels of cognitive functioning and remain actively engaged in life. According to this model, it is therefore not possible for people with a long-term disability or impairment such as post-polio syndrome be considered to be ageing successfully.” “This is important because, despite concerns that the current model ignores and encourages the marginalisation of those ageing with disabilities, international governments have increasingly turned to the successful ageing research to help form policy responses that aim to limit the future burden of caring for an ageing population,” she said. Ms Heath is undertaking a PhD study on successful ageing among disabled subjects, including those with spinal injury and post-polio syndrome. “People with polio are among the first generation of people with a physical disability to live into late age,” Ms Heath told the audience of polio survivors, family members and health professionals. Yet most polio 30 Independence Australia
polioperspectives survivors are not covered by the National Disability Insurance Scheme, which cuts out at age 65. “Research until now has been on helping people ‘ageing successfully’ without disability but what about those with disability and their participation in society?” she asked. “The problem with existing models is that only a small number of adults meet the criterion. To ‘age successfully’ under these models, you need to be able-bodied. This impacts on the self-esteem of those who aren’t – they see themselves as not being able to age successfully. Physical health isn’t the be all and end all. Those with disabilities can age remarkably well”. Her message to health professionals was they will need to be prepared to learn and listen to clients, being very mindful of their past experiences such as those who had polio who went through traumatic childhood treatments and years in hospitals. “We need to rethink and up-skill aged care facilities to consider the needs of older adults with physical disabilities,” she said. For post-polios, the main challenge is matching energy levels. One of her interviewees pointed out “You could take pain medication until you go gaga!” but that wasn’t how she wanted to live her life. “Ageing well is about getting clever in your old age, how to do things smarter,” commented one interviewee. Niki said that men in particular did not reveal to family what had happened in the past so as not to upset them. They were putting up with prejudice. “You are the most resilient bunch I’ve ever met in my life, but you do have topace yourself,” she advised. Anne Silbereisen, Psychologist at Melbourne Health. Melbourne Health clinical psychologist Anne Silbereisen conducted a practical session on mindfulness. “Mindfulness is a way of becoming comfortable with the mind, paying attention on purpose, in the present moment without judgment. This can allow us to de-stress and rest the mind. A growing body of research shows mindfulness can help both the mind and body,” she said. Anne took the group through a session of mindfulness, focusing on breathing in, holding for a count of two, and then exhaling, several times until we were able to stop following our thoughts. Questions and comments afterwards showed how much people gained from the experience. One participant said her mind was continually racing, but had stopped during that session. Inform – Autumn 2018 31
