Abstract
Self-transcendence is a developmental process inherent in late life that shapes one’s perspective on self, others, the material world, and the spiritual or existential dimension. Self-transcendence has been associated with well-being, life satisfaction, coping, depression, self-care, and health-related quality of life, but few interventions designed to promote development of self-transcendence or explore its effects on community-dwelling older adults were identified. This paper reports qualitative results obtained as part of a mixed methods pilot study assessing the Psychoeducational Approach to Transcendence and Health (PATH) Program in 20 older women at two community senior centers. The PATH Program, an 8-week theory-based intervention, combines mindfulness exercises, group processes, and creative projects, reinforced by at-home practice, to create an experience that is meaningful, emotionally supportive, and cognitively stimulating. The specific aim was to evaluate participants’ experiences of the PATH Program and the meanings ascribed to those experiences. Findings indicated group members gained a new perspective on life and death, discovered personal meaning in past experiences, and found support for positive self-identities, with new options for self-care and personal growth. The study supported the structure and contents of the PATH Program and suggested it merits further testing. The PATH Program has the potential to be a practical and affordable intervention available for use in multiple settings where older adults gather such as retirement communities, faith-based groups, adult day centers, and assisted living facilities.
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References
Acton, G. J. (2002). Self-transcendent views and behaviors: Exploring growth in caregivers of adults with dementia. Journal of Gerontological Nursing, 28(12), 22–30. https://doi.org/10.3928/0098-9134-20021201-06.
Adams-Price, C. (Ed.). (1998). Creativity and successful aging: Theoretical and empirical approaches. New York: Springer.
Ahmed, S. M., & Palermo, A. S. (2010). Community engagement in research: Frameworks for education and peer review. American Journal of Public Health, 100(8), 1380–1387. https://doi.org/10.2105/AJPH.2009.178137.
Angus, J., & Reeve, P. (2006). Ageism: A threat to “aging well” in the 21st century. Journal of Applied Gerontology, 25(2), 137–152. https://doi.org/10.1177/0733464805285745.
Bickerstaff, K. A., Grasse, C. M., & McCabe, B. (2003). How elderly nursing home residents transcend losses of later life. Holistic Nursing Practice, 17(3), 159–165. https://doi.org/10.7748/nop.15.6.8.s5.
Birditt, K. S., Miller, L. M., Fingerman, K. L., & Lefkowitz, E. S. (2009). Tensions in the parent and adult child relationship: Links to solidarity and ambivalence. Psychology and Aging, 24(2), 287–295. https://doi.org/10.1037/a0015196.
Borson S. (2000). The Mini-cog: A cognitive “vital signs” measure for dementia screening in multi-lingual elderly. International Journal of Geriatric Psychiatry, 15(11), 1021–1027.
Cappeliez, P., & O’Rourke, N. (2002). Profiles of reminiscence among older adults: Perceived stress, life attitudes, personality variables. International Journal of Aging and Human Development, 54(4), 255–266. https://doi.org/10.2190/YKYB-K1DJ-D1VL-6M7W&%23x00B7;.
Carlson, M. C., Saczynski, J. S., Rebok, G. W., Seeman, T., Glass, T. A., McGill, S., et al. (2008). Exploring the effects of an “everyday” activity program on executive function and memory in older adults: Experience Corps. The Gerontologist, 48, 793–801. https://doi.org/10.1093/geront/48.6.793.
Carstensen, L. L., Fung, H. H., & Charles, S. T. (2003). Socioemotional selectivity theory and the regulation of emotion in the second half of life. Motivation and Emotion, 27(2), 103–123.
Centers for Disease Control and Prevention. (2013). The state of aging and health in America 2013. Atlanta: Centers for Disease Control and Prevention, US Dept of Health and Human Services.
Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. Thousand Oaks: Sage.
Ciro, C. A., & Smith, P. (2015). Improving personal characterization of meaningful activity in adults with chronic conditions living in a low-income housing community. International Journal Environmental Research and Public Health, 12(9), 11379–11395. https://doi.org/10.3390/ijerph120911379.
Coward, D. D., & Kahn, D. L. (2004). Resolution of spiritual disequilibrium by women newly diagnosed with breast cancer. Oncology Nursing Forum, 31(2), E1–E8.
Coward, D. D., & Kahn, D. L. (2005). Transcending breast cancer: Making meaning from diagnosis and treatment. Journal of Holistic Nursing, 23(3), 264–283. https://doi.org/10.1177/0898010105277649.
Ellermannn, C. R., & Reed, P. G. (2001). Self-transcendence and depression in middle-age adults. Western Journal of Nursing Research, 23(7), 698–713. https://doi.org/10.1177/01939450122045492.
Erikson, E. H. (1982). The life cycle completed: A review. New York: W. W. Norton and Company, Inc.
Erikson, E. H., & Erikson, J. M. (1997). The life cycle completed: Extended version with new chapters on the ninth stage of development. New York: W. W. Norton and Company, Inc.
Fisher, B. J., & Specht, D. (1999). Successful aging and creativity in later life. Journal of Aging Studies, 13, 457–472. https://doi.org/10.1016/S0890-4065(99)00021-3.
Flood, M. (2005). A mid-range theory of successful aging. Journal of Theory Construction and Testing, 9(2), 35–39.
Flood, M., & Sharer, K. (2006). Creativity enhancement: Possibilities for successful aging. Issues in Mental Health Nursing, 27, 939–959. https://doi.org/10.1080/01612840600899832.
Gallagher, P., & Carey, K. (2012). Connecting with the well-elderly through reminiscence: Analysis of lived experience. Educational Gerontology, 38(8), 576–582. https://doi.org/10.1080/03601277.2011.595312.
Gallant, M. P., Spitze, G., & Grove, J. G. (2010). Chronic illness self-care and the family lives of older adults: A synthetic review across four ethnic groups. Journal of Cross Cultural Gerontology, 25(1), 21–43. https://doi.org/10.1007/s10823-010-9112-z.
Gerber, S. (2012). Anna Deavere Smith on art, creativity and transcendence: An interview with the award-winning host of this year’s PBS Arts Summer Festival. Published online at Next Avenue: Twin Cities Public Television at http://www.nextavenue.org/anna-deavere-smith-art-creativity-and-transcendence/.
Gilmour, H. (2012). Social participation and the health and well-being of Canadian seniors. Health Analysis Division, Statistics Canada, Catalogue no. 82-003-XPE. Health Reports, 23(4), 3–12.
Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine Pub. Co.
Goll, J. C., Charlesworth, G., Scior, K., & Stott, J. (2015). Barriers to social participation among lonely older adults: The influence of social fears and identity. PLoS ONE, 10(2), e0116664. https://doi.org/10.1371/journal.pone.0116664.
Hagestad, G. O. (2011). Parent-child relations in later life: Trends and gaps in past relationships. In J. B. Lancaster, J. Altmann, L. R. Sherrod & A. Rossi (Eds.), Parenting across the life span: Biosocial dimensions (pp. 405–428). Piscataway: Transaction Publishers.
Hatch, L. R. (2005). Gender and ageism. Generations, 29(3), 19–25.
Haugan, G., Tannestad, T., Hammervold, R., Garasen, H., & Espnes, G. A. (2012). The relationships between self-transcendence and spiritual well-being in cognitively intact nursing home patients. International Journal of Older People Nursing, 9, 65–78. https://doi.org/10.1111/opn.12018.
Hertzog, C., Kramer, A. F., Wilson, R., & Lindenberger, U. (2009). Enrichment effects on adult cognitive development: Can the functional capacity of older adults be preserved and enhanced? Psychological Science in the Public Interest, 9(1), 1–65. https://doi.org/10.1111/j.1539-6053.2009.01034.x.
Hutchinson, S. L., & Warner, G. (2015). Meaningful, enjoyable, and doable: Optimizing older adults’ activity engagement at home. Journal of Aging Life Care. Fall. Retrieved online at http://www.aginglifecarejournal.org/meaningful-enjoyable-and-doable-optimizing-older-adults-activity-engagement-at-home/.
Hvidt, A. E., Iversen, R. H., & Hansen, H. (2013). Someone to hold the hand over me: The significance of transpersonal “attachment” relationships of Danish cancer survivors. European Journal of Cancer Care, 22(6), 726–737. https://doi.org/10.1111/ecc.12097.
Kausch, K. D., & Amer, K. (2007). Self-transcendence and depression among AIDS memorial quilt panel makers. Journal of Psychosocial Nursing, 45(6), 44–55.
Kidd, L. I., Zauszniewski, J. A., & Morris, D. L. (2011). Benefits of poetry writing intervention for family caregivers of elders with dementia. Issues in Mental Health Nursing, 32, 598–604. https://doi.org/10.3109/01612840.2011.576801.
Krinke, R. (2005). Contemporary landscapes of contemplation. New York: Routeledge.
Lundam, B., Alex, L., Jonsen, E., et al. (2012). Inner strength in relation to functional status, disease, living, arrangements, and social relationships among people aged 85 years and older. Geriatric Nursing, 33(3), 167–176. https://doi.org/10.1016/j.gerinurse.2011.11.001.
Mann, A. T. (2010). Sacred landscapes: The threshold between worlds. New York: Sterling.
McCarthy, V. L., & Bockweg, A. (2013). The role of transcendence in a holistic view of successful aging: A concept analysis and model of transcendence. Journal of Holistic Nursing, 31(2), 83–91.
McCarthy, V. L., Bowland, S., Hall, L. A., & Connelly, J. (2015a). Developing the PATH Program: An intervention to foster self-transcendence and well-being in community-dwelling older adults. International Journal of Aging & Human Development, 82(1), 3–29. https://doi.org/10.1177/0091415015623549.
McCarthy, V. L., Ling, J., Bowland, S., Hall, L. A., & Connelly, J. (2015b). A pilot study of a psychoeducational intervention to promote self-transcendence and well-being in community-dwelling older adults. Geriatric Nursing, 36(6), 431–437. https://doi.org/10.1016/j.gerinurse.2015.06.007.
Merriam-Webster Online Dictionary. (n.d.). Definition of introspection. Available online at http://www.merriam-webster.com/dictionary/introspection.
Messervy, J. M. (1990). Contemplative gardens. Charlottesville: Howell Press.
Miller, J. B. (1976). Toward a new psychology of women (pp. 6–12). Boston: Beacon Press.
Mishara, A. L. (1995). Narrative and psychotherapy: The phenomenology of healing. American Journal of Psychotherapy, 49(2), 180–195.
Moe, A., Hellzen, O., Ekker, K., & Enmarker, I. (2013). Inner strength in relation to perceived physical and mental health among the oldest old people with chronic illness. Aging and Mental Health, 17(2), 189–196. https://doi.org/10.1080/13607863.2012.717257.
Myers, S. (2003). Reflections on reflecting: How self-awareness promotes personal growth. Person-Centered Journal, 10, 3–22.
National Institute on Aging, United States Department of Health and Human Services. (2015). Participating in activities you enjoy: More than just fun and games tips from the national institute on aging. Retrieved online at https://www.nia.nih.gov/health/publication/participating-activities-you-enjoy.
Newman, B., & Newman, P. (2014). Development through life: A psychosocial approach. Stamford: Cengage Learning.
Nygren, B., Alex, L., Jonsen, E., Gustafson, Y., Norberg, A., & Lundman, B. (2005). Resilience, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health among the oldest old. Aging and Mental Health, 9(4), 354–362. https://doi.org/10.1080/1360500114415.
Orwall, L., & Perlmutter, M. (1995). The study of wise persons: Integrating a personality perspective. In R. J. Sternberg (Ed.), Wisdom: Its nature, origins, and development (pp. 160–180). New York: Cambridge University Press.
OxfordDictionaries.com. (2013). Definition of spiritual in English. Retrieved online at https://en.oxforddictionaries.com/definition/spiritual.
Rabb, D. (2014). Creative transcendence: Memoir writing for transformation and empowerment. Journal of Transpersonal Psychology, 46(2), 187–207.
Reed, P. G. (2003). The theory of self-transcendence. In M. J. Smith & P. Liehr (Eds.), Middle range theories in nursing (pp. 145–165). New York: Springer.
Reed, P. G. (2014). Theory of self-transcendence. In M. J. Smith & P. R. Liehr (Eds.), Middle range theory for nursing (3rd edn., pp. 109–139). New York: Springer.
Rogers, E. B. (2001). Landscape design: A cultural and architectural history. New York: Harry N. Abrams.
Smith, M., Kolanowski, A., Buettner, L. L., & Buckwalter, K. C. (2009). Beyond bingo: Meaningful activities for persons with dementia in nursing homes. Managed Health Care: Connect, 17(7), 22–30.
Sonntag, K. E. (2014). The role of the transcendent in landscape. Master’s thesis for Utah State University. Available at Graduate Theses and Dissertations, Paper 3697 at http://digitalcommons.usu.edu/etd/3697.
Stinson, C. K., & Kirk, E. (2006). Structured reminiscence: An intervention to decrease depression and increase self-transcendence in older women. Journal of Clinical Nursing, 15(2), 208–218. https://doi.org/10.1111/j.1365-2702.2006.01292.x.
Sue, D. W., Capodilupo, C. M., Torino, G. C., Bucceri, J. M., Holder, A. M. B., Nadal, K. L., et al. (2007). Racial microagressions in everyday life: Implications for clinical practice. American Psychologist, 62(4), 271–286. https://doi.org/10.1037/0003-066X.62.4.271.
Tornstam, L. (1999). Transcendence in later life. Generations, 23(4), 10–14.
Upchurch, S. (1999). Self-transcendence and activities of daily living: The woman with the pink slippers. Journal of Holistic Nursing, 17, 251–266. https://doi.org/10.1177/089801019901700303.
Upchurch, S., & Mueller, W. H. (2005). Spiritual influences in ability to engage in self-care activities among older African Americans. International Journal of Aging and Human Development, 60(1), 77–94. https://doi.org/10.2190/X05G-XGRL-778R-UHBW.
Walsh, S. M., Lamet, A. R., Lindgren, C. L., et al. (2011). Art in Alzheimer’s care: Promoting well-being in people with late-stage Alzheimer’s disease. Rehabilitation Nursing, 36(2), 66–72. https://doi.org/10.1002/j.2048-7940.2011.tb00068.x.
Williams, K., & Kemper, S. (2010). Exploring interventions to reduce cognitive decline in aging. Journal of Psychosocial Nursing and Mental Health Services, 48(5), 42–51. https://doi.org/10.3928/02793695-20100331-03.
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This study was funded by a grant awarded to Dr. Valerie Lander McCarthy by the American Nurses Foundation and the Midwest Nursing Research Society.
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McCarthy, V.L., Bowland, S., Nayar, E. et al. Developing a New Perspective in Late Life: The PATH Program. J Adult Dev 26, 304–320 (2019). https://doi.org/10.1007/s10804-018-9319-8
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DOI: https://doi.org/10.1007/s10804-018-9319-8