Upon retirement, a person enters a new phase of his life where he faces Ego Integrity vs. Despair. Erikson posted that ntegrity is achieved as the aging person struggles to maintain wholeness in strength and purpose despite the apparent degeneration of physical capabilities. Havighurst suggested that two of the six tasks of retirees who are in the late maturity stage are “adjusting to retirement and decreased income and adjusting and adapting to social roles in a flexible way” (Hogstel, 2001). With the physical changes and transition of role function, retirees do need holistic support from family, friends and the health care system.
Nursing interventions are vital in helping aging people view retirement positively.
Physically, nurses should actively replace the energy lost by an aging client and should prevent further degeneration of the body, as proposed by Levine’s Conservation Model (Tomey, Alligood, 2002) for him to be able to enjoy retirement. Primarily, nurses, together with other heath disciplines, should monitor the client’s body functions to determine the extent of activities that he may engage into. It is essential to formulate a diet with nutritional contents adequate for the client’s needs and general condition. Encouraging and educating the client about and adherence to pharmacologic treatment or supplements is also our task. Teaching the client exercises that are not too extraneous will also prevent muscle wasting, and promote good circulation and over-all energy. (Kozier, Erb, et.al, 2008)
The cessation of productivity for a person whose job was his source of interest, social life and activities threatens his integrity. The major stressors of a retiree are declining health and vigor, loss of family and friends, reduced income and, all leading to, loneliness. The feeling of loneliness can immediately be addressed by the nurse by listening. It is also reduced by encouraging aging clients to have pets, have some place to go to and have something to look forward to. Psychological well-being can be preserved by helping the client develop interests that are not related to his work, volunteer for a cause, make new friends from all ages and stay active by keeping himself busy. (Judd, 1983)
The way nurses are to deliver health education regarding interventions should involve the family, in congruence to Kuan’s idea of Family Constellation. A retiree enjoys this phase of his life mostly by being able to spend more time with family, especially his grandchildren (Hogstel, 2001). Moreover, people working in groups succeed better in goal attainment than a person working alone (Schultz, 2002).
The major role of a nurse in an aging client’s retirement and role discontinuity is to be the resource person.
According to Hall, nursing requires and interdisciplinary approach in preserving a client’s wholeness (Tomey, Alligood, 2002). The nurse’s hands-on care is the amalgam that holds all the contributions of different professions and disciplines to the adaptation of a patient. A nurse’s role in an aging person’s transition does not only involve collaboration with physicians, dieticians and physical therapists to maintain physical wellness. Ideally, nurses should be able to offer retirees access to community-based psychological health services, outreach programs, volunteer work, support groups, activity and recreation centers and other institutions that will help him discover a new dimension to self awareness and productivity. (Judd, 1983)
As a nurse, I would advocate Kuan’s theory because it has positive impact to the quality of life of aging persons.
Kuan’s theory supports the ideas that nursing should promote wholeness (Rogers, Levine), adaptation (Roy), patients’ discovery of himself and insight (Peplau), and patients’ empowerment (Orem). It also shows that there are difficulties and needs that a nurse should anticipate when a patient is transitioning into retirement stage. This anticipation allows the nurse to intervene with the overt issues that a person is dealing with (Abdellah). (Tomey, Alligood, 2002)
The goal of aging is “to enter into the last half of life determined to make the most out of it” (Judd, 1983). Remaining involved with significant others, interests and benevolent work allows a person to welcome the next stage of his life with confidence, contentment and a balanced perspective. Somehow, Kuan was able to contribute a framework by which a retiree may have a better chance at a quality life.
However, Kuan did overlook some important considerations and there are points of improvement for her theory.
In determining how a person may deal with retirement, his past experiences should also be assessed. Erikson posited that an adult’s completion of past developmental tasks affects his behaviour toward later maturity and retirement (Hogstel, 2001). Personal experiences are unique. Their impact on the lives of people would need to be approached differently. Some aging clients may have had more challenging lives than others and they may need more help. Some retirees may have been more productive than others and may be able to adapt faster. This is something that I would explore so that i may be able to address my client’s facets of insecurity with higher priority. Hence, preparation for retirement should be highly individualized.
Looking at retirement in a positive light may also be more beneficial for an aging person. In Achtley’s Continuity Theory, he proposed that continuity is more potent than role discontinuity. He said that even after retirement, a person does not lose his job-related identity, but the identity of a retired person adds up to it (Hogstel, 2001). For example, I would orient an aging client that the values of being hardworking and committed that he gained from being employed will be enhanced if he utilizes his availability in soliciting donations and goods for orphanages. After all, people adapt more with a positive perspective.
Kuan’s theory may not be applicable with the current health care system, but it may find hope in the inherent Filipino characteristics.
Blaming substandard nursing practice on understaffing is a cliché, and sadly almost a norm. With many diseases and patients flocking in hospitals, health care has been focused on curing physical illness. Nurses are required to do more with less – less time, less resource, less manpower. This scenario belittles the importance of addressing the concerns of those who are not physically sick, such as retirees undergoing identity crisis. To provide holistic assistance to aging persons is almost impossible with our health care system.
What can we do? Educate the primary people in the lives of retirees of Kuan’s theory and similar ideas.
The beauty of the Filipino people is that we are adaptive, quick to learn and highly family oriented. We take care of our elders and we let them live with our own nuclear families. If not, we keep them in close proximity whether literally, on a regular schedule, or by constant communication. Sharing nursing knowledge about the needs of aging persons with their significant others, would increase the probability that they would be assisted during their transition because they are in constant interaction among each other.
Kuan’s “Retirement and Role Discontinuity” does not only provids a picture of ideal nursing care for the aging. On a larger perspective, it reminds us that people who retire once contributed to the economy that sustains us, no matter how barely surviving it is. It is their right to have their unique needs recognized and holistically met.
“Fundamentals of Nursing Concepts, Process and Practice 8th Edition”, by Audrey Berman, Shirley Snyder, Barbra Kozier and Glenora Erb, 2008
“Nursing Care of the Adult”, by Eloise Judd, 1983
“Gerontology: Nursing Care of the Adult”, by Mildred Hogstel, 2001
“Psychology and Work Today”, by Duane Schultz and Sydney Ellen Schultz, 2002