Deep Knowing

When we talk about how we work with elders we use the phrase “deep knowing” often.  It’s a phrase that’s easy to toss around but a concept that has real meaning and a great deal of value.  Deep knowing is our desire, and commitment, to learning about who the people we care for really are, not just labeling them with a diagnosis or a room number.

In the “old days” of senior care, old days that still exist in some places, individuals were categorized that way.  It was seen as more expedient and fit in with the idea of care as “tasks to be performed,” a mindset that seems to categorize people as problems to be solved rather than as individuals with unique histories, abilities and preferences.

Deep knowing is the effort to remember that each person is an individual and that each has their own story to tell.  We believe that this approach must be so ingrained that it is natural and effortless.  Deep knowing is understanding someone’s history to inform both care and services.  Understanding who someone is and what their life experience has been is important for all of us and it is critical for older adults, especially those with cognitive impairment.

There are so many examples of how this impacts quality of life.  Knowing that someone is a survivor of abuse, for example, enables us to approach personal care in a different way, beginning with both the words we use and the way we physically work with the individual.  As well, if we understand the lives these individuals have led, we can better tailor activities and engagement.  I remember vividly one woman who had been a physician and now had advanced dementia.  She would walk into the other elder’s rooms and try to examine them, playing the role she had always played.  Knowing her background enabled us to create a space for her in the nurse’s station with her own paper charts (that were, of course, not real patient information) and she found that fulfilling.

These lessons apply beyond our walls as well. Older adults are not a collective group to be labeled and seen as such.  Defining someone by their age category, their medical condition, their living situation—it’s not just inaccurate, it’s discriminatory and it’s just plain wrong.  That matters not only for those of us who work with older adults but for anyone who interacts with an older adult.

Even as family members we assume that we know, we believe we understand but unless we really ask the questions—and listen to the answers—we are missing the opportunity to know and, more importantly, to make a difference.