Resolution

Abstract

This article proposes that disoriented very old people enter a new life stage with a new life task. In extremely old age, a person must confront what is here called "resolution versus vegetation." Behavior among disoriented old people often is dismissed as dementia or disease. But it is the behavior of people in conflict, dealing with an old-age task that might have been avoided had other stages of life been better managed. Recognizing this new task that lies ahead can lead to better diagnosis and therapy. It also helps us face our own aging by better dealing with earlier life tasks. I began working with disoriented very old nursing home residents (aged 80+) in 1963, trying to orient them to "reality." I soon found that reality orientation was unrealistic for them. They ignored me and retreated inward, moving even more to their past. In 1967, I began to move with them. I no longer expected them to conform to my standards of behavior or to accomplish middle-age life tasks. By validating them-acknowledging the truth of their feelings-I discovered that they restore the past to resolve past conflicts. They must justify having lived. They must make peace. As naturally as the adolescent rebels for identity, the disoriented old clean house before death. They express bottled-up feelings at last. When validated, they feel happier and often return to present reality relating to others in present time. Validation is a combination of empathy, touch, eye contact, mirroring body movements, matching voice and rhythms, picking up cues about feelings and putting them into words, accepting without judging, and genuine, total listening.

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