Lesson 6: Retirement, Play, and Creativity


Attention

Video Games May Help Combat Depression in Older Adults

Science Daily (Feb. 28, 2010) — Research at the Sam and Rose Stein Institute for Research on Aging at the University of California, San Diego School of Medicine suggests a novel route to improving the symptoms of subsyndromal depression (SSD) in seniors through the regular use of "exergames" -- entertaining video games that combine game play with exercise. In a pilot study, the researchers found that use of exergames significantly improved mood and mental health-related quality of life in older adults with SSD.

The study, led by Dilip V. Jeste, MD, Distinguished Professor of psychiatry and neurosciences at UCSD School of Medicine, Estelle and Edgar Levi Chair in Aging, and director of the UC San Diego Sam and Rose Stein Institute for Research on Aging, appears in the March issue of the American Journal of Geriatric Psychiatry.

SSD is much more common than major depression in seniors, and is associated with substantial suffering, functional disability, and increased use of costly medical services. Physical activity can improve depression; however, fewer than five percent of older adults meet physical activity recommendations.
"Depression predicts nonadherence to physical activity, and that is a key barrier to most exercise programs," Jeste said. "Older adults with depression may be at particular risk for diminished enjoyment of physical activity, and therefore, more likely to stop exercise programs prematurely."

In the study, 19 participants with SSD ranging in age from 63 to 94 played an exergame on the Nintendo Wii video game system during 35-minute sessions, three times a week. After some initial instruction, they chose one of the five Nintendo Wii Sports games to play on their own -- tennis, bowling, baseball, golf or boxing.

Using the Wii remote -- a wireless device with motion-sensing capabilities -- the seniors used their arm and body movements to simulate actions engaged in playing the actual sport, such as swinging the Wii remote like a tennis racket. The participants reported high satisfaction and rated the exergames on various attributes including enjoyment, mental effort, and physical limitations.

"The study suggests encouraging results from the use of the exergames," Jeste said. "More than one-third of the participants had a 50-percent or greater reduction of depressive symptoms. Many had a significant improvement in their mental health-related quality of life and increased cognitive stimulation."

Jeste said feedback revealed some participants started the study feeling nervous about how they would perform in the exergames and the technical aspects of game play. However, by the end of the study, most participants reported that learning and playing the video games was satisfying and enjoyable.

"The participants thought the exergames were fun, they felt challenged to do better and saw progress in their game play," Jeste said. "Having a high level of enjoyment and satisfaction, and a choice among activities, exergames may lead to sustained exercise in older adults." He cautioned, however, that the findings were based on a small study, and needed to be replicated in larger samples using control groups. He also stressed that exergames carry potential risks of injury, and should be practiced with appropriate care.

Additional authors include Dori Rosenberg, Jennifer Reichstadt, Jacqueline Kerr and Greg Norman, UCSD Department of Family and Preventative Medicine; and Colin A. Depp, Ipsit V. Vahia and Barton W. Palmer, UCSD Department of Psychiatry.

The study was funded in part by grants from the National Institute of Mental Health, the UCSD Sam and Rose Stein Institute for Research on Aging, and the Department of Veterans Affairs.


Learning Outcomes

Upon completion of this lesson's material, students will be able to:

  • Discuss the importance of play across the lifespan
  • Identify the needs that work, play, and other activities meet in our lives
  • Identify ways in which individuals with mental illness may be able to meet the needs and tasks of retirement (at any age)

Teaching

Reading

Read Chapter 8 - Retirement, Play and Creativity in Vaillant

There is a quote at the beginning of this chapter:

Old age is full of enjoyment if you know how to use it. -Seneca, 4 B.C.-A.D.65

How true this is!

We have to ask ourselves though: What is retirement?

When I (Dr. Kavanaugh) was in a money-making business called AMWAY there was a truism that I encountered. The saying was retirement is not an age but it is an income stream! However, regardless of this hopeful (early) retirement option, the fact remains we all have to STOP at some time and decide what we are going to DO from that point on. I remember years ago that it used to be said that once one has retired it is all down hill from there. Certainly there are stories in your own family of individuals who walked off the job and soon walked off the planet. Vaillant says that there is no evidence that retirement is "bad for your health".

Some of us will continue to do what we have been doing all along...because...well...consider the list of reasons for returning to work that are on p. 223! I'll paraphrase...

  • I was bored
  • I like challenges
  • I don't have enough money
  • The work I was doing still wants me
  • I love my work
  • I am needed
  • It is my social life
  • It is what I do

Consider your own personality and what work means to you...whatever work is for you. These "reasons" for going back to work seem to really touch on basic needs that people have. We can even see a number of levels of Maslow's Hierarchy of Needs (see pyramid below) being met in these areas.

As we age we still have all these needs. When things change in our lives, which is going to happen, these needs are still there.

Vaillant identifies four Tasks of Retirement:

  1. Make new social connections as fast as the old ones are lost
  2. Learn how to maintain self-respect (play)
  3. Learn to create (creativity)
  4. Keep learning

These are the tasks you are going to explore as part of your homework assignment this week.

WOW...I'm going to have you consider something! Look at the list of why people return to work...then look at the tasks of retirement...consider our clients who may have never worked, or their "job" was being a person with a mental illness. How do they engage the world...regardless of age. How do they find fulfillment in their lives as they age? The needs they will have are the same...so are the tasks!

This assignment has you exploring some fun apps on the iPad. There are lots of trivia and mind games as well as other fun ones in the Apple App store. Try one or more of the fun activities below to consider how you might suggest some activities (electronic or traditional paper puzzles or crosswords) for consumers in the future. Keeping one's brain sharp has been proven to help ward off brain degeneration as one ages.

Elevate - Brain Training

You are invited to select what skills you want to work on.

MindGames

It prompts you to register but you can enter the app as a guest and not have to register. Give you choices of many games to try to build different brain skills.

Colorfy

You can create colorful images on their coloring pages. We know there has been lots of media lately on the benefits of adult coloring. How relaxing it is. Give this electronic version a try.

Word Search +

Traditional word search format using the touch screen.

Download one or more of the free apps above and give it a try. Did you find it relaxing or fun?


Assessment

Lesson 6 Discussion (for online class only)

In this discussion I would like you to share with each other what activities you do to play and relax. How do the older people in your life play? How do persons with mental illness play? Why is play so important?

Lesson 6 Assignment

This assignment is ONE paper with three parts to it. This paper is to be written in APA format (see APA Format/Purdue link below). This whole paper should be about 3 - 4 pages long, plus title page all in APA format. No references are needed. Remember, this assignment needs to be written in MS Word or Pages and then submitted as a PDF. Please ask for help from your instructor if you do not know how to convert to PDF. Once completed go into the Lesson 8 Assisgnment in Blackboard, browse your computer and attach the file as instructed. Do not cut/paste text into the comment box. Also, make sure that your title page is the first page of your document, not a separate file.

APA Format resource/Purdue University Link: https://owl.english.purdue.edu/owl/resource/560/01/

Part 1:
I want you to interview someone who is older than you, a lot older, maybe retired and seemingly "aging well". Ask them what they are doing to meet the tasks of retirement that Vaillant writes about. These tasks are in Vaillant on pages 226 - 246. You are going to use these four specific Tasks of Retirement (listed in the lesson above as well) and write a summary of the ways your interviewee has applied each of these four tasks into their current lives. This summary completes Part 1 of this paper.

Part 2:
For Part 2 you need to write out YOUR plan to address the four Tasks of Retirement. How are you going to make sure you meet your NEEDS and how do you think you might address each of the TASKS?

Part 3:
Write a plan for the client Roberta who's case study is below. What are her needs and tasks of retirement? What would you set up to assist Roberta in achieving these four tasks of retirment? Your Part 3 will include what her 4 tasks are and at least one way you would help her achieve each of the four.

Case Study

Roberta is 56 years old. She has suffered from depression her entire adult life. She was well cared for by her late husband, but he passed away 2 years ago of a heart attack. Roberta could not live alone so her two daughters got her into a boarding home that provides some level of assistance for her. She has some physical ailments including arthritis and high blood pressure, but otherwise she is healthy.

She is lonely and angry that her husband died and her depression has lower lows than it used to.

She denies any suicidal thoughts, but she often says that she wishes she could join her husband in death.

In the past Roberta has been an excellent cook and had done many crafts, but her depression has kept her from engaging in these activities on her own.