Create Circles: Lessons Learned about Elderly Care and Social Engagement

Copyright free photo from Andrea Piacquadio

Note: The name of the woman described in this article has been changed to protect her privacy.

“… and that’s the story of how I met the President!” Martha concluded her story with a flourish. I laughed, amazed at Martha’s boundless imagination and creativity in her storytelling. Despite struggling with dementia for several years, Martha never failed to surprise me with her (often made-up) stories and nuggets of wisdom from throughout her life.

I visited Martha’s nursing home as a volunteer for Create Circles, a non-profit organization dedicated to addressing common challenges faced by older adult populations, such as social isolation, negative aging and cognitive decay. One of Create Circles’ primary goals is developing projects with the home’s residents to promote a sense of purpose. According to a 2018 study, a purpose of life (PIL) “is conceptualized as having goals, a sense of direction, and a feeling that there is meaning to present and past life.” The study also found that having a PIL is associated with positive health outcomes like fewer chronic conditions and reduced mortality

Social isolation and negative stigma are also prevalent problems among older adults. The former has been shown to increase risk for heart disease, cognitive decline, obesity and other health conditions, while negative stigma surrounding aging has been linked to increased rates of physical and mental decline. The prevalence and consequences of these issues make addressing them integral to Create Circles’ mission. I had previously been unaware of these unique problems affecting older populations, but I became fascinated with them and the measures being taken to support such individuals. I began volunteering at a nursing home which specializes in patients with various forms of dementia during my first semester of freshman year. 

I began my first visit to the nursing home with wracked nerves, nervous that I was unprepared to engage with a dementia patient – that I would somehow mess up. Meeting Martha assuaged some of these initial worries, as she greeted me warmly and welcomed me graciously to the home. After we sat down for our first discussion, I soon noticed that Martha spoke in circles, often repeating things she had said a few minutes earlier and forgetting my words just as quickly. Despite my training, I initially struggled to navigate the conversation, unsure of how to reach through to Martha when it seemed like nothing we discussed stuck. The meeting began to feel more and more disjointed, with long periods of silence punctuating short, awkward exchanges. 

Fortunately, Martha’s daughter visited the home soon after I arrived, and her presence proved invaluable in facilitating our conversation. Even when Martha struggled to remember facts like how many children she had, her daughter responded with warmth and patience, gently reminding Martha of her children and anything else she would forget. What struck me most was how the daughter went with the flow of Martha’s repetitive and false statements, how confident and animated Martha became as she spoke with increasing excitement and energy. As I began to imitate this approach, I found myself engaging with Martha more meaningfully, even after her daughter left early to attend to another commitment. By the time my session with Martha came to end, I felt more confident in my ability to converse with her and looked forward to my next visit. 

My second trip to the home got off to a much smoother start as Martha and I built on the rapport from the previous visit, even though I had to remind her a few times about the last time we had met. Martha launched into conversation and I was enthralled in her story. My mentor told me that Martha was known for telling fantastic stories, but I didn’t realize just how imaginative she could be. When she wasn’t spinning tales about meeting the President and traveling to far-off exotic lands, Martha shared insights and lessons from her decades of living in St. Louis, telling me about her favorite locales and giving me advice about exploring the city. This visit went by in a blur and I realized that Martha’s penchant for stories could make for a perfect collaborative project. Having learned so much from Martha, I decided that sharing her stories online would be a great way to promote a PIL.

I wasn’t able to return to the home for almost a month after this visit, however, due to an increased academic workload and continued transition to college. When I finally proposed my idea to Martha during my third visit, she responded very enthusiastically. We chatted animatedly about different websites where I could post her content as well as potential stories to share. As we talked, I noticed how Martha was more engaged and animated than during our previous visits. The prospect of this storytelling project had sparked a greater excitement in her as she found a new goal to apply her passion towards. I found myself feeling just as invested in the project as well and I left the nursing home that day in high spirits and eager to resume work with Martha.

Near the end of the semester, I met with the other Create Circles volunteers for an additional training session with two administrators from the nursing home. The administrators taught us more about the history of the home as well as more specifics on how to interact with dementia patients. The meeting was going well, and in one of my conversations with an administrator, I asked her, “By the way, how’s Martha? I haven’t been back to the home in a while.”

The administrator exchanged a look with her partner, then carefully said, “I’m sorry… but Martha passed away a few weeks ago. She was struggling with a lot of health complications, and, well…” 

Her words hit me like a truck, stunning me into silence. The rest of the day passed in a blur as my mind replayed the conversations and moments I had shared with Martha. It surprised me how much I could be affected by the death of someone I had only spoken with three times. As I thought about the exciting project plans Martha and I had made, I found myself grieving not just Martha, but her lost opportunity to share her wonderful voice with the world. 

As time passed, I learned to not only to grieve, but to reflect fondly on the times I spoke with Martha and the personal lessons our work imparted upon me. As an aspiring physician, I came into college focused on learning how to treat people’s illnesses and promote healthier, longer lives. Working with Create Circles and speaking with Martha helped me develop a greater appreciation for how focused engagement with the elderly can prevent cognitive decline and encourage a more positive, purposeful life. While I continue my studies and path towards medicine, I now understand better than ever the value of care beyond the clinic and the importance of community engagement in promoting positive physical and mental health outcomes. With the increased social distancing policies implemented to combat the spread of the recent COVID-19 outbreak, it has become more important than ever for people to engage with older adults who have lost their support systems, as increased socialization is associated with lower rates of depression, cognitive decline, and physical disability. It has been inspiring to see that, even amidst an unprecedented global pandemic, Create Circles is still training volunteers to hold online visits with the elderly and prevent the negative effects of social isolation. 

Although it hurts knowing I’ll never speak with Martha again, I remain inspired by her creativity and, although I can never know for sure, I like to think that speaking with her and helping her develop her project had a positive impact on her life. My experience with Create Circles helped me develop a deeper appreciation for the unique challenges faced by our aging population, and how active engagement can help combat the social isolation, negative stigma, and loss of PIL associated with aging. I will always remember the joy Martha exuded while sharing her fantastic stories, and I intend to apply the lessons I learned from Create Circles and emulate Martha’s infectious energy in all aspects of my life. 

For those interested in getting involved with Create Circles’ virtual engagement, please visit learn more.

Written by: Ryan Chang
Edited by: Isaac Mordukhovich

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