Contemplative Play

As a developmental segue to a new set of parameters in defining health, Erikson, in the 9th Developmental Stage, refers to Gerotranscendence, or the “shift to a meta-perspective, from a materialistic and rational vision to a more cosmic and transcendent one, normally followed by an increase in life-satisfaction” (E & E, 1997. p.124). Margaret Newman, one of nursing’s foremost theorists, defines health as “Expanding consciousness” (Newman, 2002).  Vollman (2008), describes existential wellbeing as a powerful determinant in health, and Bandura refers to the experience of self-efficacy in older adulthood as, “a larger set of human attributes that provide the capacity for becoming a spiritual being” (Bandura, 2003. p 167).

Aging in our culture has largely carried with it the stigma of degeneration and loss of self-efficacy (vs. other cultures, eg. the role of the elder). The question of, “why am I here, with a body that does not work as it did, with a mind that is not as sharp as it was, but with a spirit that is still searching for understanding, connection and meaning?” (Nell, Drew, Klugman & Jones, 2010) – is a universal theme, especially prevalent in Western culture, in which aging is often seen as either a reflective process or one of loss.

Perceptions of effective coping have a significant influence on wellbeing and health outcomes (Vollman, 2008 & Plante, Bandura, Thoresen, 2007). With the introduction of the palliative precepts declared by the National Coalition of the Palliative and End of Life Care, that convened in 1997, we are still standing before the threshold, asking the question of how we may best promote our patients’ experience of comprehensive care, aka, self-determination, in order to uphold our intention, that wishes are to be  valued and respected. How we, as health practitioners, utilize cost effective resources to facilitate patient’s self-efficacy when faced with complex symptoms and decisions regarding goals for care – how we address loss, and transition, as an opportunity to promote self-recognition and self-efficacy, is determinant upon our ability to utilize our most valuable resource:  the patient and their families.

The article, “Intersection between Geriatrics and Palliative Care: A Call for New Research Agenda” (Goldstein & Morrison, 2005), calls for interventional research that promotes, “psychological wellbeing, spiritual wellbeing, and quality of life” (p.1594). In a report by the National Consensus Project: Improving the quality of spiritual care as a dimension of palliative care (2009), concepts defined are, “Assessing the relief of suffering, forgiveness, and meaning in life.” How clinicians assist patients in navigating self-awareness and/or peace when faced with suffering and paradoxical meaning in life, provides implications for intervention-outcome metrics. Said another way, how we may promote psychological and emotional wellness during challenging transitions in acute care settings, longterm care, hospice, and community aging, requires creative approaches to measuring outcomes for the mainstream integration of compassionate and medical care.

CONTEMPLATIVE PLAY AS MEDITATION: PROMOTING RESILIENCE IN AGING