When I was a child, I was often reminded “children should be seen and not heard.”  I believe that profound piece of social correction came from my great-grandmother’s Victorian era, passed on to my father.   Though he was kind, he was much older than most of my peers’ parents, and perhaps less tolerant of excessive noise and fidgeting.  His message was clear:  “Be invisible.  Don’t speak for your needs, don’t contradict your parents, don’t whine, don’t interrupt.  What adults are talking about is important.”

It troubles me that this same correction seems to be the social standard for Elders, as well, to be “Seen and not heard” and fosters myths about their plight.  “Don’t ask for help, no one will come.” “Don’t complain, there’s nothing you can do about your situation anyway.”  “Don’t contradict your doctor, because s/he knows best.”  “Don’t talk of pain, or loss, or fears, because you don’t want to be a burden and no one wants to hear it.” 

My work with seniors suffering from depression and anxiety, validates my awareness that unspoken concerns create the foundation for emotional health problems, even in those who never suffered them in younger years.  Some Elders, when they feel they have lost their voice, become withdrawn and isolate from family and friends.  They don’t feel good, and don’t want anyone to know about it.  Others react out of anger, a last ditch effort to show they still have power.  They take pain and make it mean something, not always in a proactive or productive manner.  Many hopeless or powerless Elders use “no” or refusal as a way to show they still have some of what makes them “them” left. 

Somewhere in our cultural dialogue, honestly sharing fears, hurts and losses translates to becoming a burden, and it is time to write a new story.  Rarely do I hear adult children speak of their parent’s ills as burdensome.  They voice concern, they want their parents to be comfortable, content and relaxed as they move through their days.  It is the Elder generation that walls up against sharing, as if through some externally imposed sense of shame, do not have cultural permission to reveal what is really happening with them.  Denial and minimizing are dangerously common issues, and one I faced with my own mother even though I had the therapeutic communication and nursing education to try and draw her out.  Her lack of sharing brought many trips to the local emergency department for crisis management, when had we gotten more honest information earlier, might have been resolved with a simple office call and medication adjustment. 

Our situation was in no means unique.  I have the benefit of working with a dozen or so highly functional, independently living albeit clinically depressed Elders every day.  The denial and avoidance of shame for becoming a recipient of care and attention instead of the provider is the daily norm. Emotional health dictates that we speak our truth and our needs, at every age, because unspoken feelings fester, resentments develop and once strong and capable adults begin to see themselves as victims of aging.  Too often I have people tell me they wonder why they must still wake up in the morning (which is passive suicidal ideation).  Sharing one’s fears, limitations or needs is often confused with relinquishing autonomy, but can be vitally important for safety and comfort.