Cumulative trauma: The intersection between continuous security threats and the COVID-19 pandemic among Israeli older adults.

INTRODUCTION: Research on cumulative traumatic events and their consequences for older adults have yielded inconclusive findings, especially when the traumatic events are different types of events and happen simultaneously. OBJECTIVE: To explore older adults' perceptions of cumulative trauma, specifically exposure to continuous security threats via living in a war zone and COVID-19. METHOD: Seventeen in-depth, open-ended, and semistructured interviews were conducted with older adults living near Israel's border with Gaza. We used ATLAS.ti software to perform thematic analysis. RESULTS: Various perceptions of continuous security-related stress and COVID-19, indicative of categorical differences in the perceptions of the two, were found. Namely, the characteristics, difficulties, and emotions that accompanied each of the two abovementioned traumas revealed three trajectories: negative cumulative; positive cumulative; and unrelated. CONCLUSIONS: We suggest conceptualizing cumulative trauma responses as an intersecting trajectory model, between the effects of previous traumatic events and those of the current one, reflecting a combination of individuals' resilience and vulnerability. Suitable policies/practices in which each specific traumatic event is seen alone, as well as in tandem with others, should be implemented. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The second empty nest: The lived experience of older women whose intensive 'grandmotherhood' has ended.

Grandmothers are the major nonparental unpaid source of childcare in Western societies. Intensive caring for grandchildren may pose challenges to some grandmothers, but also offers an opportunity to refill the 'empty nest' often experienced in mid-life. When grandmothers' intensive involvement in their grandchildren's care decreases significantly or ceases altogether, they may experience a recurrence of the empty nest syndrome. This may be particularly powerful in the familial and pro-natalist Israeli society, where caring for children is a central tenet of femininity. Despite the growing numbers of grandmothers whose intensive involvement in caring for their grandchildren has ended, this transition has been overlooked socially and rarely examined empirically. To fill this void, the present study examined the lived experience of these grandmothers and the relevance of the concept of the 'second empty nest' in this context. Within a phenomenological study, in-depth interviews were conducted with 11 Israeli women whose intensive 'grandmotherhood' (childcare occurring at least three times per week, for at least two hours each day, for a minimum of two years) has ended. These interviews were analyzed according to Moustakas' phenomenological analysis. The analysis revealed four themes: the circumstances of the cessation of intensive childcare involvement; difficulties and challenges experienced; positive aspects associated with it; and behavioral and cognitive strategies utilized to cope with the void in grandmothers' lives. The grandmothers' experiences reveal a significant similarity to that reported by mothers undergoing the empty nest syndrome. Hence, we offer the term 'the second empty nest' to represent the phenomenon of grandmothers' cessation of intensive childcare. Alongside the similarities between the two empty nests, the challenges of the second transition seem more intense than those posed by the first. This is due to the different locations of mothers and grandmothers across the lifespan and the intersection between sexism and ageism that underlies Western societies. Possible practices to assist grandmothers undergoing the second empty nest are suggested.

Dignity in Action in the Home Hospice: The Narrative Selection of a Multidisciplinary Staff.

Home hospice (HH) is a palliative care framework that is becoming more and more common in Western countries. HH staff face unique challenges, resulting mainly from their multiple clients and the provision of care in a private territory. Despite the recognized role of professionals in preserving end-of-life (EOL) dignity, how HH staff conceive of EOL dignity has remained unexplored. To fill this lacuna, we invited the multidisciplinary staff of an Israeli HH to recount unguided narratives of dignity and indignity in the HH. We analyzed the mechanisms of narrative selection in each story and in the entire dataset, particularly regarding two dimensions of dignity: situation-whether the recounted cases present dignity, indignity, or both; and relations-who provides (in)dignity to whom. The analysis revealed four interconnected end-points: HH is a dignity-providing framework; HH staff provide and promote dignity; HH dignity as relations and communication; and HH dignity as a holistic process whose boundaries are expanded and blurred, both spatially and temporally. The differences between these and other findings on healthcare professionals' perspectives of EOL dignity highlight the uniqueness of HH staff, and possibly the distinctiveness of the Israeli case with its traditional familial values. Importantly, the findings were generated due to the narrative paradigm guiding the study. The unique attributes of the narrative text enabled us to capture the dynamic temporal nature of dignity-in-action, as embedded in the staff's daily practice. Implications for training professionals to preserve EOL dignity in HH and other EOL care frameworks are discussed.

Alone in the shadow of terror: Strategies and internal resources of older adults living alone in a continuous traumatic situation.

Continuous traumatic situations (CTS) caused by prolonged exposure to terrorist threat can harm individuals' mental and physical health. For older adults living alone in CTS, this risk joins the challenges of aging and loneliness, creating a triple vulnerability. No previous research has explored this particular vulnerability and specifically addressed the coping strategies and internal resources used by older adults to manage these stressful circumstances. The present study aimed to fill this lacuna, by exploring how older adults living alone in CTS cope with these challenges and the internal resources that help them do so. In-depth interviews with 15 persons aged 65 + years living alone in Sderot, an Israeli city exposed to a continuous terror threat, were conducted and analyzed thematically. Participants described various coping strategies. Some are deployed at the psychological level: positive thinking, deliberate disengagement, perception of being alone as an advantage, and social comparison; others have behavioral implications: acknowledging reality and dealing with it and "turning it into an engine." Participants also identified four internal resources that helped them cope: functional independence, faith, character traits, and previous experience with stressful life events. Participants coped with the difficulties of living alone in CTS actively and creatively, relying on various psychological and functional resources. The findings support theories that emphasize older adults' resilience and ability to cope with stress and trauma, suggesting ways to strengthen the resilience of older adults facing CTS, particularly those living alone. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Three strategies for doing narrative resistance: Navigating between master narratives.

Narrative psychology emphasizes the role of culture in shaping identities. Less attention has been paid to how individuals resist culture. Specifically, two aspects have remained understudied: the diverse forms of doing narrative resistance and the navigation between different types of master narratives involved in the process. The present study aimed to fill these gaps by examining the personal stories of former residents of Yamit, an Israeli region in the Sinai Peninsula that was evacuated following the peace agreement between Israel and Egypt. Holistic narrative analysis of the personal stories revealed three strategies of resisting the episodic master narrative of Yamit established in Israeli society - explicit debate, implicit debate, and neutralization - which differ in the relative weight of my/our story and the story about us. To remain within the Israeli consensus, resistance to the episodic master narrative was intertwined with appropriation of the Zionist foundational master narrative. The study demonstrates that narrative resistance can take diverse forms and simultaneously involve compliance with and resistance to different types of master narratives. Investigating these two findings offers a nuanced understanding of counter-narratives as multifaceted, illuminating the complex relationships between personal stories and culture.

Narrative research on mental health recovery: two sister paradigms.

BACKGROUND: Despite the breadth of narrative studies on individuals with severe mental illness, the suitability of narrative inquiry to exploring mental health recovery (MHR) has not been examined. AIMS: (1) Examining the appropriateness of narrative inquiry to studying MHR; (2) assessing the extent to which narrative studies on MHR conform to the unique features of narrative research, as a distinctive form of qualitative inquiry. METHODS: Review of empirical, theoretical and methodological literature on recovery and narrative inquiry. RESULTS: Considering the perspectives of recovery and narrative as paradigms, the similarity between their ontology and epistemology is shown, evident in 10 common emphases: meaning, identity, change and development, agency, holism, culture, uniqueness, context, language and giving voice. The resemblance between these "sister" paradigms makes narrative methodology especially fruitful for accessing the experiences of individuals in recovery. Reviewing narrative studies on MHR suggests that, currently, narrative research's uniqueness, centered on the holistic principle, is blurred on the philosophical, methodological and textual levels. CONCLUSIONS: Well-established narrative research has major implications for practice and policy in recovery-oriented mental health care. The narrative inquiry paradigm offers a possible path to enhancing the distinctive virtues of this research, realizing its potential in understanding and promoting MHR.