Why do our loved ones resist our efforts to help them stay safe? Every time the phone rings at a strange hour, we wonder if they are ok.
Wouldn’t you resist and fight too?
“Dad won’t use his walker even though he keeps falling.”
“Mom keeps getting angry because dad keeps forgetting things.”
“My wife isn’t eating enough.”
“My husband shouldn’t drive anymore.”
Why do our loved ones resist our efforts to help them stay safe? It is so frustrating to see them take so many unnecessary risks. They seem so defensive. What are they defending?
Dignity, Identity and Independence
Why won’t they do what is so obviously in their best interest? What are they protecting?
They are protecting their dignity, identity, and independence. As family, our challenge is to help them stay safe, while respecting how hard it is to go through this phase of life. Think about the challenges your loved one is experiencing – with mobility or incontinence for example – and how that threatens their dignity. Understand how that contributes to their resistance to what others think is best for them. Imagine if age or illness eroded your sense of self. You worked hard and sacrificed to be the person you are. As you age, however, a gap forms between that identity and your physical and cognitive ability to maintain that identity. We all resist that gap.
How Can We Help Seniors Live with Dignity and Independence?
From the day we’re born we strive for independence. We raise our children to be independent and consider it a sign of our success as parents. We become adults, and after 80 or 90 years most of us become a little dependent (especially during COVID) – on our family – and we often don’t like it.
I see these dynamics with almost every client.
Unfortunately, the most frequent event that precedes a call to us at Caregiver Services Ltd. is a fall: a loved one forgets to use their walker, refuses help in the bathroom, or gets up alone in the middle of the night. It is impossible to prevent all falls, but there are ways to make it more likely they will act more safely:
1. Take it one day at a time.
Focusing on everything that can go wrong never ends and overwhelms. Do what you can to help, when you can.
2. Appreciate your loved one’s need for dignity, identity and independence.
Seek to understand what they are experiencing. Feeling heard makes a big difference in accepting help from others.
3. Recognize that as long as your loved one is legally competent, they make decisions about their life.
Which includes the right to make bad decisions
4. Driving or incorrectly using appliances, can put others at risk.
If you feel they shouldn’t be driving, get their doctor involved. See how you can help them navigate their needs without having to drive as much or at all. Look to eliminate or disconnect appliances if they forget to turn them off.
5. Let the health professionals deliver necessary messages.
Your loved ones are more likely to accept changes in lifestyle if recommendations come from a trusted doctor, nurse or Occupational Therapist, rather than their spouse or child.
6. Have an OT assess your loved one’s functionality and the home safety situation to determine what needs to be addressed.
7. Look for ways to be creative and offer solutions that your relative would be more accepting of.
When my father had mobility issues, he resisted using a walker or scooter. They made him feel diminished. When we went to the cottage, he rarely left the building as the walk to the beach was too difficult. We bought him a used golf cart. The next day he was the King of Kensington, giving people lifts and taking kids for joy rides. When we got back to the city, he started using his scooter.
There are no simple answers to the dilemma of reconciling our loved one’s dignity and safety. Nira Rittenberg, an OT specializing in geriatrics put it perfectly: “I always try to maintain a person’s independence, sense of dignity and function while trying to assess safety issues. Safety and risks cannot be ignored, however, as ultimately a fall will likely lead to less dignity, and independence. This is a process that takes some negotiating and expertise to deal with effectively”. One day at a time.
Dignity, Identity and Independence
I just saw Elton John’s Farewell concert in Toronto. We had great seats, so great, I could see Elton struggle in the dark to climb the stairs to the stage. He is 72 and has been through multiple lifetimes of experience, recent surgery and illness. I bet there is no shortage of people who told him enough is enough, you don’t need to keep touring – or, don’t climb the stairs, we can elevate you onto the stage. He climbed those stairs. He played 3 hours of outstanding music with his classic showmanship. We all fight to be the people we want to be and do the things we want to do. Then, maybe, something happens and we see things differently – and it’s unlikely because someone we love told us to change. It took Elton John prostate cancer, a deadly infection and being a father to see things differently. He did, and decided that this is his last tour – dignity, identity and independence intact.