Options Rather Than Orders: Helping Elders Make Decisions

  • “Why is Dad so stubborn? We only want what’s best for him.”


    “Mom needs to get rid of stuff. She’s going to fall over something.”


    “If Grandpa doesn’t quit driving, he’ll kill himself or someone else.”


    I get questions from readers, about these issues, on a regular basis. It’s frustrating to “know” what is best for an elder, yet have them balk at making any changes. Yet it so often happens that Dad doesn’t want to move to a better house with fewer stairs; Mom resists your efforts to get rid of at least half of her five hundred boxes of the jigsaw puzzles that crowd her hallway, making it unsafe. And Grandpa’s driving. Well, giving up the keys is long overdue.

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    Most of these seniors, if they were able to step back and view the situation dispassionately, would agree that changes need to be made. However, caregivers also have to step back and look at what they are asking.


    Aging takes away many things without our consent:  eyes weaken, hearing diminishes, joints give us problems. Even those elders who don’t have these problems, and those that have taken very good care of their bodies and minds, usually find some slowing down occurs. Most people, as they age, also find that retrieval of information stored in memory takes longer than it used to and it’s easier to forget things.


    Think about these losses. Think about your eyes growing so weak that you can’t – even with corrective lenses – read your favorite books. Think of your hearing so diminished that you need hearing aids. Good as today’s models are, the sound of a grandchild’s voice is not as natural as it would be with “two good ears.” Think about feeling pain every time you tie your shoe. Of having to tell your wife that you can’t help her lift the grocery sacks, because of your back problems. Incidences like these are keenly felt as losses by most elders.


    After awhile, enough is enough! People, understandably, start looking for something they can control. This is where poor decisions are often made.


    Dad will say, “I like it here. I’m not moving.” He may not like it all that much, but he fears the change a move will bring, and even more, he resents being told that he has to do this.


    Mom may feel overwhelmed by all the stuff piling up in the house. But, when she’s told she has to throw things out “for her own safety,” they are no longer just things. She feels one more loss of control – that of what she keeps or throws away.


    Then, of course, there is driving cessation. Elders driving beyond when they are physically and mentally capable of safe driving must be stopped. However, giving up driving is one of the biggest losses elders incur. Driving symbolizes independence to many. No car, no independence. It’s that simple.


    So what does a caregiver do? It’s never easy, but if possible, give the elder options.


     “Dad, do you want to hire someone to put a bathroom on the main floor so you don’t have to climb so much?”


    “Mom, can we store some of these puzzles in my basement or give them to charity?”

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    Driving? That’s the toughest. But, if you can locate a program that is available in many community hospitals, where they examine the physical and mental states of an elder and actually have him or her drive with a trainer – if you can do that, you will have some answers, and ammunition, should you need it. If you don’t have that option, you may have to bring in the help of your parent’s physician and/or the driver’s license people. You’ll likely need some kind of reinforcements.


    It helps us, the caregiver, keep frustration at a lower level if we can remember how much the elder has already had to give up; if we can be aware of his or her losses; if we can, whenever possible, ask rather than tell; give options rather than orders.



    To learn more about Carol, please go to www.mindingourelders.com or www.mindingoureldersblogs.com.

Published On: April 10, 2007