Column 9- Self-rule, A Life-Saving Act?



As we reflect on caring for our children, grandchildren or others, do we see the development of hope within their lives as something important? Hope can also be described as faith, confidence and courage, among other words. When I think of contributing to another person’s life, I expect that I am providing some hope in their life. My goal is to contribute to their confidence, however, I could be too helpful and take away some of their self-reliance by doing too much for them. It does not mean I am any less caring. There could be times when stepping in to take on more functions within their lives may be needed, however, we really need to be careful. I will share with you something that has become clearer and clearer to me over the years. Teaching and encouraging will help much more than a warning and doing for someone. This takes on a clear meaning when we are caring for older people in our lives. Choice and input into how a person wishes to spend their days are very important.
What a difficult line we walk when we see someone spending their days in a way that we do not see as good for them. What happens when they choose to take part in different activities than they used to? What if we believe they are being taken over by an illness? Research has shown us that even though a person may need a great deal of care, they still need to be able to make decisions that affect their lives. We can actually do more harm than good to a person if we take over their decision making. A person needs to feel some control over their lives in order to feel satisfied with their life. If all decisions are being made for them, and things being done to them, research has shown that people living with this higher constraint in their lives are less satisfied and in poorer health.
As we age we may have many changes contribute to us losing control. We may lose our ability to walk freely, and we then get back our control through the use of walking aids or perhaps getting a wheelchair in order to give us some control again. Perhaps some people would see using a walking aid as a constraint, I prefer to see it as a tool to keep us more independent. Beyond physical losses, we usually have financial losses that affect us as well, although some people experience more financial freedom as they age because they receive a regular income that they may not have had when they were younger. A loss that I dread is the day that I can no longer safely drive. The loss of being able to independently get behind the wheel and head off somewhere or nowhere is a massive loss, especially to those who have driven all their lives. Another huge loss that many people have to deal with is moving from their home into a care facility. This move can often be a huge blessing as well, however that does not negate the fact that the person is dealing with another loss.
Believe it or not, there are many services and opportunities that are aimed at ensuring people have autonomy in their lives. Home care services are in place to support people to remain in their homes with their belongings, memories and surroundings that are important to them, for as long as that is possible. Policies are in place in the long term care homes to have avenues like Resident Councils available for people to be able to express their opinions in ways that they can be considered when supports, care and programs are being planned. A great number of studies have taken place over the 40+ years that have influenced these great practices. For example, some studies compared situations where the older population had very little say in what activities they took part into those who had more control over what activities they took part. The results consistently showed that the less control the people had, the more negative effects on their emotional status, their functioning, personal well-being and on their physical health.
So what does this all mean? To me, this is a very important concept for all of us to understand because it is something that affects all of us. Think about yourselves, when you feel like you have no control over aspects of your life, how do you feel? I am guessing it is not positive. The truth is we will all need to deal with the stuff life throws at us that we will not have control over, yet if we maintain control over those parts of our lives that we can, it will benefit our health and lives as we age. I see taking away choice just because I am older is a form of ageism, discrimination because of age. I challenge each of us, myself included to observe more deeply how we can and do encourage autonomy for our older population. When we come up short, let’s work together to find a better way. It will benefit all of us. Hope is courage and courage gives us the chance to make our own decisions for as long as we can.

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