How Can Older People be in Control of Decision Making About Their Care and Support Needs?

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When a person begins to age, life changes. We all want to pretend that this is never going to happen to us, but the fact remains that life means birth, the middle part, ageing, and then death. This is the cycle that keeps everything in balance. Despite that, it is never easy seeing someone you care about ageing and losing the ability to look after themselves the way they always used to.

In many ways, the tables turn. Your parents look after you when you are small, raise you and teach you how to do things, and when your parents become elderly, you need to start to look after them. It can be tough for many to deal with, but it is a fact of life for a large proportion of people.

The plus point of today’s society is that we have a range of care and support options for elderly people, and we recognise the vital importance of dignity and decision making support. Gone are the days when there was only one option – a care home. Many elderly people do not want to leave their own homes, and they do not want to go into a care home. In some cases this can’t be avoided, but the process in terms of making that decision and making the move needs to be done in a certain way, i.e. sensitively and with the consent of the person, throughout the decision making process.

The following options are the most common when it comes to elderly care and support:

  • In-home care, e.g. a care worker visits the home several times per week, or even daily, to provide support in every day tasks, e.g. cleaning, bathing, preparing and cooking meals, taking medications on time, and general household chores
  • Living with a family member
  • Living in a care home

It’s important to note that not every elderly person will need support the moment they begin to age! There are many elderly people in society who are living very well and very happily on their own or with a partner and they are perfectly able to perform all the tasks they need to perform, without requiring help. Whilst the is the situation, great, life is perfect, but when help is required, it is vital to make the right decision, and it is extremely vital that the person it pertains to is part of the decision making process, therefore making the final choice.

A Difficult Decision

Most elderly people do not want to face up to the fact that they may need a little help or support to continue on with their daily tasks. Think about this from another side – if the shoe was on the other foot, would you want to admit that you needed help after living a life of pride and dignity for so long? Of course not. You would want to continue on for as long as you possibly could, probably not owning up when you needed a little extra support.

This mindset is what causes many problems. Pride comes before a fall, this is something we have all heard. When a person begins to show signs of needing support, it is up to those close to them to deal with the situation sensitively and calmly. A decision needs to be made in terms of what type of care, the level of care, etc, but it needs to be done in a way which is open, easy to understand, and honest on all sides.

Encouraging an elderly person to get help and support when they need it is about control. The person needs to be in control of the decision and they need to have all the information around them in order to make the best choice for them. They need to feel supported and they need to feel that they are respected, and that their dignity remains in place. The ageing process robs us of so many things in life, and dignity should not be one of them. This is a person which has lived through countless events in life, they deserve respect at all times, including when maybe they can’t do the same amount of things for themselves anymore.

How to Help an Elderly Person be in Control of Care Decisions

When an elderly person is in control of their care decisions, they are more likely to make positive, helpful choices. When they feel their dignity is being taken away from them, that they are being told what to do, and that their confidence is declining as a result, they are far more likely to close down, refuse to do anything, and end up isolating themselves from those who love and care for them. It is all about the way you approach a decision, but also about the way you approach the entire conversation.

There are six areas which need to be considered. Let’s discuss each one in turn.

Take The Time to Discuss and Understand The Situation

In order to have an informed and positive discussion prior to a decision being made, you need to be fully informed and fully understand the situation. Talk to your elderly loved one and ascertain the facts. What can they do easily? What can’t they do at all? What do they struggle with? How do they feel about everything? Listen and take it all on board. You cannot help your loved one with their decisions if you don’t know how they feel deep down and what they are struggling with. It’s likely that they have no issues with some things, but they struggle with others. Knowing the scope is vital.

Once you know the situation as well as your elderly loved one, you can sit and have an open and frank discussion. As your loved one whether they feel they might need a little help and support, and the level they think they might need. Remember, many elderly people are very proud and may even tell you they don’t need anything. In that case, never shout or talk down to them, acknowledge what they are saying and take it all on board.

The fact that you are fully in possession of the facts and what is going on can help you to support your loved one to make the right choice. Remember, at the end of the day, while ever they are able to make a decision, it has to be theirs to make.

Always Treat Your Loved One With Dignity, And as an Equal

We’ve touched on this already but never ever talk down to your loved one or make them feel anything less than your equal. Remember, this person is older than you, they have lived through things you can’t imagine and it’s likely that at some time they cared for you and looked after you when you were young. They deserve your utmost respect, and do not deserve to be talked down to or disrespected. You may think you’re not doing anything wrong, but always consider how you would feel in their situation, and act accordingly.

By treating your loved one in this way, you are giving them confidence to make the right choice. Discuss the options, and do not try and sway them either way. Even if you do not agree with a choice, put it on the table for them to think about. It has to be their choice, and all you can do is offer your opinion in the end. By doing this, you are giving them control and giving them confidence to choose correctly.

Empower Your Loved One With Easy to Understand Information

Handing your loved one leaflets packed with confusing jargon is not going to help them be in control of their decisions about care, and it is probably going to scare them or make them even more worried or upset about what they are facing.

Care and support options are meant to be there to give confidence to a person, to allow them to continue living their life the way they want to for as long as possible. These options are not there to strike fear into the heart of anyone. Information which is loaded with jargon and difficult to understand phrases will simply make the whole experience fearful and troubling. In that case, your loved one is more likely to close down and refuse help at all.

Look for literature or websites which are interactive, informative, and positive. Keep it as light-hearted as possible, and you will encourage your loved one to read up on all their options. Again, by being well-informed, the best decision can be made.

Never Have Conversations About Care And Support Without Them

Every conversation you have about care and support choices should be made with your loved one in attendance. You would not like it if someone was making decisions for you behind your back, so do not do this to your loved one! It’s perfectly fine to have a chat about how things are going with a partner, but never give information to anyone outside of that circle, and never talk to any professionals about choices without your loved one being aware of it.

The decision at the end of it all is theirs to make, and if they feel you are talking behind them about what is going to happen, they will lose confidence, and they will not feel in control of anything. In this case, you’re not empowering them to make a positive and useful choice.

There is a lot of evidence which suggests trust between the person making the decision and those around them plays a huge part in a positive choice. Do not break that bond of trust, and you will give control and empowerment to your loved one.

Never Simply Assume That Someone Isn’t Able to Make a Choice

It can be very easy to simply assume that your loved one lacks the mental capacity to make a solid choice, and is therefore going to decide on something which isn’t necessarily right for them. This isn’t your place. You should always assume that they are able to make that decision, until proven otherwise medically.

Older people tend to go more towards how they feel in their gut, rather than facts. This doesn’t mean they aren’t able to make a decision based on that, and in some cases it can lead to better choices overall. Of course, making a firm decision on the care of an elderly person does tend to be a multi-agency process, e.g. it can become complex if they have several health care professionals already involved in their lives. Despite that, the final decision is theirs until they actually lack the ability to know what is best for them – that is something only a doctor can decide.

Keep Conversations Light

Another way to empower a loved one to make a decision based on their support and care is to avoid heavy conversations. Nobody wants to be bombarded with information and heavy talks about what is going to happen if this occurs, or if that occurs. Make sure that you mix up conversations between care and support, and more light-hearted things. Focusing too much on the decision that needs to be made is going to cause stress and upset, and that does not give control to anyone.

At the end of the day, provided your loved one has the mental capacity to make a decision, they need to be the ones who have the final choice. Their wishes need to be respected, and their dignity needs to remain intact at all times. Taking any of that away from them also removes the control they need to make the right decision in the end.

Someone who feels ignored, disrespected and does not trust those around them will make a poor decision, or no decision at all. In terms of quality care, there are many options on the table, but it has to be your loved one that chooses.