May 18th, 2013 | By | Category: Senior Moments Blog

How Are Decisions Made in Caregiving?

Caregiving for elderly loved ones carries some inherent understandings of how day-to-day activity is managed. For the most part, decisions and choices that affect the life of the elder needs to remain in her/his hands. For the most part… so what are the exceptions?

Based on our six-month experience, these are some guidelines that make sense:

  • Decisions about simple things like what the elder is going to wear are left up to her/him… except… except when she wants to put on a long flowing skirt that now comes to the floor and would likely get entangled in her legs and cause her to fall. Mother was still mobile the first three or four months of caregiving. She used a walker. One day she wanted to wear a long-to-the-floor heavily gathered skirt. It was a safety issue that she could not comprehend but she insisted on wearing it. I gave in, and within an hour of dressing, it was badly soiled from her incontinence. I hadn’t even thought of that issue because she was such a high fall risk that that falling seemed to overrun all the other concerns. That was the last time she wore that skirt. The closer we got to her total dependence on us, the more she gave in to my statement, “Let’s pick out something that is easy to get on and off and easy to wash.”
  • Many elderly loved ones receiving family care want to be helpful and do as much as they choose, or should I say, as much as they think they can do. This is a daily challenge for the caregiver. Many of the things Mother wanted to do increased her risk of falling… scooping the doggie pooh in the back yard, folding and putting away clothing, helping prepare meals, helping clean up after meals and do dishes, making her bed. All these activities were particularly dangerous for her in our living situation. For example, there is one path around an island in our kitchen, and only enough space for one person to work. She fell about every other day for the first 10 weeks into caregiving. And she generally was attempting to do something that with good judgment and appropriate problem solving, she would have chosen not to do. The challenge for us was to try to help her understand why her desires were not safe, and when that didn’t work, to say No and help divert her attention to something else. It was a constant and daily challenge. It never stopped until she was bedridden.
  • The elder needs to be able to choose their route to death. We’re not talking about suicide or self-euthanasia; that is another topic entirely. The issue we’re raising here is the elderly loved one you are caring for has the right to tell you they do not want to take medication any longer. They have the right to refuse food and water. The day comes in the lives of many care receivers when they are tired and do not want to live any longer. As difficult as that is for us caregivers, we need to respect their choices. In our case, we made sure the primary care physician and Hospice team were notified and in agreement. Mother decided to stop taking her medications. Forty-two days later, she died. She had the right to make the choices she made, and it was our place to love her, support her and keep her comfortable.

Caregiving has many challenges and most of them are difficult ones. Sharing experiences among those of us who become caregivers is supportive and emotionally necessary. A good resource we recently discovered is UnitedHealthCare’s Solutions for Caregivers service. This is only one of many available on the Internet. Just enter ‘caregiving’ in your search box, and a gazillion helpful resources will be available to you.

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