Welcome to the fourth installment in a series of blog posts on The Eden Alternative Domains of Well-Being(TM). Read more about these domains by clicking HERE!
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My first job working with Elders was as “social services designee” in a nursing home in 1983. I learned many lessons from the Elders there, and many from older, wiser, and more experienced colleagues.
One lesson in particular is really burned into my memory.
I must have been in an Elder’s room with one of the nurses, or maybe we were out in the hallway. She took me aside and told me that even if the only decision a person living with frailty or dementia could make was how they wanted their toast cut, it was important to always offer choice.
She said it was about ensuring that a person has “autonomy,” necessary to preserving human dignity.
Wow.
It might sound like a small thing, but that lesson really made an impact on me.
Autonomy is one of the domains of well-being, as described by The Eden Alternative. We have a human need to have choice, to know that we have some control over our lives.
Throughout my career I’ve tried to tune in to how physical or cognitive changes might narrow our choices.
If our ability to drive safely is compromised, “taking away the car keys” can be painful and humiliating for Elders and family alike.
It can be a challenge to find the choice in that situation, when something so essential to our independence feels threatened.
How we talk about these difficult decisions can make all the difference. We need to think about how we recognize the need for autonomy, and then work to fulfill it.
In the case of making a different decision about transportation, we must offer as many choices as possible under the circumstances. In our community, we have a bus service for Elders, and also a volunteer driver program. Offering the Elder their preference won’t completely “fix” the loss of one’s own car, but at least it preserves the opportunity to choose for oneself from the possible options.
Autonomy also means that Elders, or the people who receive services from an organization or live in a community, should have a say in how they experience services, or in how their home is operated.
Does your local home care agency have Elders on the team that interviews applicants for staff positions? Why-ever not!?!
We can also preserve choice by thinking about health care decision-making and choosing someone to speak for you when you cannot speak for yourself. This is a powerful way to ensure your preferences are honored, your voice is heard.
I wrote about this a few years ago; you can check out my blog on planning for future health care by clicking HERE.
Person-directed care doesn’t mean that we can offer any and all choices, regardless of the consequences. It does mean we look at realistic parameters, confer with the person who is most affected by changes, and find ways to offer the dignity of choice.
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Do you have stories about how you’ve been able to preserve choice, even when options have become limited? This can be a tricky area, so sharing what’s worked in your circumstance can be extremely helpful to others!
Perhaps you’re struggling with this now. Please let us know what issues are challenging you, and we’ll invite the community to share stories that may help!
Please share your thoughts in the comment section below.
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Lisa Kendall supports well-being in her work with Elders and their family members, as well as with professional care partners. She is an Educator and Mentor for The Eden Alternative, and has a private counseling and consulting practice in Ithaca, NY.
You can reach Lisa at (607) 351-1313, or via email at crossroadscounseling@hotmail.com
