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Aging: Balancing independence with safety – and who decides?

Jennifer Pass
Discussions with elders about long term living plans can be tricky, but must be done in a compassionate and understanding manner. ADOBE STOCK IMAGE

Jennifer Pass

Special to the Record

Seniors are often anxious about the future. Will I have to move into long-term care? Will I have to give up my independence and move into a “facility?”

The deeper question is, ‘Who makes the decision and on what basis?’

A few years ago I heard a CBC radio interview with a minister, who described a daughter of one of his parishioners meeting with him around concerns for her mother. The daughter asked if he thought her mother should move into care. He responded that she drove to church, related appropriately with other members of the congregation, and he did not see her having any problems that would require a move. He asked the daughter what was triggering her concern. She responded, that her mother had just turned 80.

Certainly, there are situations where adult children need to step in and make arrangements for their parent(s) to have care brought into their home, and if that is insufficient, to have them assessed for long-term care. Or when there are no adult children, siblings may have to step into that role. But how is the subject to be broached and what are the criteria to require the move?

A friend, let’s call her Francis, has no children but has three sisters, two of whom are younger than her. She is 80. Visiting last summer, one sister suggested that she needed to wear an “alert necklace” just in case she had a fall. Suggestions were made about changes in living arrangements. Francis has never had a fall, and understandably felt pressured and annoyed.

There is no magic age to begin the conversations, but begin them we must – as seniors and as adult children (or siblings). But let’s work with some diplomatic starts.

Examples for children and siblings:

“How are you finding living alone – are there any challenges for you?”

“What do you love most about your home?”

“What in your life would be the most difficult to give up if you had to move?”

For elders:

“These are the challenges I am facing and managing right now, but I may not be able to stay here forever. If not, my preferences would be…”

“What I see as a ‘game changer’ in my independence is …so if that happens, what I really would like is …”

Francis is active, still driving, and socially engaged. She also is happy to have some quiet days at home alone, for reflection. If she would have to move, she is concerned on a number of scores. While we talk it is snowing outside and she says that she still likes to clear the snow – a year ago she told her neighbours she would not do this after 80 – so they are now eagerly helping her with it – and although she is 80, she still enjoys doing it.

She has visits from a severely handicapped woman who is comfortable visiting her – would she be able to visit, if Francis had to move? Francis walks locally every day, knows her neighbours, and chats with them; she cannot imagine living in a large facility, where she would not have easy access to the outside and the neighbourhood.

As children and siblings, it is helpful to explore these concerns in a sensitive way. As elders, we need to open the conversations and also self-advocate while we are independent, while we are “doing fine, thank you.”

Our children (or brothers and sisters) often have only our good in their minds. But they may be afraid that we may suffer harm and be ultra-protective of us unnecessarily. We do need to assure them that they are not insurers of our complete safety - just like in their role as parents they need (or needed) to let their children take some risks.

We are not asking for (nor do we want) sterile 100 per cent safety. Work with us while we are competent and the way forward will be clearer.

Jennifer Pass is the co-ordinator of Comox Valley Elders Take Action (ETA)