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"Come on Dad, put your shoes
on, we're going to be late!" The busy business
woman/daughter/caregiver exhorted her father as
I eavesdropped from a distance. The father
glanced at her slyly from the corner of his eye
as he continued to fumble with his shoe.
Exasperated, she bent down and swiftly tied the
shoe. "OK, Dad, pick your feet up, let's go!"
Dad kept his feet firmly planted on the floor in
front of his wheelchair.
Noticing that I was watching, the daughter
looked at me and stated emphatically, "It's a
control issue."
"Yup," I thought. "It's a control issue, all
right. But who's controlling who?"
Independence
and Control
in Caregiving
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As caregivers, we often get
caught up in what we think are the urgent needs
of the moment, and we lose sight of the fact
that there are two people dancing this
caregiving waltz. One may be more "able" than
the other, but both have the very basic need to
stay in control and independent. Where problems
arise is when my need to be in control as a
caregiver gets in the way of my care recipient's
need to keep whatever control he or she might
have left.
As humans, we are hard-wired to seek
independence...or "autonomy," as the
psychologists like to call it. The toddler
resists being put down for a nap. The
six-year-old shouts, "You're not the boss of
me!!!" The adolescent counts the days to
"freedom." Each important independence milestone
is hard-won.
Small wonder, then, that the octogenarian is not
likely to relish losing a lifetime of
independence. Couple that need for independence
with the obvious fact that our care recipients
are not completely independent any more, and you
have a recipe for resistance.
Now throw in the fact that we caregivers are
often overwhelmed and strapped for time. We're
sometimes an impatient lot. The recipe for
resistance just doubled.
As caregivers, the most important thing for us
to understand in this dance is we're the ones
who are going to have to make adjustments. And
the biggest and most difficult adjustment we're
going to have to make is to SLOW DOWN. We'll get
there faster if we do.
Our older loved ones simply cannot move as
quickly as we do. They may need a few minutes to
digest what we're asking them to do. If they
have physical issues, they then have to muster
the energy to move. It may take a few minutes to
locate the sweater, or comb the hair. If the
issue is dementia, it may be difficult for our
loved one to remember what we just asked them to
do. Whatever the reason, it takes longer to get
things done when you're elderly and not in the
best of health.
Think about your own reaction when someone tries
to rush you. Assuming the house isn't on fire, I
know that my immediate reaction will be to get
irritated and drag my feet. I don't like being
"bossed around," and the old three-year-old in
me resurfaces. I'll skip the tantrum (most
times), but I'll try to take back control by
going into slow motion. Usually I can recognize
what I'm doing and make a conscious decision
whether I want to give in, or whether I want to
push back. Sometimes it just "happens," and
that's when things can escalate.
Our care recipients often lack insight. They
will react to the tension in our voices, and the
attitude of our bodies, even when they don't
grasp why they are reacting. It's our job as
caregivers to learn what the triggers are for
resistance and to plan accordingly.
Expect that everything you do with your older
loved one will take longer than it "should." If
it should take five minutes to get ready and out
the door, plan on a minimum of 20 minutes. If
there isn't enough time for a slow march up to,
into, and back out of the shower, then skip the
shower and use no-rinse body wipes instead.
Try dancing a slow waltz instead of a jitterbug
for a few weeks and see if your elder doesn't
seem to be less agitated and contrary. The Horse
Whisperer always made faster headway with the
rebellious horse than the cowboy who tried to
break the horse into submission.
...Not that your elder is a horse, but you get
my drift.
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