Aging Options

The Caring Dilemma: When Safety and Longevity Clash with Autonomy and Independence

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Here at the AgingOptions Blog we continually explore online news sources that we think will be of interest to our readers and radio listeners. Among the many go-to sites we visit regularly, we like the website NextAvenue because it tends to deal with some of the “real life issues” of aging – and this excellent and helpful article we just read there is a good example. The article asks a pivotal question we hear from readers and listeners over and over, in one form or another: how can a family caregiver find the right balance between preserving a loved one’s safety and helping maintain their independence?

Conflicting Goals and Needs: Safety vs. Autonomy

We know that a significant percentage of our radio listeners and seminar guests are boomer-age adults who are caring for aging parents. Roughly 34 million Americans, according to statistics from the Family Caregiving Alliance, provided unpaid care to an adult age 50 or older during the past year, and almost 16 million regularly care for someone with dementia, so if you aren’t personally serving in that capacity it’s almost certain you know someone who is. For those walking the journey of providing care to a loved one, especially an aging parent, the words of the NextAvenue article will strike a familiar chord.

“Do you lie awake at night in a cold sweat, worried about your dad living alone?” asks NextAvenue writer Debbie Reslock. “What if he falls and can’t get to a phone to call for help?” Worrying about dad’s physical safety is hard enough, but compounding the challenge is dad’s self-reliant attitude: he maintains he’s fine, and claims he doesn’t need anyone’s help to keep living independently. Therein, say the geriatric experts, lies the basis of much of the conflicts between older adults and their caregiving children: friction happens “when the goals of safety and longevity clash with those of autonomy and independence.”

Fractured Families

The conflict is easy to spot, but tough to resolve, since both the caregiver and the one receiving care have a valid argument: safety versus autonomy, and longevity versus independence. Within the family, says NextAvenue, the fallout from these caregiving conflicts can be far-reaching. “Disputes like these can fracture families. Older adults see visions of a life ending in disappointment and less meaning. [Meanwhile] their children see them lying on the bathroom floor or being duped out of their savings.” Which party is right? They both are.

Writing in NextAvenue, Reslock makes it clear that she’s not talking about parents who are mentally incapacitated – in cases involving dementia or other instances of reduced capacity the issue of safety has to be paramount. The biggest challenges seem to arise between children who genuinely care for their aging parents and have the best of intentions, and seniors who are convinced they are fully capable of understanding the consequences of their decisions but are physically frail and possibly just beginning to experience some cognitive impairment that might cloud their judgment. In this “gray area,” says the article, “older adults are [often] treated as incapable [while] their children sink under the weight of responsibility for people who refuse to listen.” In spite of the caregiver’s worries, however, the law seems to lean toward the independence of the senior. “If there’s no lack of capacity, the adult has the right to make his or her own decisions, even bad ones.” As one geriatrician told NextAvenue, “If there aren’t signs of cognitive issues and there haven’t been any red flags, the older person has the right to make their own decisions — even if they make others uncomfortable.”

Beware the Attitude of Ageism

While it’s true that adult kids may have reason to be concerned about a parent’s safety, there can also be the uncomfortable presence of stereotypes about growing older. As Next Avenue writes, “Ageism, the stereotyping of a group of people based solely on their age, plays a big role. Most of us have an unfair preconceived view of what it means to be old. So we often assume an older parent is at risk for being taken advantage of or should no longer live alone.” The article references a recent true story about a fully capable, independent woman in her 80s who wasn’t permitted to sign a home improvement contract without the approval of a younger relative, something that may be well-intended but could border on unfair treatment. Well-meaning caregivers may need to acknowledge their age-related biases as they assess the level of care mom and dad really need, and avoid coming across with a patronizing attitude.

The NextAvenue article does conclude with a few common-sense pointers for both caregivers and elders as they navigate what can be some age-related challenges. First, everyone needs to acknowledge that seniors are entitled to self-determination, and that risk-taking is a normal part of life. Then talk to each other and honestly address what’s happening, both from the caregiver’s point of view and that of the older person. The goal should be to find ways for the parent to maintain his or her quality of life while living safely, with a level of risk that is appropriate to their physical and mental health. Finally, both aging parents and their kids need to be emotionally prepared for the unexpected. As the article advises, when it comes to deeply personal issues like our identity and sense of self-worth, logical arguments are seldom convincing, especially when the parent-child relationship is involved. Emotions run deep.

Open Communication and Careful Planning

From our experience at AgingOptions dealing with hundreds and hundreds of families, let us offer two pieces of advice. First, a family conference is often the best way to start the dialogue concerning these touchy issues, and we will happily explain our process to you if you’ll contact us for assistance. Second, you definitely need a solid plan for your future as you age, one that encompasses the full range of retirement-related concerns, including your financial security, your housing choices, your legal protection, your health-care needs, and – yes – the dynamics of communicating with your family. The very best way to create a plan that weaves all these strands together is with a LifePlan from AgingOptions, a comprehensive retirement blueprint that helps you protect your assets while keeping you from becoming a burden to those you love.

Please accept our free invitation to find out more by joining us for an upcoming LifePlanning Seminar. These highly popular events are offered in locations throughout the region, so for a complete calendar visit our Live Events page where you can register for the event of your choice – no cost, and absolutely no pressure of any kind.  If you’re perplexed by questions about caregiving, aging in place, Social Security, Medicare, Medicaid, wills and trusts, or any of the other dozens of issues retirees face, join Rajiv Nagaich soon at a LifePlanning Seminar for some much-needed clarity. We know you’ll be glad you did. Age on!

(originally reported at

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