Decisions, Decisions, Decisions…
What to wear, what movie to see, where to go on vacation; making decisions can be tedious and exhausting. Choices, however, become important when you are no longer able to make them due to illness and/or care giving circumstances.
Very often, patients, whether voluntary or not, loose the ability to make even the most basic choices; like when to eat or bathe. Choice and control are key factors for maintaining dignity. When looking for care or providing care for a loved one, be sure to know and understand the patient as an individual and ensure their ability to make decisions for themselves. A patient who has played a role in deciding where to receive care, for example, will more likely have a positive attitude toward all aspects of care and thereby, more positive outcomes.
For the patient receiving care in a community setting like assisted living or a skilled nursing facility are there menu choices, can the patient decide to eat privately in their room or must they eat in the dining room? Is the patient able to decide when to wake up and when to go to bed? Are they able to take a nap if they wish? Are patients able to decide when to take medications; are they able to avoid being awoken for routine nighttime medications? Can the patient participate in alternative forms of treatment like aromatherapy, guided imagery or relaxation techniques? Are there paid for services to choose from like salon services, manicure, and massages? The more individualized the care the more comfortable the patient will be.
When providing care for the patient at home, be sure to include the patient in decision making, as well. This can be more difficult as the care may fall solely on one person, which can be draining. Additionally there may be others in the household, like small children, for which the caregiver may be responsible. If possible, using outside help for care such as bathing or physical and occupational therapy may provide a needed respite for the care giver; enlisting the help of other family members can also be helpful. In fact, the patient may prefer the meals prepared by one family member as opposed to another or may feel more comfortable having a daughter-in-law perform personal care rather than a son.
Tip: When providing care for the patient who is confused or has dementia or other cognitive impairment, narrow the choices being offered. “Would you like to wear the red shirt or the blue shirt?” “Do you want tuna salad or chicken salad for lunch?” Too many choices can be overwhelming to someone who is confused.
Whatever your care situation, empower the patient to make decisions, by doing so you are supporting the patient’s ability to maintain their dignity and control.