Today is Feb. 17. Valentine’s Day was last Thursday, and I fervently hope that isn’t news to you; if it is, put this down right now and go do what will be in your eternal best interests to do — The Daily World will still be here when you get back.
Actually, I had hoped to get a little mushy for Valentine’s Day. I like “mushy!” But then, something really important came along and I thought,”… well, I’d better do this, instead …” and then I debated and considered consequences and went back-and-forth and … then I decided that I’d better just quit while I was ahead — or, at least, no further behind.
Anyway, a couple of weeks ago a number of us were having a conversation about respect, negotiation, safety and, finally, doing nothing when nothing is all there is to do. I said:
“In my experience, negotiation, respect, empathy and a willingness to take ‘baby steps’ (a little help, then maybe a little more — you get it) works pretty well, most of the time, but not always. Because nothing is ‘always’; sometimes, you (me, whomever) can do everything ‘right,’ and an elder just refuses to accept any help…
Maybe it’s fear. Maybe it’s stubbornness. Maybe it’s saving for a rainy day, when it’s really just ‘cheap’. Maybe it’s ignorance. Maybe it’s denial (‘I’m not old!’). Maybe it’s control or greed or stupidity.
Now, if it’s honestly dementia/memory loss or a diagnosable mental health condition, those are game-changers, and we’re in a whole, different ballpark.”
I got a reply to that, from Mindi Blanchard of “Bridge Builders,” which is a private agency in Clallam County that supports elders and families. After a few kind words, Mindi said:
“…We also hear from a family who are at their wits end regarding their parents or other elderly family members. However, I want to point out as a Certified Professional Guardian that even when the Court determines someone is incapacitated, it does NOT mean that the ‘game’ changes and the client can be forced to do something he or she doesn’t want to do. I realize that public perception regarding guardianship is that guardians can do whatever they please. That may have been true 15 years ago but it is not true today. Certified Professional Guardians are required to follow the Standards of Practice developed by the Guardian Board that oversees us. This means that we have to advocate for what our client says he/she wants even though that client really doesn’t know anymore what he/she wants. I have had extremely frustrating situations where a guardianship client with dementia needed to have medical attention for a separate medical issue but the client was resistant and the mental health professionals won’t touch anyone with the first diagnosis being “dementia.” That said who wants to drag someone kicking and screaming to the hospital or into a long-term care facility? Not me! And no facility wants someone who loudly proclaims they don’t want to be there…
So, what to do? Well, a little tough love can go a long way. Families often fall into the ‘enabling’ category without realizing that they’ve done so. The goal is making the client uncomfortable in his/her current living situation. This looks different for each client. For some, just not being as available as in the past; for example, telling Mom that you just can’t take the time to take her grocery shopping but that you would be happy to call a local caregiving agency to send someone to assist. Of course, Mom would need to pay for the service. If Mom objects, apologize but don’t rescue. For some we have had to establish a ‘team’ including but not limited to caregivers, Adult Protective Services, law enforcement doing welfare checks, etc. During this process we always treat our client with dignity and respect. We also tell them their options and graciously accept their answers declining these options. Our goal is to plant ideas because over time the client may decide on one of the options as his/her own idea. If it seems that a client really needs to move to some sort of facility, we talk with the client about visiting facilities ‘just in case’ they might need to move into one and facilitate visits if they agree. When they complain that no one is helping them, we go through the options with them again, and again, and again. It can take many months before the client decides they would like to try a different option or it may take a medical crisis. It is time consuming and emotionally exhausting, even for those of us who don’t have the emotional connections that families do.”
So, there we are, and I thank Mindi Blanchard for caring enough to jump in. While I might argue that what she describes is a “changed game,” I think that’s about semantics — And people matter more than semantics.
Some of us will read this and a light will go on — “Oh!”
Some of us will be shocked or, perhaps, offended — “That’s cruel!”
Some of us will need to think about this in the context of respect, negotiation, safety and…doing nothing.
And many of us will just need to think about it — For a while. If we’re smart, we’ll think about it this way: “What if it were me…”
What if it were?
Love is a funny thing.
Mark Harvey is the director of Senior Information and Assistance for Olympic Area Agency on Aging. He can be reached at firstname.lastname@example.org or 532-0520 in Aberdeen, (360) 942-2177 in Raymond or (360) 642-3634. FACEBOOK: Olympic Area Agency on Aging-Information & Assistance.