“Children, Please – I’d Rather Do it MYSELF!”

Mother, PLEASE, – I’d Rather do it Myself!

A classic Anacin ad from the early days of TV:

The first segment of this new series was written by Art Carr as a Guest Author for the Senior Housing Forum Blog.

That young homemaker of the 1960’s is now a resident in a senior living community and is still becoming “stressed out” because she is not being allowed to do as much for herself as she desires.  Everyone around her – friends, family, AND the staff of the assisted or independent living community – believe that they are being helpful when they do everything for her.  Their intentions are just as good as her Mother’s all those years ago – yet, the result is even worse.  All her Mother did was give her a headache; well-meaning staff may be actually robbing her of the ability to care for herself!

Independence is primarily a “state of mind” – a person’s desire and belief in their ability to perform a task or handle a situation under their own direction.  They may choose to accept minimal assistance, but the CHOICE is theirs.  In the book, “Successful Aging” based on the MacArthur Foundation Study of Successful Aging, the authors found that older men and women named remaining independent with the ability “to take care of themselves” as their primary goal.[i]

Dependence is a Learned Trait

Beginning in infancy, we are taught to do things for ourselves: e.g. toileting, eating, walking, and dressing.  As we mature, we are encouraged to become self-reliant, think and act independently and, as responsible adults, to “stand on our own two feet” and become productive in society.

Yet, once we reach the normal retirement age (around 65), we enter “a time of life when nothing is expected”[ii] of us.  This roleless role continues in old age, often couched in terms such as “You’ve ‘earned the right to leisure’[iii], so just sit back and let me take care of you.”  While an admirable sentiment, this approach misses the key point that forced leisure is not what aging adults are seeking.  Like all of us, they want the RIGHT to choose and make decisions for themselves about their care and lifestyle.

As we age, our care needs and dependence on others for assistance naturally increase, but the desire for independence and satisfaction of ego and other higher level needs [see Maslow’s Hierarchy of Needs[iv]] continues.  However, the cumulative effect of family, friends and/or healthcare professionals telling the senior that they CAN’T or SHOULDN’T continue doing specific tasks (e.g. laundry, yard work, cooking) and/or caregivers taking over responsibility for these functions weighs on the individual.  Ultimately, they’ll give in and become dependent on the caregiver – EVEN WHEN THEY COULD STILL DO IT THEMSELVES!

To emphasize this point, consider what would happen to the development of a toddler if the parents continue to cut the child’s food at every meal?  It’s fairly easy to recognize the problems this would cause the child when they go to school, but less clear that the same dependency can be learned by the elderly as their sense of purpose and productivity is removed by others with their misguided efforts to do “what’s best for them”.

The attitude of the management and staff and the approach taken in a given situation is often more important than the actual action in preserving a resident’s independence and dignity.  For instance, there is a fine line between a gentleman opening a door as a courtesy and a senior living employee treating every resident with a walker as disabled.  Please go to the “Children Please …” category on the Progressive Retirement Lifestyles blog [https://progressiveretirement.wordpress.com/category/Children please …/] for more insights into specific examples and suggestions as to how management can PROMOTE INDEPENDENCE.  Embracing these concepts will lead to higher resident satisfaction, longer lengths of stay and an environment that will be more appealing to higher functioning seniors.

 

[i] “Successful Aging”, John W. Rowe, M.D. and Robert L. Kahn, Ph.D., Masterpiece Alliance Foundation, 1998

[ii] Ibid

[iii] Ibid

[iv] https://progressiveretirement.wordpress.com/category/maslows-hierarchy-of-needs/

If you remember this ad and the cultural phenomena it created, PLEASE share your remembrances in the comment section below. COMMENTS:

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“STOP – You’re not supposed to . . . !”

A staff member is walking across the lobby and sees Mr. Smith trying to open the front door and exit wman with walker at doorith the aid of his walker.   The following scenarios illustrate 3 different approaches to this situation[i].  In each case, the resident receives a message that may be very clear or more subtle, but conveys information about the community’s culture and  resident management philosophy. This can impact both the resident’s well-being and the perceptions of visitors who observe the encounter.

1)   You Can’t:

The staff member yells “STOP” as she runs to the door.  In a loud voice, she then asks Mr. Smith “What are you doing?” telling him that he is not allowed to go “out there” alone.

Maybe the resident simply wanted a breath of fresh air or to enjoy the sunshine for a few minutes[ii].  Regardless, this approach generally leads to either a confrontation or total submission by the resident.  The first is reminiscent of the “Mother, Please…” scenario with the resident even becoming combative because he is being told what he CAN’T DO!  The other response can be just as devastating because a flicker of independent thought and action has just been snuffed out!

2)   You Shouldn’t:

In the second scenario, the staff member walks expeditiously (but doesn’t run) to the door and greets Mr. Smith there.  She opens the door for him while counseling that he should never try to open the door by himself.  She warns him that he might get hurt and should always ask a staff person for assistance.  She was cheerful, upbeat and walked away thinking: “I’m glad I walked by when I did because I got a chance to do something nice for Mr. Smith.  I’m a good person and good employee!”

Unfortunately, her good intentions were off the mark and Mr. Smith received a very different message.  He just had his frailties emphasized and made to feel disabled with the reminder that he is no longer capable of “even opening a door for himself”.  All he heard was that he shouldn’t try to do it himself and probably never even heard or internalized that the staff would be happy to help him when he wanted it.  These may even contribute to feelings of being “trapped” and isolated in the senior living community.

3)   It’s OKAY:

As an alternative, the staff member could greet Mr. Smith and begin to engage him in conversation while walking toward the door.  (e.g. “Hey, Mr. Smith.  How are you doing this morning?  Boy, it sure looks cool {rainy, hot, etc.} out there today.”) The employee then has two options:

  1. Ask him: “Can I give you a hand with that door?”  This enables the resident to preserve dignity by being offered a choice that can be graciously accepted.  For ladies, I generally add something like “my Dad always taught me to be a gentleman and it’s my pleasure to open the door for you.”  The act of opening the door becomes a courtesy instead of a necessity.
  2. Continue the conversation through the door.  This is the most subtle approach as the staff person is able to effortlessly hold the door open for the resident without making an issue of it.  This has taken a couple of minutes of the employee’s time but been a great investment in resident relations.

The employee’s response to this situation[iii] is a combination of the community’s culture and the individual’s own concepts and beliefs.  Both evolve over time and are influenced by training (e.g. “soft skills”), policies & procedures, stated management philosophies, and the personality of the people involved.  Creating a culture that PROMOTES ON-GOING INDEPENDENCE[iv] for the residents will have a direct impact on the type(s) of people who choose to move into the senior living community.

In the next segment, we’ll explore how the design decisions of the Architect and Management support or conflict with the desired cultural perception.  PLEASE SUBSCRIBE {by clicking on the “Sign me up!” button at the bottom of the right hand column} to make sure you don’t miss any exciting installments.


[i] In each example, it’s assumed that this isn’t an outside entrance to a secured memory care unit or skilled nursing facility and that Mr. Smith is mentally competent and not at risk for elopement.

[ii] Recent studies have shown some potential of benefits from daily exposure to natural light in delaying the onset and/or effects of Alzheimer’s disease.

[iii] Note:  each of these scenarios is considered positive because the employee recognized the resident and intervened instead of simply continuing to walk past.

[iv] This is a basic tenet of the Progressive Retirement Lifestyles program.  You may contact Art Carr at 615-414-5217 or art@progressiveretirement.com to learn how these concepts may be applied to your organization.