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Celebrate Independence of Older Adults

As we mark the independence of the USA, let us also celebrate the independence of older adults. Independence for this population means more than living on one’s own or being able to move about without assistance. It includes making financial decisions, making choices in daily life, and being allowed to do tasks on one's own, all leading to a more fulfilled and dignified life. All individuals have basic needs, desires, emotions, thoughts, and personality traits. All individuals should be allowed to express them and meet them. As people age, unfortunately, their abilities diminish, and they need help. This does not mean that those who care for them should take over.   Planning in advance is prudent. Plan for wills, trusts, living arrangements, and end-of-life decisions while the person still has clear cognition and can decide. Discuss possible scenarios so when the time comes you will know what the person wants.   Here are ideas of how to grant independence in everyday situations:   Financial: Let the person see the bills and sign the checks and credit card receipts. Let her choose what to buy and where and when to shop. Let him decide how to pay and be the one to hand over the cash, check, or credit card.  Mobility: Let him personalize his cane, walker or wheelchair – as well as which one he will use today. If you disagree, either persuade him otherwise gently, but just try to keep him safe. Ask him when he is ready to stand, sit, or transfer.   Grooming: Allow the person to choose when to shower or bath and to do as much as possible even if it is slow. Respect privacy and modesty. Let her choose what clothes to wear. Let her select her makeup, perfume, and jewelry. You still want to make sure they feel like them, and that includes looking the way they’d like to look.   Instrumental Activities of Daily Living (IADLs): Let her make the call to Access-A-Ride or to order a taxi. Let her decide when she will take her meals and what she will eat, and, if the individual is able, let him participate in food preparation. Maybe he wants to order out? Ask, and let him make the call.  Let her  feel she is in control of her home, even though someone else is leaning and organizing.  Technology: Set her up to make calls on her own by putting phone numbers in the speed dial. Teach him how to make video calls and surf the internet.  When an individual becomes used to having things done for him, he will lose his self-confidence. He will stop doing things for on his own, expect others to do things for him, and complain or become flustered when he is left to fend for himself. Use encouraging words. Ask, don’t tell. Never talk down or in a tone you would use for a child. Mind your phraseology: Instead of “Let me help you.” say, “Could I help you?” Better yet, “How may I help you?” Praise gently and honestly, never superficially.   When one is caring for an older adult whose abilities have declined, it is hard to allow for self-determination. There may be physical and emotional strains on the relationship. Harriet Blank, Director of Geriatric Services at OHEL ( says there needs to be a balance of both sides respecting each other. When someone feels heard, even if he does not like the answer, that can be enough.   As Maria Montessoru said, “Human dignity is derived from a sense of Independence.”


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