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Independence, Control
and Self-determination

It shouldn't be a surprise that you and your loved one don't always agree on what's best for him or her. No two people agree on everything all the time.

When conflict arises, what can you do? As you make your decisions, it's helpful if you keep in mind these guidelines:

--Encourage and allow independence.

A part of growing to adulthood is accepting, and sometimes demanding, independence. An illness or mental deterioration can mean the chipping away of that personal freedom. A goal for you as a caregiver is to delay or to minimize that erosion. Your role is to offer assistance that helps your loved one remain as independent as possible.

That means you don't take over tasks or make decisions that person can still handle. For example, don't dress her in the morning just because it would take you only five minutes but it takes her twenty. Don't decide he needs a lifestyle that is as active as his health will allow when what he really wants is a quieter schedule because he's lived a long and hectic life and now he wants to rest.

--Whenever possible, let your care-receiver be in control.

It's human nature that we want to be in the driver's seat when it comes to our own lives. Giving up control, or having it snatched from us, can make us angry and frightened.

For example, what you may see as a mere detail can be monumental to Dad. Maybe he has always gone to the 8:30 Mass on Sunday morning but now you're concerned about his getting there on his own. So you unilaterally decide the two of you will go to the 5:00 Mass on Saturday evening and you can't understand why he's so upset.

After all, you're the one making the sacrifice, aren't you? You're the one doing him a favor. But from your father's point of view, you're trying to ruin his Sunday morning routine. Now he won't be able to say hello to his fellow "8:30 regulars," the friends and peers he enjoys visiting with each week.

Letting him keep some control might mean mutually agreeing that one or two Sundays each month you take him to the 8:30 on Sunday. Let him pick which Sundays. Likely, after a while, he'll feel equally comfortable with "the strangers" at the Saturday Mass, too.

--Remember each of us has a God-given right to self-determination.

We were created to make choices. We were given free will. This means that day-to-day living, your loved one has the right to determine what his or her life will look like. To do this or to do that.

That's fine in theory, but complicating the issue in the real world of the caregivers and care-receiver is the fact that, sadly, at some point your loved one's ability to make safe decisions may begin to fail. He or she may begin to choose what is dangerous or unhealthy or may lapse into self-neglect.

That's not a valid excuse for you to decide on your own that your loved one is "incompetent" and to take over all decision making for him or her.

It's better for you, and the care-receiver, to ask for a professional geriatric assessment, to help objectively evaluate the situation. Your diocese's Catholic Charities or Catholic Community Services office may offer services to help you assess your loved one's needs and make plans for the future.

It's possible to design a plan including any necessary precautions without losing sight of:

--the importance of your loved one's independence;

--his or her the need to be in control as much as possible; and

--that person's right to determine how he or she wants to live the remainder of his or her life.