Odds are, you have someone whom you love a great deal and who has gotten older and less independent. It’s a fact that as we age, we go from gaining more and more independence in our youth and adulthood, to losing it little by little as we become older adults.
Whether they live in their own homes, or use home health care or live in assisted housing, there are things that seniors can do to keep as much of their independence as possible. In this article we’ll be discussing the following:
- Defining what a loss of independence means
- Why it is important for an elderly person to maintain independence
- The relationship between dependence and mental health
- How to promote independence in the elderly
- How to promote independence in a person with dementia
- Promoting independence in hospital settings
Knowing and understanding these things will help family members and caregivers guide their elderly loved one so they can maintain the highest quality of life for as long as possible. Take the time to thoroughly assess each section to see what applies to your senior’s particular situation.
Table of Contents
Loss Of Independence Definition
There are six basic activities of daily living (ADLs) that older people need to be able to perform in order to be considered independent. They are as follows:
- Washing oneself or bathing, including the use of showers and sponge baths, with or without using assistive equipment
- Getting dressed, which includes putting on articles of clothing and any needed medical equipment (such as braces or a prosthesis), with or without the use of assistive equipment
- Being able to feed oneself, with or without the use of assistive equipment
- Using the toilet, along with performing related tasks, such as getting on and off the toilet and maintaining personal hygiene, with or without the use of assistive equipment
- Getting in and out of bed and on and off of chairs, with or without the use of assistive equipment
- Maintaining one’s continence or having the ability to control one’s own bladder
According to the definition of loss of independence, once a person has lost the ability to perform at least two of these personal care daily activities over a span of 90 days or more, they have lost their independence.
These everyday tasks may seem mundane and second nature to younger people, but for some elderly people, these simple daily living tasks often aren’t so simple any more. Especially if they are dealing with major health issues such as chronic conditions, stroke, Parkinson’s disease, dementia, etc.
The best way to approach an older parent who is losing their independence is to express concern of their health and encourage them to express their thoughts on how to best handle the situation. This is a great way to give them some sense of control over their own life. As long as they are cognitively able to participate.
It may be that the best option would be to move to an independent living facility or perhaps using a local area agency to hire a professional caregiver for home care services to help them on a regular basis. Whatever decisions have to be made, the most important thing is to include them, if possible, in the decision making process.
For some extra support, you may want to consider consulting with social workers or a geriatric care manager. These professionals are skilled in the needs of elderly and their families and what services can be utilized to help them all. Read more about geriatric care managers here.
Why Is It Important For An Elderly Person To Maintain Independence?
It is extremely important for the elderly to maintain their independence. Keeping them involved in things like making decisions and being responsible for certain tasks is good for their mental health because it boosts memory skills and wards off depression.
When you are independent, you have a sense of self (a feeling of being a person instead of an object that just gets shuffled around). Independence provides confidence and satisfaction in being able to meet the challenges that come with aging. It keeps seniors from feeling like their life has been taken out of their control. Even in a hospital setting, it is still important to reinforce these things.
The Relationship Between Independence And Mental Health
It’s important for family caregivers to understand how devastating losing one’s independence can be, especially for seniors.
Maintaining independence is important for seniors as it directly relates to their sense of self worth. After all, they have spent years working, paying bills, driving to medical appointments and taking care of themselves – not to mention raising children and sometimes even grandchildren. To suddenly lose that independence can be a crushing experience.
For example, when my father lost his driver’s license, he fretted about it for the rest of his life about it. Even though he didn’t drive very often or very far, to him having a license meant he was still “capable” and in control. He told me that losing it was just another thing that had been taken away from him (he had lost my mom and moved out of their home in the two years prior to losing his driver’s license).
Some of the mental health benefits of independence in the elderly are:
- A feeling of accomplishment that they can still contribute to the family or help out in a volunteer capacity (my 93 year old aunt just told me yesterday that I can’t call her on Tuesdays any more because that’s her “work day” volunteering in the hospital gift shop!)
- Being better able to maintain physical health and strength because of staying active (Aunt Mary can attest to this)
- A sense of purpose in fulfilling even small goals
- Helping to retain cognitive and recollective (memory) skills
How To Promote Independence In The Elderly
Ensuring that your elderly loved one has the best quality of life might mean taking a few extra measures to ensure that they are enjoying their independence at home. Maintaining certain things, such as keeping to the schedule they are used to, helps to keep them in their comfort zone. However, it can be a juggling act to do this while ensuring their needs are being met.
Here are a few tips to help with promoting independence in your senior loved one:
- Encourage them to perform daily tasks: This is important if the senior still has the ability to perform day to day tasks. When you visit them (or if the senior lives with you), encourage them to do things like folding clothes, washing the dishes, doing the laundry, writing a grocery list, and helping to prepare meals. They may not be able to help much when it comes to such things as lifting heavier objects, but being able to perform regular household tasks will provide a sense of reassurance.
- Consider hiring an Occupational Therapist to work with your senior loved one to help train them to perform their ADL’s in a different way or with tools to help them keep their independence.
- If they are willing and able to prepare their own meals consider using a home delivery service such as Purple Carrot to deliver fresh food that’s ready for meal preparation. It’s a great and convenient service that can ensure they are getting fresh and nutritious food without the hassle of shopping for it and assembling the ingredients.
- Or, if they would prefer meals that are already put together and all they have to do is heat it up – then take a look at Freshley. There’s a nice variety of chef prepared healthy meals ready to go.
- Promote engagement of physical activity: Exercise is important, especially for the elderly. It is a stress reducer and it helps to lower blood pressure. Another benefit of exercise for seniors is that it helps promote balance and strength, which reduces risk of falling. Making them accountable (i.e., telling you how far they walked or how many steps they took with their exercise tracker, etc) will help keep them motivated.
- Focus on what they are still capable of doing: Seniors can become frustrated at the increased difficulty or inability to perform tasks that once were second nature to them. You can foster independence by helping them focus on the things they can still accomplish.
- Make sure that their home is equipped with the appropriate safety devices: As we get older, navigating around the surroundings within the home becomes more dangerous due to things like throw rugs or slippery floors, or when performing tasks such as getting into and out of bathtubs. Adding pieces of equipment to the home, such as grab bars and non-slip rugs and mats will make it safer for them to get around in the home.
- Consider hiring a senior care professional: Hiring a senior care professional is not just for an individual who is not capable of taking care of themselves. They actually can allow an active elder to maintain their independence by helping with tasks that are now a little more difficult, such as picking up heavier objects and house cleaning. Senior care professionals are also a great resource for transporting the elderly to help them complete their errands and get to any necessary appointments (Read our articles about how Uber and Lyft can help with this, as well).
- Sit down with them and discuss the tasks they feel capable of doing (and are able to do): This is also important in that it helps the person feel like they can still contribute instead of having everything done for them. It also gives them a voice in what’s going on in their lives. Again, this helps to maintain a sense of control.
Mail carriers can help to keep a watchful eye on seniors. Read about the USPS Carrier Alert Program.
How Can You Promote Independence In A Person With Dementia?
Dementia is a difficult disease to deal with. Anyone who has had a family member diagnosed with dementia knows the toll it takes on their loved one and the challenges it brings to both the person and their caregivers.
Here are the top two things you can do to help promote independence in a person with dementia:
- Promote exercise: Exercise is important as it can help an individual with dementia perform their tasks longer. Going for a walk with the person gets them out in the fresh air; stretching exercise helps them maintain flexibility. Studies have shown that exercise may help a person with dementia extend their ability to perform tasks for a longer period of time as their condition progresses.
- Keep to a routine. Routines and patterns help to aid memory and give a sense of security.
- Focus on what they can do, even in the later stages of the disorder: There are tasks that an individual with dementia can still perform, despite their condition. For example, they may not be able to cook a meal, but they can wash the vegetables or set the dinner table.
- Use bulletin boards and wall calendars so the person can see upcoming appointments and activities, which will help their memory.
- Promote social engagement according to the person’s ability. This stimulates brain function, can trigger memory, and provides a sense of purpose. Be aware, however, that some people with dementia can become overwhelmed and agitated in crowds or by loud noises or bright lights, so plan a social activity with the person’s preferences in mind.
You must remember, though, that some days are going to be much more difficult than others. If the senior struggles with a task of activity one day, it is possible that they can do it another day.
Promoting Independence In Hospital
When in a hospital, it is important to help the patient to take charge of their own health. This means establishing a partnership with the patient, involving them in what they need to do and what steps they need to take in order to develop a plan of care. This results in better medical care, fewer hospital visits, and improved satisfaction with current medical treatment.
The longer an elderly person remains immobile in a hospital bed, the more it decreases their overall mobility. As Esther always says, “You need four days of activity to recover the muscle tone and strength you lose for every one day you lie in a hospital bed.” (That’s her 10 plus years of Occupational Therapy experience talking!)
If your loved one is able to walk, then walk the hallways with them. If they are able to feed themselves, sit with them to encourage them to eat. Let them brush their teeth and keep up with personal hygiene if they are able. In other words, help them keep up as much of their regular routine as possible.
In summary, it’s important for older adults to maintain as much independence as possible but only if it’s safe to do so. Even if a senior person requires help from home caregivers or other family members, given the chance to do what they can do is vital for self worth.