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Helping Seniors Cope with Loss of Independence
One of the most difficult consequences of growing older is a loss of independence. Physical and mental decline can make it difficult for seniors to take care of themselves or manage their own lives. The solution, in many situations, involves senior living arrangements, from in-home care assistance to assisted living or nursing home facilities. However, while these arrangements can help seniors manage day-to-day tasks that they could no longer handle on their own-getting around, bathing, dressing, preparing meals, and more-they don't necessarily address the deep sadness and frustration that can come with a loss of independence.
Different Types of Independence Loss
To understand how seniors feel as they lose facets of their independence, you need to consider what it is they are losing. A loss of mobility, for instance, can be problematic for seniors on numerous levels. On one level, a senior can be frustrated over mobility problems simply because they can't get around as well as they once did. It's alarming to have difficulty with climbing the stairs, walking short distances without assistance, standing up, or getting out of bed. Seniors are used to being able to do these things themselves, so losing that independence can be both a logistical issue and a blow to seniors' self-worth and confidence.
On another level, a loss of mobility can also impact a senior's social life. Perhaps he used to go for walks with friends, but can't anymore. Maybe a sport such as tennis or badminton was a big part of her social life that has now been taking away. A loss of mobility can also impact a senior's ability to attend parties or events, or even to go out to dinner. As a result, loss of independence for seniors can mean seeing their friends and family less often than they used to, which can in turn lead to sadness or depression.
Loss of mobility is not the only issue that can lead to independence loss for seniors. Memory loss issues, vision or hearing problems, or even diminishment of stamina can affect a senior's ability to live alone, drive, prepare meals, keep a house clean and well-maintained, and more. The loss of a spouse can also put a senior in a position where independent living may become more difficult and less safe.
How a Senior Might Be Feeling During a Loss of Independence
To help your elderly loved ones cope with a loss of independence, you need to understand how they are feeling at this difficult time. The truth is, different people react to losing their independence in different ways. Some will feel angry or frustrated that their bodies are betraying them. These individuals may lash out at you or other loved ones in resentment, and might even blame you for taking away their independence. Don't worry: these feelings of anger, betrayal, and blame are normal, and will pass.
Other seniors will simply feel sad or afraid as they become less independent. They will feel vulnerable and helpless due to their inability to take care of themselves, and may start to lean on family members much more than they once did. In these situations, the resentment and blame discussed above is replaced with dependence.
Finally, some seniors will simply feel confused about why they are losing independence. They won't understand why they can't do all the things they used to, or why you or a caregiver is trying to assist them with simple things including getting up or cooking meals. Seniors in this boat will often try to reject care or help, or act as if they don't need it. Guilt may also be a contributing factor here. Indeed, a senior may feel guilty about not being able to help herself, and may reject offers of help simply because she doesn't want to be a burden.
The Keys to Coping
Regardless of whether your elderly loved one is feeling anger, fear, confusion, or guilt during a loss of independence, the keys to helping that person cope with their loss are more or less the same. Perhaps the most important of these is patience. It can be frustrating to have a once independent loved one suddenly feeling dependent on you for everything, or to have a parent or grandparent lashing out at you for something that isn't your fault. Still, you need to recognize where the senior in your life is coming from-loss of independence due to aging is one of the hardest parts of any life-and give that person time to come to terms with the change they are going through.
Another key to helping a senior cope with a loss of independence is to help them hold on to the things in their life that they love most. For instance, if a parent or grandparent has lost mobility and needs to be moved into an assisted living home, they are already probably saying goodbye to the familiarity of the house they've known for years. Helping them to keep in touch with other grounding foundations in their life-namely, relationships-can help to lessen the blow. Scheduling frequent visits with family and friends, or making a point to call your loved one regularly, can go a long way.
Finally, just try talking with your loved one to help them understand why this is happening. Studies have shown that many older adults fear losing independence more than they fear death. As a result, just having a conversation where you give your senior loved one a chance to open up about their fears or frustrations can do wonders. In this conversation, you can reassure the senior that loss of independence is a fact of aging and not a sign of failure or even an indicator of imminent mortality. You can also explain to your loved one that you can't always be there to provide the help they need, and bring up the idea of in-home care or other senior living arrangements.
Bottom line, this conversation is your chance for you and your elderly loved one to understand each other, so set aside plenty of time to work through everything that needs to be discussed. Ideally, a good, constructive discussion will get everything out on the table and make it easier for the senior in your life to come to terms with their loss of independence and carry on regardless.
When It's Time to Give Up Driving
Your parent may be full of zip, ideas and big plans, but last week you noticed a dent in the car fender or realized the mailbox was at a jaunty new angle. Did Dad — like all of us — have a moment of carelessness? How do you know when a bump is just a bump, or when it’s a sign that your loved one should pull off the road for good? Here’s how to tell the difference, and how to help your loved one transition from chauffeur to chauffeured.
Step 1: Talk
Talk about giving up driving long before it becomes a must. A matter-of-fact approach will help your loved one accept what’s ahead.
Step 2: Assess
Assess your family member’s driving skills by riding along regularly. Don’t present a drive as a test. Instead, tag along when your loved one is driving — in both daylight and darkness. From the front passenger seat you can look for signs of diminished driving ability. Don’t make age alone the deciding factor. Ability, agility and vision are the main criteria.
Signs to look for in your loved one’s driving:
Is easily distracted
Has delayed response to unexpected situations
Runs lights or stop signs
Clips the curb
Exhibits lane drifting or has trouble changing lanes
Shows loss of driving confidence
Has frequent close calls
Drives too fast or too slow
Other drivers honk often
Gets lost in familiar places
Not alert to other cars or pedestrians
Family is worried about driving
Has trouble moving foot from gas to brake
Confuses gas and brake
Has been pulled over by police for driving infraction
Has had accidents, fender benders, car scrapes
If you notice these red flags, it’s time to have the conversation.
Step 3: Prepare
Before broaching the topic, use resources such as the Eldercare Locator to review neighborhood services. Find referrals for senior transportation services, volunteer driver organizations and programs to help elders learn to use public transportation.
Sign up your loved one for a ride-sharing service such as Lyft or Uber, or make arrangements with a local taxi service. Knowing that you won’t be entirely dependent on family and friends does a lot to soften the discussion ahead.
Be part of the village. The Village to Village Network is a national neighborhood program designed to help people age in place. Village volunteers or ride-sharing services provide local rides. They also arrange group trips to places like the grocery store, library, and fitness and yoga classes, and host social events such as concerts, lectures, restaurant lunches and candlepin bowling.
Get ready for the conversation with AARP's We Need to Talk online seminar.
Step 4: Have the conversation
Remember that driving is as important to a person’s independence at 60 as it was at 16 — maybe more so. Approach with empathy and solutions. Here are a few tips.
Suggest a formal driving assessment. A professional, neutral party is almost always more convincing than a family member.
Expect resistance. For most people, handing over the keys is akin to snipping a lifeline.
Focus on safety. Protecting the driver and other people is the first talking point.
Acknowledge that driving today is more intense than when your loved one was younger.
There are more cars on the road, more aggressive drivers, more road construction and more distractions.
Many roads are wider and more complicated.
Your loved one — like many older people — may take prescription or over-the-counter medicine that can impair driving.
Be direct and honest. Cite examples of problems you observed when riding with your loved one, such as:
An infraction like running a stop sign or light
Not noticing a pedestrian or another car
Trouble judging distance — such as stopping short, parking too close or lane drifting
Other drivers honking
Anxiety or lack of confidence
Driving too fast, too slow, or both
Empathize. Assure your loved one that you understand this is a difficult loss, and that no one — including you — wants to give up the freedom of popping in on a friend, last-minute lunch dates or taking that pottery class. Acknowledge that being dependent on others for rides will mean paying someone or adapting to someone else’s schedule, shopping at someone else’s preferred grocery store, or giving up pottery because it conflicts with a grandchild’s soccer practice.
Introduce alternate transportation early in the conversation.
Put apps for ride-sharing services on your loved one’s phone. If using a taxi service, enter the contact information. If your loved one is uncomfortable booking through an app, the senior transportation service GoGoGrandparent will do it for a small fee. It also will send a family text to let you know your loved one is being picked up, is en route — “Betty is on the move!” — and has reached the destination.
Demonstrate how to use the ride-sharing app, going over the features, charges and options. Explain that drivers have been vetted by the company and are registered and insured, and that no money is exchanged at the time of the ride. For safety, the car is tracked using GPS; the rider sees a picture of the driver and knows the person’s name before the car arrives.
Search for local volunteer groups that offer transportation for older people. Independent Transportation of America, for example, is a door-to-door, arm-to-arm service that provides rides to members age 60 and older. Dues-paying members book a car by phone, and a volunteer drives them to and from their activities. Assistance is offered. The nonprofit has affiliates in many parts of the country, including nonurban areas.
Step 5: Fight loneliness
Feeling isolated and depressed is a real danger when one is housebound. It’s important that your loved one continues to interact with friends, neighbors and the world. These plans of action will help make the transition easier.
Have family outings.
Make it easy for your loved one to see friends.
Encourage your loved one to invite friends over or arrange to meet nearby.
Continue established activities, such as classes, book club, card games and worship services.