Today we wanted to touch on a topic that is quite sensitive to many : The right to live at risk!
Now you may ask, why would anyone want to choose to live at risk? Before you pass judgement let's explore the matter a bit more closely (1).
Let's explore a common scenario: You or your loved one may be having a bit more difficulty walking in recent times, and then unfortunately one day a fall happens resulting in a broken bone! Ouch! You or your loved one gets checked out by a doctor and it's recommended that you from now on make use of a cane when walking. Now you or your loved one may say to yourself " I've been independent my whole life, and I've only had one(or a few) falls, and now I'm being told I can't walk on my own anymore!". It can seem a bit extreme for some.
In this scenario, however, it was assessed by a health care professional that there is a proposed risk(i.e. future falls), thus they are making a recommendation. Furthermore, because of this fall and recommendation, family members may also now start discussions about not living at home alone anymore because it's too dangerous.
Here's the issue many face: I, as the individual, may not agree with the recommendation(from a professional or family member), nor the suggestion of there being a proposed risk! And this is where the fighting disagreements can take place, between individuals, families and health care professionals.
Health Care Professionals: Despite your assessment, your client/patient may choose against your recommendation, which may pose- in your opinion- great risk. It is their right however to choose how to live their life (assuming they are in a state to make such a decision), even if that means living "at risk" as you would pose it. Your responsibility is to provide the relevant information, recommendations, and potential risks, and your client/patient then makes their choice.
Seniors: Your family and health care team likely have your best interest at heart, and are not intentionally trying to frustrate you or strip you of your independence. They are genuinely concerned for your well-being. Do listen to the relevant information and risks being presented to you and take into consideration all perspectives. In the end, however, you do get the final say in the decision making regarding your care, even if you do decide against provided recommendations or suggestions.
Family Members: Listening to all the possible risks that can occur if your loved one goes against family or medical advice is a very scary experience. Thus it's completely understandable why some of us get a bit "pushy" in trying to force our loved one to agree with what we want, or what a professional recommends (whether using a walker, getting help at home or even going into a long-term care home). As humans we have rights and freedom of choice, and even if that choice may appear to be a very poor decision, we cannot force our loved one against their will to do as we would want. This is NOT an easy situation to accept, as it is a major source of stress for many families we have encountered, but it is indeed the reality.
The best approach ideally is for all parties to be able to have an open discussion, and work towards a compromise which respects the need for independence of the senior involved, while also taking the level of risk into consideration by attempting to address possible safety concerns. For example, instead of a senior moving out of the home into a retirement home or long-term care home, it could be negotiated that they would be willing to now allow help in the home in order to remain in their home. Now we're aware this is much easier said than done, but when facing this issue please do try to gain perspective from all parties and work to respect their vantage point.
1. For the purpose of our discussion we will be working on the premise that the senior involved is capable/competent at this time to make decisions. We can examine in future articles the complexities of determining one's capacity to make decisions for themselves.