REFUSAL OF MEDICAL CARE OR A CAREGIVER AND WHAT CAN BE DONE
A shout of “No”, or a polite “No thank you” or maybe silently shaking the head no, these responses indicate that you are the de facto driver of your life. And you can slam on the brakes and abruptly stop medical care. Moreover, you do not have to hire a caregiver notwithstanding the insistence by family and friends. Even if such decisions place you at risk or harm, you because of the right of autonomy can legally refuse in spite of those who object passionately or compassionately. Please understand that a refusal can give you a sense of power and satisfaction, but also realize that it is hard on your family and friends. They love you and find it difficult to have their well-intentioned advice ignored. They may feel that you are unreasonable and stubborn, and you may feel their help is hurried and unnecessary. All they can do is hope and pray that someday, hopefully sooner than later, you take their suggestions. My great uncle Wayne who had gangrene of the foot refused to go to the doctor until it was too late. We cannot force the ones we love to undergo treatment or to accept a caregiver so long as they retain their decision making capacity and understand the consequences of the failure to care. Maybe he didn’t want to be like my great aunt Shobe, his sweet departed wife who had lived most of her later life with an amputated lower leg because of her diabetes. Who knows why, but he refused care and died. So what can we really do? Certainly friends and family can standby for when help is finally requested; but more constructive than “c’est la vie” (French for “that’s life”) is when you and they try to understand why the help is refused.
Understanding why you reject a caregiver or medical care is paramount in maintaining a healthy interfamily relationship. Your adult children are continually learning or have learned another set of heartaches about independence when their own children (your grandchildren) test their adolescent independence by driving too fast, running up their cell phone bill, drinking too much alcohol, and falling in love with an infatuation that leads to a broken heart. But in your case, your adult children are learning with heartache that you are not willing to give up any independence to which you have been accustomed for so long. So what is really happening? Everyone must realize the underlying feelings that are surfacing when help is refused. What you are feeling when you reject a caregiver or medical direction is a sense of power. Yet this is not the same as being empowered because here this emotional feeling of power is masking the undeniable fact that the aging process means a loss of bodily and mental functions, a loss of power, a weaker you.
Aging leads to many mind and body changes and less self-sufficiency; there is no escape. I repeat less self-sufficiency and therefore less independence. Almost everyone readily understands that they are not going to live forever. On the other hand, most of us must undeniably realize too that the end of the journey is not going to be similar to the lights going off in a room after nature flips the switch. The unescapable reality is that the mind and body changes, however gradual or quick that may be. Moreover, these changes are not primarily for the better, but rather things get worse. In fact, we have been so accustomed to the good changes in our early development that growing old could be considered an oxymoron. When we were young, growing a little older implied a lot of good things happening with an actual increase in self-sufficiency. But in growing old, many seniors are surprised that they can no longer do things as quickly, agile or for so long as they once could. These new experiences simultaneously create new and sometimes unpleasant feelings. To fully appreciate the old and new passions awakening in our soul is to accept the aging process and its consequences on our emotional wellbeing. Consequently, less self-sufficiency is a critical fact for you to understand and more importantly before we go any further for you to accept.
Physically, we start to lose our prime around the age range of fifty and sixty. Our body gradually starts to deteriorate as it so happens with all living creatures. In the abstract, it is easy to recognize the consequences of aging as if they happen to everyone else but you. But in your very own life it takes more effort and an honest realization that you are not as young as you once were. Your body undergoes changes just as it has since you were born, except that later in life they are not for the better. The hair begins to thin and gray out. The skin becomes less firm and you get more wrinkles. Your muscles become less strong and more susceptible to injury. Your body does not heal as quickly as before. Your metabolism slows down and you get fat. The bones become brittle and fragile due to osteoporosis. Your heart begins to react to the effects of hardening arteries. Reaction time diminishes and stamina falls. You may need to get reading glasses and hearing aids to alleviate any loss of vision and hearing. And other physical problems just continue to mount. You just are not what you use to be in your prime. Remember what we discussed at the beginning concerning the geriatric evaluations and the nine domains for examination. Our true feelings about diminishing body functions must be fully appreciated when these changes begin to affect our self-sufficiency.
But not only is there physical deterioration, but also mental degradation occurs as we grow older. We are not that quick to solve problems. Our memory becomes worse and worse. Again, you just are not what you use to be in your prime. Our true emotions about diminishing mental functions should be self-realized in their totality or else we are being delusional, another mental health problem. The mental deterioration from possibly vascular disease along with the declining physical functions impacts our power to care for ourselves and affects our psychological wellbeing.
In turn, this less and less self-sufficiency as you grow older brings a whole lot of emotional baggage. Frustration appears when there is a diminished independence, which is a loss in the ability to do the things that you used to be able to do. Other feelings may include depression over the same or different losses. There can be anxiety because you lose privacy when a caregiver enters your home and it feels like an invasion of your sanctuary. The growing number of medications that you are taking may upset your equilibrium and you ask “What is happening to me?” A deep sense of isolation could feel overwhelming if the keys of the car are taken away. Fear of being put into a nursing home could lead to outright hostility when the family just broaches the subject of your future living arrangement. When you go into a room and forget what you wanted could trigger the emotion that you are losing your mind. Being a wife or husband to a spouse with Alzheimer can be tremendously stressful and lead to caregiver burnout. Being a son or daughter to a parent with dementia is also very trying on one’s nerves and patience and can bring a lot of heartache. Or for you, going to a doctor and being diagnosed with dementia or Alzheimer would truly feel the worst. And then there is the number one fear, the fear of dying, whenever you have a new or more intense ache or pain. All these unhealthy situations are frightening to any normal person as cancer would be to a younger person. It is natural to feel bad because you are human – yes human! You are not a machine, but a person with a full range of emotions including frustration, depression, hopelessness, anxiety, anger and fear. These emotional changes and their subsequent psychological adjustments can be either slow or quick just as the changes of the mind and body functions
Because aging in seniors adversely affects the body and mind, the negative feelings due to less self-sufficiency should be addressed too when they materialize. Most seniors do recognize them in some form or another, but their acceptance is much harder to handle. It is the real and absolute test of whether you are coping with the aging process when you are able to deal with the unpleasant emotions in a positive way.
We have natural coping mechanism for frustration, depression, anxiety, anger and fear similar to our physical coping mechanisms. For example, with poor hearing we can compensate by raising the sound on the television. Another way to manage these disagreeable feelings can be called “Blowing off steam” through exercise. However, many of these coping mechanisms are bad and some very unhealthy. Anxiety can lead to avoidance of the doctor office. Depression can lead to overeating, undereating or more sleeping and therefore poor nutrition and less exercise. You deal with frustration by throwing the remote control or slamming down the phone and breaking them. Not only does that cause physical damage to your property, but also in the case of the phone it ruins your communication with the outside world or with respect to the television’s remote control it hinders your primary method of entertainment. Maybe the latter is a good thing because now you have to physically get out of the chair and turn the channels. Anyhow, Together Helping Seniors is about compassionate care and helping you deal with any unhealthy emotions due to aging in a positive way.
Our services can be as simple as going to the doctor with you in order to minimize your anxiety. Also, by suggesting products, we can lessen such feelings as insecurity and panic. For example, by wearing a monitor around your neck, you can quickly contact emergency services in the event of a fall. Additionally by our product suggestions and the service referrals, we supplement the compassionate care that we ourselves would like and enjoy as we journey with you. And through a very systematic problem solving process, we focus on you!
To control and mitigate the negative effects that are detrimental to your feelings, a senior care specialist uses a systematic approach in selecting the right products and services. First, a senior care specialist listens emphatically to your concerns about any emotional challenges that can impact your psychological wellbeing. Second, we assess the situation and provide excellent product recommendations and or service referrals. A senior care specialist has extensive knowledge and expertise to understand and fix the problem. Third, we empower you by actually contacting the experts and persistently following up on our referrals. And fourth and more importantly, Together Helping Seniors provides emotional advice and support concerning any unhealthy and unpleasant feelings that you may be experiencing. This systems approach with the all-important human elements of compassion, empathy and love is one of our keys to success.
We firmly believe that with professional help, you can be assured of accepting medical care and a caregiver. For example, we connect you with an audiologist who specializes in hearing aids in order to improve your hearing and minimize your frustration of missing out on conversations. Moreover, we know psychologist who advise older people about the stress of being a senior caregiver to their spouse. We can also put you in contact with support groups for loved ones with Alzheimer. We can recommend a security company that can provide 24 hour monitored protection to relieve your fear about any break-ins and intruders. A caregiver can minimize your anxiety of staying at home alone. We can refer you to a geriatric psychologist who can help you with the more severe forms of depression and anxiety so that it can be treated with medication. Whatever it takes, we know the resources, and we treat you dignity, respect and above all love. Our support and empathy cannot be overemphasized. A senior care specialist will be your special envoy to help with frustration, depression, anger, stress and anxiety. You are at a point where family and friends have tried, but advice coming from professionals is more likely to be accepted because we have years of the right experience.
