Denial of aging has become a looming healthcare crisis
By Pat DreaPat Drea is the Chief Operating Officer of Visiting Angels, one of the nation’s leading home care service companies. She is a 23 year veteran of the private duty home care industry, a nationwide presenter on homecare issues, a contributor to industry publications and is on the Advisory Board of the National Association of Private Duty Home Care. She can be reached at firstname.lastname@example.org
At 82 my father was amazingly active. So active that he fractured a vertebra by taking the door off the bathroom to plane it down so it would fit better. When he was being treated, the doctor asked why he had been trying to do something like that, didn’t he know better? Dad said it was OK, because his wife was helping him. She was 80 at the time.
My father wasn’t alone in not seeing his age as a limitation. Very few people truly perceive themselves as having the age, or actual capabilities, that they truly do. We see ourselves, whether we’re 80 or 40, as being able to do more, lift more, accomplish more than sometimes is safe. Even at younger ages, this denial of actual ability exists. The difference is that in younger years, that denial can function perfectly well as a mechanism to push us to accomplish more. But for older people who may have some significant limitations, and also issues with appropriate judgment, it can become dangerous.
It’s no secret that Americans are living much longer today than we ever have. But what is less often acknowledged is that we have not come to terms with the fact that this longevity may also mean that we are going to need some assistance to maintain the independent lifestyle we want. Working in the home care field, I’ve come to see that denial – of circumstances, needs and limits – is one of the most dangerous health issues confronting people today.
Very smart people, of any age, who are very good at taking care of themselves can often have poor judgment when it comes to their own limits. “But this is who I am!” people think. People see themselves as the person who does the home repairs, the one who regularly climbs ladders to dust the ceiling fans. They don’t see that their balance may not be as good because they’re older, they don’t recognize that the reach to dust the ceiling may strain their backs. And if they are fortunate enough to have people who do see this, they often deny they need help.
So how can we get people to accept the help they need? That’s one of the most common questions providers hear when a family wants to bring in home help, and it can be a challenge. Help that is effective, and accepted, is subtle, never “taking over” anything but only making it easier for the care recipient to accomplish what they want. Respect is critical, and so is the training and experience to know how to offer help so that it is seen as enhancing and not diminishing a person’s abilities.
One of the best techniques to make the idea of help more palatable is to make it not about the care recipient. For example, if you have a father who is Mr. Fixit, don’t try to make him stop fixing things. Instead, let him know you want him to keep doing what he does well and loves, but that you’d like him to get help with the heavier, harder aspects of the job and lend his expertise to supervising and teaching. Make it an intergenerational activity, where you use your dad’s tools to do the more difficult aspects with him teaching – you can turn a dangerous repair job into a moment you’ll be able to always treasure, and still respect his skills in a safe way.
Sometimes you may need to get help at home for a loved one. It’s easier if there’s a clear issue – recovering from an illness or something similar – but when it’s just a matter of managing daily life it can be difficult to persuade people to accept assistance. We find for many people that they may be resistant to accepting help for themselves, but they’ll do it if it’s for their family. Make it clear that you understand your loved one doesn’t feel a need for help, but tell them you are not comfortable with them being alone because you care. Look for aspects of their lives that they’re concerned about – maybe it’s the laundry not being ironed or not getting to the grocery store easily. If you and a caregiver focus on those aspects, home care can be restorative. Having help doesn’t have to mean a person is less able, often it can make them more able to be independent and do the things they want.
As a nation, we’re living longer. But if we want to keep quality and independence part of that longer life, we are going to have to come to terms with our limitations. Limits need not define us, but we need to acknowledge them, and get the help we need to manage them, in order to make the most of all of our time.