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One of the key objectives of a caregiver is preserving the dignity of the individual in your care. When this journey with my mother-in-law began she was mentally acute, all her senses functioned normally, she was ambulatory and semi-independent. But as the years passed her hearing grew worse, her vision weakened, her cardiac condition worsened, she fell and broke a leg and is now confined to a wheel chair. In addition her ability to process information has slowed and her short term memory fails from time to time. Having her understand and make decisions about her care is becoming more difficult. In the past she understood the options given to her by her doctors, medical support staff and caregivers. Making these decisions reinforced her sense of independence and self-worth.

As her ability to understand and process information declined we had to come up with another way for her to continue being an active partner in her care. One strategy we’ve used when a decision has to be made concerning her care is to make a list with her of all her options. The repetitive organized nature of the process increases her ability to understand and clarify the information. Ranking or prioritizing the options helps her see which choice she feels is most important to her relative to the others.

To illustrate this recently my mother-in-law lost a cap on one of her teeth. There were some structural issues so a simple replacement was not possible. We sat down and discussed with her all the options the dentist gave us with their ramifications from do nothing at all to a root extraction with a flipper tooth replacement. We made a list of all her options discussing the steps each would entail. We then had her order her choices giving the reason for her selection. At the completion of this task my mother-in-law understood her options and felt confident in her decision. This manipulation of information discussing, listing, and prioritizing helped her to organize and understand her choices.

One of the difficult decisions as a caregiver is recognizing the tipping point when the individual is no longer capable of making their own decisions about their care. Until that time as caregivers we must utilize a variety of strategies to help guide them in making decisions for themselves.