Protecting the ‘agency’ of older people

This week I had the pleasure of speaking at the Adelaide Better Practice Conference, conducted by the Aged Care Standards and Accreditation Agency. My topics were Enhancing dining in aged care and Depression in Aged care.

The message for me from these two days of reflection and exposure to stimulating ideas was that we must protect the agency of the people we care for if we are to reduce the number of people who are depressed in aged care. By ‘agency’ I mean the capacity and will to make a choice. We reduce this in older people by making choices for them and treating them as if they can’t make effective choices for themselves. We all do it and we often dress it up as “in their best interests”.

But how do we know what is in their best interests? Empathy gives us some idea but it is only ever a guess. The better we know someone the better we can guess. Sometimes our own anxiety shapes our choices for older people. “Its time Mum moved to a nursing home/assisted living”. Is it because of our anxieties. If so what effect is this going to have on your mother if you make the decision for her? We must avoid taking over out of anxiety.

What to do? Avoid making decisions for them, ask more questions, seek information from the person, find out what they want and adjust yourself to their preferences. I can hear you saying, “But what if they make an unsafe choice?” Of course you need to be there to help or prevent physical danger. But if there is no physical danger let the person make the choice.

Let me know what you think. Its an important issue. Thanks for reading.