An excerpt from Tough Decisions In Care Of Elderly Loved Ones (A guide for caregivers).

Empathy is more than just loving an elderly loved one. It is more than simply making the decision we may feel is best for our loved one. Empathy is different from sympathy. Empathy means putting ourselves in someone else’s shoes and making an informed decision. Empathy is seeing through our loved ones’ eyes, hearing through her ears, feeling her emotions, and thinking about her thoughts. It requires internalizing her feelings and acting accordingly. It is a crucial component when working with older adults.

As people grow older, they become increasingly vulnerable, and their needs increase. This may be for a number of reasons – they don’t want to be seen as a burden, feel uncomfortable switching roles having been the caregiver to their children, may be unaware. However, it can be quite difficult for elderly loved ones to show and explain their needs to family and friends. They may try to tackle issues such as financial stress, physical limitations, poor health, or loneliness on their own to avoid “imposing” or “being a burden” to others. This is where empathy comes in. Given that a loved one may be reluctant to ask for help, we must be actively watching and listening for signs of a problem. We must be ready to help, sometimes before help is sought.

In many cases, empathy is the most important thing we can provide. Our loved ones want us to be on their side when they are frail or in distress. They want us to be their strength when they need it most.

This is how we can empathize with elderly loved ones:

• Understand that listening is more important than talking.
• Talk in a soft voice while showing our concern.
• Focus on their feelings and their needs.
• Asking them how they are feeling, if we think anything is wrong.
• Offer to help with the groceries, dishes, laundry, or house-cleaning.
• Don’t push if an offer of help is refused. Back off, give it a little time and try again with a different approach.

Mary and David, 83 and 85 respectively, have lived in their home alone for the last 65 years. They have two children who themselves are in their 60s. Mary recently had a fall, which caused a hip fracture. She needed urgent surgery, and after surgery, she couldn’t walk and needed some rehabilitation at a nursing home. While in a nursing home, she developed pneumonia and became very weak. Despite the best efforts of the rehab team, she didn’t recover completely and needed help. David was adamant about taking her home while the nurses, physical therapists, and doctors believed that Mary needed more care than David could have provided. David himself is too old and frail. The son tried to make David understand for a few hours but did not have any success. David was furious at his son for being “too bossy and not understanding his feelings.” Their daughter, Deborah, sat patiently with them for long hours every day and listened to their concerns. She told them that she “understands their feelings and won’t do anything against their wishes.” She let them express their frustration and anxiety. Finally, after addressing all the concerns to the best of her ability and according to the wishes of her parents, Deborah convinced them to move to an assisted living facility. Deborah visited the facility with the parents, let them meet the staff, and checked the quality of help the facility provided. She made sure that all their needs would be properly addressed, and this is how she was able to convince both her parents.

When we see or sense there is a problem, the first question we need to ask is not, “How will I get him or her to accept help?” It should be, “How much help do they need?” It’s a critical step in the process. If we seek to provide more help than actually needed, a loved one may feel we are trying to steal their independence.

Patience

If empathy is seeing through a loved one’s eyes, patience is accepting what we find when we look. American society is built on speed. We like fast cars, we eat fast food, and we rush from meeting to meeting. But as we age, we slow down physically, and mental processes may slow as well. This can create tension and stress when, for example, dining with an elderly relative.

If a senior is capable of feeding himself, but does so slowly, allow them to eat slowly rather than offering to feed them. If they can use the bathroom, we don’t have to get toilet paper for them. If they can safely use a walker, allow them to do so, rather than suggest it’s time for a wheelchair. If our elderly relatives can take care of an issue safely, it’s fine to let them do so.

Just be patient.

Showing patience with our loved ones allows them to maintain their dignity. Quality of life and dignity are very important for them, and that’s why they want to do as many things as they can by themselves. This means that we should not interfere unless their safety is being compromised.

We should only intervene when things become unsafe – when we see that they are having falls, we have to intervene. When dementia, arthritis, or other problems impair their ability to drive, we need to intervene. Anything that may threaten their safety should be given the highest priority. But until that point, act with restraint. Remember, even when our loved ones have a threatening disease like dementia, they will still want their independence. We need to let them have their independence for as long as safely possible.

Just be patient and take it easy for the sake of our loved ones and ourselves.

Every situation is unique; there is no single solution for everyone.

Mahesh Moolani is an internal medicine physician and author of Tough Decisions In Care Of Elderly Loved Ones (A guide for caregivers).

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