Few of us are prepared for the enormous challenge of making choices for another adult. Unlike children, adults have their preferences, habits, and goals fairly well established, and they are notoriously resistant to giving up control. No matter how well we think we know someone, there are all sorts of finishing touches he or she expects in personal grooming, doing the laundry, handling the finances, and especially at mealtime. It can seem like there are a thousand ways to do the simplest task wrong, and only one way to get it right.

The other side of the picture is this: that a person who has lost mental or physical capacity is often aware that something is wrong. Such a person is anxious to regain control of the situation. Small matters that would have been irrelevant once are now highly significant. Being able to decide how far apart the drapes should be drawn looms large as a way to impress one’s will upon the circumstances of his or her life once more. Respecting the dignity of our loved ones while choosing what’s best for them can be a balancing act that demands constant adjustments to the relationship we had with them before the impairment.

Things are not the same. When someone we love is disabled mentally or physically, independence and ability are not the only factors that have changed. A shift in power has occurred, and depending on the nature of your relationship in the past, the new roles you will both play can be difficult to accept, painful to learn, and confusing to sort out.

It’s not about you. Fear, confusion, and anger are emotions that frequently accompany a loss of ability to determine our own way in the world. Touching our mortal limits is a scary proposition in the best of times, as when we narrowly avoid an accident or recover from an illness. But when there are long-term or permanent changes in our ability to control our bodies or our lives, we express our anxiety by every means still available to us. Some people will retreat into silence or depression. Others will lose their temper often or burst into tears unexpectedly.

Get what you need and ask for help. When it comes to money and health issues, you will need to have the proper documentation to deal with the bank and the doctors with full authority. In some states, power of attorney for health care has been separated out from the authority to make financial decisions, so you may need to notarize two different forms to insure that your loved one is represented in both ways.

There are plenty of ways to make use of outside assistance. Consider any proposal of help, however unexpected or unlikely it may seem.

Let your loved one do what is possible. When we accept authority for decisions a loved one normally made alone, it’s important to be aware of how much interest that person shows in the issues to be decided. Some people will give up command of domestic matters entirely without protest, but show concern for where the money is going. They may become apathetic during the long doctor’s conferences about the progress of their condition, but be acutely sensitive to a small loss of function. Listening carefully, asking questions that can be answered with a simple yes or no, and involving our diminished family member or friend in the decision-making process is the most loving and respectful thing we can do.

When a loved one becomes impaired and needs our care and protection, we may be just as emotionally confused by the new terrain as they are, but with a little time to adjust and some outside support, we will find our footing. It may surprise us to learn that we are stronger, more resourceful, and more capable of handling the new responsibilities than we thought possible.

Excerpt from “When a Loved One’s Care Decisions Are In Your Hands” by CareNotes.

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