There is a thin line between safety and autonomy. I heard some version of that statement at the outset of my caregiving journey.
When you’re taking care of someone you love, it’s hard to resist the urge to prevent absolutely all possible harm. The problem is that to achieve absolute safety, you’ll need to swaddle them in bubble wrap.
The cost of zero risk? Loss of autonomy and all that goes with it.
Somewhere along that spectrum—from total safety to complete autonomy—a caregiver has an opportunity to help preserve dignity during a time of change and loss.
If your person has been independent, mobile, and relatively healthy until now, it would be rather unusual for them to request assistance using the hospital bathroom or bedside commode, let alone in the home.
You’ll want to do everything you can to maintain that privacy. Maybe it’s placing wet wipes in the bathroom in addition to toilet paper, which doesn’t clean as well (or installing a bidet). Maybe it’s a walker with a seat that helps your loved one transfer to the bathroom.
Maybe a time will come when you need to introduce and encourage the wearing of incontinence briefs discreetly. Your loved one may not ask for these, but they may also quietly thank you in their head for making it happen when it’s clear that something needs to change. Place them where they normally keep their underwear and put some in the bathroom as well.
Bathing may become progressively more difficult in terms of getting into and out of the bathtub or shower staff, handling bars of soap, cleaning hard-to-reach places, and avoiding falls. Don’t wait for something dramatic to occur before you make modifications. A handrail inside the tub, on the walls, and next to the toilet.
Unless you have a walk-in tub, which can provide great convenience for your person, a bath chair at the least and even better a transfer chair for ease of moving into and out of the shower or tub. A sponge that's attached to a long handle. A no-slip bath mat.
Your loved one may be more accepting of bodily changes than others, in which case they might ask about and request these items. However, if you make improvements that make daily toileting and bathing rituals easier and even more pleasant, they will likely say nothing and not argue.
Despite these efforts, there may come a time when your person simply cannot do it alone, regardless of how much you’ve adapted home devices. They may need help cleaning themselves after a bowel movement, otherwise there is a risk of skin breaking down in their backside, which is a recipe for an infection and worse.
They may need assistance or at least supervision transferring into the shower or bath. They may be grateful for help managing all the details in the shower: the soap, the washcloth, the sponge, reaching parts of their back. Everything we took for granted for decades.
At some point, a physician may recommend that a professional walk through your loved one’s home to identify safety risks and propose solutions. That visit may be covered by some form of health care insurance. Until then, you are among the best positioned to scan their environment with similar goals. As you walk through their home, here are some guiding questions for each room.
Bathroom
Living Room
Kitchen
Bedroom
General
As you take this journey alongside your loved one, it may be emotionally difficult (not to mention logistically and physically). At the end of the day, you will know that you’ve done your best to find a balance between safety and autonomy.
Now drink a glass of water and get some rest.
Caregiving: Safety and Autonomy
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11.04.2024
There is a thin line between safety and autonomy. I heard some version of that statement at the outset of my caregiving journey.
When you’re taking care of someone you love, it’s hard to resist the urge to prevent absolutely all possible harm. The problem is that to achieve absolute safety, you’ll need to swaddle them in bubble wrap.
The cost of zero risk? Loss of autonomy and all that goes with it.
Somewhere along that spectrum—from total safety to complete autonomy—a caregiver has an opportunity to help preserve dignity during a time of change and loss.
If your person has been independent, mobile, and relatively healthy until now, it would be rather unusual for them to request assistance using the hospital bathroom or bedside commode, let alone in the home.
You’ll want to do everything you can to maintain that privacy. Maybe it’s placing wet wipes in the bathroom in........
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