Risk Assessment Not Simple

“I’ll do it, thank you very much. Just sit down and worry about that precious cargo of yours.”

Gulp. What could I, a 36-week pregnant woman say to my 82-year-old widowed family friend, who insists on making me fresh tea, requiring her to wobble up and down the rickety stairs to the backyard patio?

With a near trip on the stairs, my gerontology hat falls off my head and I nearly scream, “You shouldn’t be doing that on your own. You might fall and break a hip. Please allow me to help.”

Instead, I place a hand on my bulging belly (it’s not as if I can move anywhere fast), breathe a quiet sigh of relief and graciously accept my hostess’ generous offer of tea and cookies.

All of us are exposed to potential harm simply by living or going about our normal routine. Some of us partake in activities that are considered risky to others but not to ourselves.

As caregivers and concerned family members, how do we determine the extent of risk as it relates to our aging loved ones?

In general, the term “living at risk” means that aging individuals are free to engage in activities that might be considered risky so long as they are mentally competent and don’t place others at risk or expose them to harm.

With age comes a higher likelihood of exposure to risk than other adults. Changes in health, presence of chronic disease or varying mental capacity can make elderly loved ones more vulnerable to accidents or injuries.

Morally, caregivers and concerned family members have an obligation to protect loved ones from harm.

It’s a fine line.

Smothering your aging mother or great-uncle can also undermine self-esteem and confidence. Having the ability to make choices about how to go about one’s day is not only a right but a fundamental underpinning of living a dignified and independent life.

Putting it into practice, however, is rather tricky.

How can a son who guides his mountaineering clients to altitudes of 20,000 feet reprimand his 85-year-old mother for using a ladder to clean her windows?

Before placing limits on your aging loved one’s abilities or becoming your dad’s risk manager, ask yourself these questions:

• Do I want a protective or safer environment for my aging loved one’s sake or my own?
• Is my assessment of the risk influenced by personal fears or desires? Or is my aging loved one minimizing the risk due to fear of loss of independence?
• Is the risk real, or would I experience less guilt and worry less knowing my aging loved one is safe?
• Do I feel the need to have my loved one’s mental competency assessed or are they able to function globally at present?
• Do I feel my aging loved one is aware of the effects of their decisions and choices on others?

Family caregivers are often challenged to respect their loved one’s choices and accept risk while continuing to offer support. It shouldn’t, however, be limited to non-interference. Caregivers also have the right to negotiate ways of managing risk to protect their aging loved one’s value, beliefs and safety.

In two weeks’ time, we’ll provide caregivers with strategies to negotiate the delicate path of respecting their elderly loved one’s individual rights while making decisions on the basis of what’s best for the collective whole.

Wendy Johnstone is a gerontologist and is the founder of Keystone Eldercare Planning. Her column runs in the Comox Valley Record every second Friday.