I recently had the opportunity to attend a conference hosted by the Tennessee Association for Homes and Services for the Aging (TNAHSA) where more than 300 leaders in aging services gathered to discuss current issues effecting elder care.
During a session entitled “What is the Right Thing to Do?” lead by Bioethical Services of Virginia, Inc. president Dr. Michael Gillette there was enlightening discussion about who holds the burden of proof in determining a person’s capacity to make his or her own decisions. One must understand that we all have the power to decide for ourselves until the burden of proof is met that we cannot do so.
It was explained that there are two reasons for restricting one’s own decision making. Paternalism refers to restricting someone’s ability to decide for his or her own good (EX: restricting a severely demented person from operating a stove). Distributive justice refers to restricting someone’s ability to decide because others may be at risk (EX: restricting a severely demented person to drive a car on a busy street).
August 25, 2010
Anyone who has had the opportunity to live around someone with dementia recognizes the challenges associated with difficult behaviors. Melanie Bunn, RN, MS, recently explained “The 3 Truths” related to dementia patients.
First, people with dementia are doing the best they can. Second, care partners are doing the best they can. And third, caregiving is difficult for the person doing and the person receiving care. So, the key is the relationship between the two people.
We have all heard of patients with heart failure and kidney failure. Ms. Bunn suggests that dementia patients are in brain failure. None of us expect someone with heart failure to simply be able to stop their symptoms, i.e. shortness of breath for example. So, why is it that we might think a person with brain failure can just stop a behavior? As the brain physically changes in dementia, certain functions of the brain just cannot work any longer. The key is that we as caregivers must learn to change our behavior because the person with dementia simply cannot.
Three tips for change include:
1. Give up expecting life to be like it used to be.
2. Let go of needing to be right.
3. Learn to go with the flow.
August 16, 2010