Watching for loss of independence

Ultimately, the straw that broke the camel’s back was a decision taken by medical personnel in the hospital not to treat my father and to let nature take its course.


Last week I suggested that the primary caregiver for most elderly people is, in fact, the spouse.

It can also be both spouses to each other, if both of them are dealing with health issues.

Without a doubt, that makes for complicated and stressful situations for the couple, and for their children.

Although this is not the case for everyone, one of the biggest impediments to helping the elderly is simply their pride. No one wants to give up their independence, nor admit that they are losing the ability to care for themselves or handle their own affairs.

In fact, resistance to such assertions can become quite heated, and relatives can be very conflicted about what to do. There is, after all, no ‘alarm system’ that goes off automatically when a specific point in time arrives where caring for oneself tips a scale towards impossible.

Just as we don’t notice the daily changes in our children that elicit from once-a-month visitors’ outbursts of, ‘Wow, you’ve really grown since I saw you last.’ neither do we notice subtle changes in our ourselves, or our spouses, that others might notice over a longer period of time: greater fragility in mobility; loss of coherence in conversation; loss of memory; weight/energy loss.

All are examples of gradual changes that chip away at our ability to truly take care of ourselves, but on a day-to-day basis they may seem so gradual to us, and our spouses, that we deny the fact that we have passed some point of no return in our independence.

Still, there is a point when the ability to care for oneself, or one’s spouse, or to mutually care for each other, is so compromised as to be unsafe to the physical or emotional welfare of either or both. In most cases, that perception will come to relatives or objective caregivers before it will come to the individual or couple.

This is when the discussion of an intervention or the implementation of a family plan becomes essential to reduce the stress and risks associated with spousal care.

There was a time, a generation or two ago, when a family doctor had a relationship with an entire family, and might take a step to push a family into some form of recognition and intervention. But I believe that is more the exception than the rule today and, thus, we need to be more vigilant in communicating with our parents and looking for any signs that they are struggling to maintain their independence.

In our case, with parents who were, frankly, too proud for their own good, and with our locations quite a distance from them, my sister and I relied on regular conversations with my parents’ friends as to how they were coping. It was the only way we could get some objectivity to help us decide if we should be personally present to do some of our own observations and perhaps generate some conversations with professional staff to get the necessary answers as to their ability to care for themselves.

Ultimately, the straw that broke the camel’s back was a decision taken by medical personnel in the hospital not to treat my father and to let nature take its course.

Unable to advocate for themselves, it was obvious they needed greater support to get him out of the hospital and focus on his care at home.

Neither of my parents view my current status of living with them as me being their caregiver.  I am simply on an extended vacation because I recently retired.

That view is just fine with me as it provides them the support they need while assuring them they are still independent.


Graham Hookey is

an education and parenting writer


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