Tuesday, May 12, 2009

Nothing Is Set In Stone

Molly began helping with her father’s care a few months ago and is finding the experience far more difficult than she ever imagined. “I have such a hard time making decisions,” she admits. “What if I make the wrong choice? What if Dad doesn’t like the home nurse I hired? How can I choose when it’s Dad’s health, his life, I’m deciding? I want to do the right thing, but I’m afraid I’ll mess up somehow.”

We all want to do what’s best for our parent. We want to do what will work for us, too. In this striving for the best, for perfection in choosing, remember: there’s one thing certain in caregiving…Change.

Your parent’s condition will improve. Or worsen. Care services that worked well for a while suddenly don’t. The physician who has been seeing your parent retires. The rehabilitation therapist suggests that your parent may not be able to live alone again. The surgery that wasn’t needed last month is now critical.

The decision you made last week was made in last week’s situation and with last week’s information. This week will probably be different. Nothing is set in stone.

Adjustment and change. Normal.

What a relief!

Your first decision doesn’t have to be perfect. It just has to fit the circumstances and information you have that day.

Considering Options
When you’re making a decision that seems particularly difficult or complex, try the following:

• Create a list of alternative choices. Write down as many as you can think of. One of those choices may be to postpone the decision. Brainstorm.

• Evaluate each choice. If you don’t have enough information about a choice, ask questions, find out more. Note the possible positive outcomes to each choice and the possible negative outcomes.

• Weigh the importance of those positive and negative outcomes on a scale from 1 to 10 (1 = I don’t care if this outcome happens; 10 = If this outcome happens, it will substantially affect my life and my parent’s care). There may be many negative outcomes to one choice, but those outcomes may not matter much to you or to your parent’s well-being.

• With your evaluations and the weights of the outcomes in hand, make a choice. Notice that now you have back-up choices if your first one doesn’t work out.

Permanent Consequences
There are some decisions that, by their nature, do have permanent consequences for you or your elder. The choice to remove an artificial respirator when signs of life have faded, the decision for surgery that will remove diseased tissue…these bring a permanent change to a person's health status. Using the suggestion for considering options above still applies, but the outcome weights will be near 10 for some choices. These decisions are particularly difficult.

But over the course of caregiving, nearly all the decisions you make for your parent will not have permanent consequences…inconvenient, less than optimal, aggravating consequences perhaps, but not permanent.

Resist acting or thinking that a decision is one of life-or-death when it is not.

To read more, try:

Simon, Sidney B. Getting Unstuck: Breaking through Your Barriers To Change. Chapter 4: Change and Options. p. 85-114. Grand Central Publishing, 1989.
This chapter provides more details about brainstorming choice options and how making effective decisions keeps you moving forward.

Throughout the caregiving experience, remember that you always have a chance to make changes, to adjust, to do something better, to do it differently. That’s the wonder and happiness of being human. We always have options. Usually more than we imagine. Next time we'll start exploring sources of information that will help rev up your imagination.

Blessings on you and your caregiving!

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