I had reason to think about independence vs safety for an ageing relative recently when my aunt, aged 85, had a fall while shopping. She tripped on the pavement and hit her head. It was a bad fall and resulted in an ambulance being called. May aunt was taken to A&E where she was checked out physically before being allowed home with instructions to visit her doctor the next day.
Worryingly, her doctor noticed that my aunt appeared somewhat confused about the timing of her fall. Notwithstanding that she had hit her head, the doctor was concerned that her confusion might be a sign of the onset of dementia. Suddenly independence vs safety considerations came to the forefront of his agenda.
The doctor arranged for cognitive tests and a home assessment visit from a community nurse to decide if my aunt was able to continue to live alone without assistance.
Usually strong-minded and independent, my aunt was still upset and shaken by her fall. She was also confused and now extremely stressed at the turn of events which put her independence at risk.
Family and friends, on the other hand, tended to agree with the doctor. There was some consensus that it would be good if my aunt had some support at home.
Thankfully, she sailed through the cognitive tests — a great relief to her. Almost immediately, once the stress eased, her confusion also diminished. However a couple of issues came up in the home assessment. The nurse who carried out the assessment identified that a rug in the living room represented a tripping hazard. While accepting that the nurse meant well, this infuriated my aunt who had carefully chosen the rug. It covered 80% of the living room floor and was a centrepiece for the room. She was determined to keep it in situ. A difficult discussion ensued with independence vs safety as the theme. It culminated when, for the sake of peace, my aunt agreed to remove the rug. It was duly rolled up and put away in a storage cupboard only to be quickly reinstated it once the nurse was safely off the premises.
There is no question in my mind that dragging the rug from the cupboard and moving the furniture around in order to replace it, represented a greater safety hazard for my aunt than the potential risk of tripping. She was cross about the incident for days, not to mention worried about having to hide the rug for every subsequent visit by the nurse.
You have to wonder, what is to be gained from a long argument that is stressful and distressing for my aunt who is perfectly happy to take the consequences of a fall – even if that means a broken hip – because she wants that rug in her life.
Of course, the nurse has a duty of care and is rightly insistent on safety standards but equally, my aunt is an adult, well aware that risks intensify with age but she still feels strongly – and I think, rightly – that she is entitled to make her own decisions.
Working out who’s right and wrong in these circumstances is tricky and I suspect it won’t be the last such dilemma as time rolls on.