Can you do it for me? The importance of remaining independent

The importance of remaining independent in the activities of daily living should never be underestimated. Independence is a quality that is closely linked with self worth. Carrying out the activities of daily living have usually been part of a daily routine that the patient has been following for decades. By removing independence in these daily tasks, impact on the patient can be widespread affecting both their physical and psychological well being. Sometimes in an effort to assist an elderly or disabled person we do too much and can remove their independence completely.

It’s part of human nature to want to do things ourselves.  As children we’re guided to be independent by our parents and aspire to carry out activities when and how we want to. It’s only when carrying out an activity becomes too difficult, or when we fail, that we look for help.

Sometimes the immediate solution is to remove the task completely from the individual and hand it over to a carer in its entirety.

I witnessed this when working as a community occupational therapist. If a patient was unable to cook independently, for whatever reason, the immediate response was to provide a carer for a mealtime visit. This resulted in the activity of cooking being completely removed from the patient. Although the patient may have been struggling with carrying out just one aspect of the cooking task, by introducing a carer, the activity was removed from patient altogether.

One particular patient had a care package in place and different carers visited her every day to cook her lunch and prepare a sandwich for tea time. There was no consistent time when they visited and their attendance time ranged between 11.45 and 2pm. This meant that some days she ate before she was hungry and on other days she was very hungry before having her lunch. This caused resentment and the feeling of loss of control felt by the patient affected her profoundly.

During the Occupational Therapy assessments it became clear that the patient was able to carry out the majority of the cooking activity but was unable to carry heavy saucepans from the hob to the sink and was at risk of dropping the boiling water. By introducing a lighter saucepan and a colander, the patient was able to cook by using the colander in the saucepan and lift her vegetables straight out of the hot water and onto the plate. With some minor kitchen equipment and some changes in the kitchen layout she was able to prepare and cook her meals independently.

Whenever assistance is provided to the elderly or disabled, it needs to be balanced with ensuring that as much independence as possible is maintained. I’d like to suggest that you consider the following;

  • Identify which part of the activity is causing the difficulty.  It may not be the whole task but just one component.
  • Can an alternative method be adopted to help with the specific task? (Like the example of using a colander for boiling the potatoes)
  • Is there any equipment available which will help? There are many aids to daily living that have been specifically designed to assist with daily activities.
  • Encourage independence. Even if only a small amount of the activity can be undertaken by the patient, it all helps toward promoting self worth and maintaining an independent lifestyle.

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