Maintaining Autonomy in an Assisted Living Environment

Autonomy is an individual's capacity for self-governance. It is one's ability to act according to their own will, the capacity to decide for oneself and pursue a course of action in one's life. We strive to be able to choose how we want to live our lives without external interference. Our laws allow each of us to live at significant risk and make decisions as long as we maintain the ability to understand those decisions. 

Maintaining autonomy and receiving informal care are very important for people living in assisted living facilities. The concept of autonomy as а fundamental right, however, is compromised when diagnoses such as dementia and Alzheimer's need to be taken into account.

Compromised Autonomy in Dementia

Early dementia may reduce the ability to perform daily tasks, such as cooking, banking, and even driving. Unfortunately, this reduction in performance increases with the progression of the illness. The functional decline is followed by gradual removal of freedom—the cancellation of driver's license, moving out of the family home, and surrendering power of attorney over financial matters. At this level, the individual often must rely on family members for assistance with daily tasks, abide by the rules of doctors or caregivers, and obtain permission to access their own money. A large amount of sovereignty has now probably been surrendered.

People residing in assisted living facilities want to be actively involved in their care. Studies show residents living with dementia who are more independent in performing daily life activities (such as dressing, bathing, and going to the bathroom) have better health.

Now the question arises, how can we maintain people's autonomy with assisted living and memory care? There are a few innovative ways to maintain independence in patients with cognitive decline.

Factors That Maintain Autonomy in Patients with Cognitive Decline

1. Knowing when and how to Help

The biggest problem for caregivers, whether it be a family member or healthcare professional at a memory care or assisted living facility, is knowing when and how much help is needed by the client. That's why our caregivers here at Garden of Palms assisted living in Los Angeles take the time to interact with the individuals to evaluate their abilities. It helps to understand what can be done to assist as necessary, and in such a way it minimizes infringement of their autonomy. The best way is to ask that person about their needs, and that's an approach we use whenever possible.

2. Addressing Communication Barriers

People with cognitive decline face many communication barriers due to multiple problems resulting from mental illness such as hearing loss, vision impairment, ataxia, and dysphasia . The person cannot correctly answer the questions asked by the caregiver or doctor due to these problems. Health care providers should always promote the autonomy of those with cognitive impairment, regardless of their capacity. One way this can be done is to actively engage these patients in discussions based on where they live and in decisions about their health. If the ideas being discussed are beyond their comprehension, then these should be presented in simple language. Even with the most severe dementia, encouraging participation in simple decisions, such as dressing and eating, can maintain some.

3. Habilitation therapy

Habilitation therapy is a technique to maintain a person’s autonomy, skills, and faculties. It enhances following experiential areas to illuminate a positive emotional response.

• Physical
• Social
• Behavioral
• Communication
• Functional Response

4. Encourage participation in daily activities.

Especially in the early stages of the diagnoses, or shifting of an individual to memory care or assisted living, it is essential for caregivers to actively encourage their loved ones to take part in daily activities. This could include tasks such as dressing and grooming, as well as household chores like helping in the kitchen and watering plants.

5. Encourage physical activity

Physical activity is beneficial not only for strength and fitness but also for mental wellness. Regular exercises may extend how long people living in retirement communities continue doing their daily tasks. Caregivers at these centers should encourage physical activity like walking or stretching daily.

6. Focus on the person's Expertise

In earlier stages of onset of cognitive decline, those diagnosed with dementia and Alzheimer's residing in assisted living facilities can often accomplish their daily tasks. So, we here at Garden of Palms assisted living encourage their participation on such tasks. The "Use it or lose it" principle is specifically beneficial for patients with dementia. Person-Centered Patient Care is the best way to handle these cases and maintain the freedom of the individuals.

7. Provide opportunities for social engagement

As we age, we become more worried about becoming isolated from loved ones and family. And of course moving to a new place is never an easy option, especially if it's due to things we can't control, like inability to care for ourselves as we would like. It takes time to become comfortable in a new environment. Community involvement and social activities boost the feelings of inclusion.y

8. Coordination between All Caregivers

To meet the person's medical, emotional, and social needs, the doctors, social workers, family members, friends, and the client in assisted living should all work together. This helps maintain a continuity of care, and keeps everyone on the  same page to provide a care plan tailored to the individual.

All these arrangements collectively give courage and confidence to the clients resulting in fast rehabilitation and better patient care when needed. Whatever the needs of yourself or your loved one, we are confident we can help maintain the all important autonomy we all strive to maintain, for as long as we are capable. 

Please call Garden of Palms now to let us work with you to discuss your needs for a healthier and happier future for yourself, or someone you care about. Stay well, and we look forward to speaking with you to arrange a tour of our unique and beautiful facility.