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Supporting Independence

Practical tips for caregivers to help patients maintain and build independence.

 

The biggest mistake most caregivers make is providing too much care. As a caregiver, your highest goal is to give the person you are caring for the power and the permission to be in control of his or her own life (as much as possible). It is important for patient’s to feel independent both for their emotional needs, and physical.

• Expect more from a care recipient. People respond to expectations so if you expect the person to get dressed or prepare a simple meal, they often will. It is also important to limit your availability to help. If you are not there to do everything for the care recipient, they will be forced to do more on their own.

• Give the person something to take care of . Some studies show that when nursing home residents were given a responsibility, such as taking care of a pet or house plant, that they lived longer lives. This also helps them become and feel more independent.

• Encourage movement and exercises. Mobility increases independence and decreases complications due to inactivity. Exercises that put the major muscle groups through the full range of motion (ROM) must be encouraged. Even the smallest efforts, if done consistently, will lead to greater independence for the care recipient.

• Break big tasks into small ones. Depression, fear, and humiliation are major obstacles for a patient. If tasks are too complex, the care recipient may feel frustrated and defeated. Simplify complex tasks into small parts or steps.

• Encourage the use of assistive devices. Ambulatory aids such as canes, crutches, rollators and walkers encourage independence. As do sensory assistive devices such as vision aids, hearing aids, and dentures.

• Offer encouragement often. It is often hard for a patient to see their progress. Reward for both effort and result. Make the patient feel good about doing things independently.

• Let the patient make as many decisions as possible to maintain their independence. Deciding what to wear, what to eat, and what time to go to bed, are all important to make them feel they are in control of their own lives.

• Provide for psycholosocial needs. Care recipients who are ill or disabled often have an increased need for acceptance from loved ones. Entertainment and social interaction is essential to everyone, especially someone trying to recover from an illness or someone living with a deteriorating health condition. Encourage family and friends to visit, and remind them as well. Because patients often feel isolated, plan outings of their choice to enable them to socialize and feel more independent.

Dressing

  • Provide as much privacy as possible during dressing. Patients may take longer to dress and be fearful of breaches of privacy.
  • Offer frequent encouragement to relieve stress and frustration.
  • Provide assistive devices such as a buttonhook or loop and pile closures that may make it possible for a patient to continue their independence.
  • Encourage the use of clothing one size larger. This will make dressing easier and more comfortable.
  • Clothing items that may increase independence include front-opening brassier and half slips and elastic shoelaces or loop and pile closures on shoes.
  • Provide a makeup mirror and assist as needed. Fine motor activities may take longer and could be beyond the abilities of the patient.

Bathing

  • Maintaining privacy during bathing is fundamental for most patients. Allowing the patient to select a bath time when they are rested and unhurried ensures the best outcome.
  • Provide support with assistive devices such as a long-handled bath sponge , a shower chair, and grab bars.
  • Encourage your patient to brush their hair, brush their teeth, shave and perform minimal oral-facial hygiene to maintain autonomy.

Communicating

    • Evaluate the need for adaptive equipment on the telephone such a pushbutton phone, larger numbers, and increased volume.
    • Supply patients with felt-tip pens for writing. These require little pressure marks and are easier to use. Evaluate the need for a splint on writing hand, which assists the writing device.


 

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