Gary's Guidance: Self-determination: Balancing Safety with Being Autonomous

March 2015

The right to self-determination may be a vanishing value as seniors’ age.  Seniors freedom of choice and being able to make decisions can be impinged upon by adult children wanting to protect parents, or by others who happen to be stakeholders in the life of an elderly person.  That being said, it is important for families and others working in the senior care services industry to ensure the health and safety, and general well-being of older adults.  The children of elders want to have their parents be safe as possible while living at home.  That is why home care agencies are often contacted to provide non-medical care in the comfort of home.  It is why personal care facilities are often accessed to serve the elderly in a more structured environment with greater supervision.

Regardless of the settings, seniors desire to be independent and generally resist any changes perceived to threaten their autonomy.  Along the way of growing older it is important to be mindful of one’s right to self-determination.  Self-determination needs to be respected, promoted, and honored.  Too often self-determination is violated during simple interactions between seniors and others in the spirit of people just trying to be helpful.  Being helpful could possibly be viewed as something being done to others and compromising autonomy.  Especially if the help being offered was not asked for, but just done without any explanation or consent.

When being in the position of being helpful one should understand that independence may be lost by the very actions taken in helping others.  Helping seniors must be balanced with promoting autonomy, ensuring safety, and honoring self-determination.

Gary Kozick, LCSW