The Whys and How-tos of Promoting Independence in the Patient
By nature, we value our independence as human beings, whether as an individual or as a country. We fight to be able to decide and do things on our own and live our lives free from the control of other people.
Remember taking that first bike ride around your neighborhood without your parents tailing you? How about the mixed feelings of pride, excitement, and uncertainty when moving out of your parent's house to live on your own?
Wanting independence is a sign of a healthy mental state. A person who wants to do things without the help of others feels motivated and can have a positive outlook on life. This is true even in patients who are struggling with their health.
But there are times, such as in the midst of debilitating disease or disability, wherein patients lose their confidence to tend to their own needs, thinking that others can do it better. So, they begin to (unnecessarily) completely rely on others for their wellbeing. There are also situations wherein a patient feels depressed and expresses no interest in getting better.
In some cases, it is the caregivers who lack trust for their patient’s ability to care for themselves without sustaining some kind of injury in the process. So, instead of assisting them and doing things WITH a patient, they do everything FOR their patient, which ultimately results in poorer health outcomes.
Caregivers can be instrumental in promoting independence in patients. Self-care is an important part of the patient’s physical, emotional, and mental well-being.
So, why promote independence in patients?
• It strengthens a person's sense of purpose in society as an individual capable of making a contribution.
• It promotes a sense of control.
• It makes them feel good about themselves, so it curbs frustration.
• It gives them a sense of achievement, thereby enhancing mood.
• It improves their physical condition because they can exercise their muscles.
• It makes them want to do more for their health.
When your patients lose their drive for self-care, consider the following tips:
1. Start a procedure and let the patient finish it. For example, if you are giving your patient a full bath, wash the areas they cannot reach, then let them clean and rinse the rest of their body.
2. Do the most difficult procedures, then let them perform the simple ones. Have a patient brush their teeth and comb their hair after giving them a bed bath. Over time, slowly involve them in more complex activities.
3. If they are confused and having trouble making sound decisions, provide at least two safe options for them to choose from so that, either way, they benefit from their decision.
4. Recognize achievements and improvements, however small. Focus on what they can do and not on what they can’t. If they fail to make any progress on a given day, try again the next day.
5. Encourage physical activity like taking a walk. Exercise can improve the flexibility and strength needed to do things on their own.
6. Provide tools that help them manage self-care, such as reachers, buttonhooks, sock aids, raised toilet seats, shower or bath seat, etc. Keep commonly used items within easy reach. If moving around is a problem, provide wheelchairs, a cane, and crutches, whichever they are allowed and trained to use.
7. If you are using technology, such as mobile devices, to help patients, enable voice recognition, screen readers, and font adjustment.
8. If the patient is stubborn or reluctant to act more independently, encourage them and provide opportunities to perform a simple activity by themselves. You may observe them the first few times, until they are fully capable.
Promoting and maintaining independence in a patient is indeed a challenge, not only because there are disease or disability to overcome, but also because safety can be compromised if done incorrectly. Caregivers can work with the rest of the healthcare team in providing holistic care and while safely involving a patient in their own care.
