Topics on Aging

By Juan Gallo

How do we balance health and self-determination as we age?

June 27, 2022

self-determination

At Heart2Heart, we believe people retain the right to self-determination even as they age. Self-determination is important, even if a person decides to go against the best health recommendations.

In elementary school, perhaps you had a teacher who showed you a picture of black lungs and explained the dangers of cigarettes. In Europe, you can’t buy a tobacco product that isn’t plastered with similar, graphic pictures.

However, even knowing the risk, people still decide to smoke.

For doctors, there’s an ethical rule called informed consent. When a doctor recommends a specific treatment, she must explain the risks and the benefits. However, the patient has the ultimate decision. Once informed, patients can decide to go forward with a surgery that may save their lives … or not.

The same principle should apply to your aging loved one. Your parent or grandparent may be diabetic, for example, and refuse to change behaviors that can lead to negative impacts on their health. However, I personally don’t think there is much you can do.

If the person is lucid and cognitively sound but not making healthy decisions, that’s something different. In that case, it’s our job to offer solutions, but leave the final decision to them.

If the person has an advanced stage of Alzheimer’s disease or dementia, you can apply for guardianship or pursue other legal options. That’s one way to help that person.

However, if the person is lucid and cognitively sound but not making healthy decisions, that’s something different. In that case, it’s our job to offer solutions, but leave the final decision to them.

My father and I went out to lunch a couple of weekends ago. While we were eating, we overheard a loud conversation between a woman and her son.

The son was telling his mother that her actions were irresponsible. He used guilt to explain how her decisions were affecting him and his wife and making them go out of their way to correct her mistakes.

The mother was in tears. She tried to explain that she was not intentionally hurting them. She was making decisions that she thought were right.

The son called her selfish.

If I wasn’t a stranger to that family, I would have wanted to say: “Look, it’s obvious that you love your mom. But it’s also obvious that the words you’re using are not getting the results you want. You’re hurting her instead.”

When you love someone, it’s not always fair to expect them to love you back in the way you prefer, especially as they age. Love is not an exact return on investment.

What we can do is provide information and continue to love and support them. We can be watchful: guarding and protecting, but never forcing.

We must do what’s ethical and in the best interest of the person and not – as hard as it may seem – what’s best for ourselves.

How would you balance health and self-determination for older adults you love?

To become an integral part of self-determination for a senior in the community,  join us as a home-based volunteer!

Read more about:
Juan Gallo
Juan Gallo is the CEO of Heart2Heart Outreach, where he oversees the mobilization of volunteers to provide hope, share love and restore purpose to the lives of the aging population across South Florida.

He also serves as a local pastor and as an adjunct professor at Trinity International University, where he is teaching a course on diversity and aging. Juan has a master’s degree in counseling and psychology and is a licensed mental health counselor intern.

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