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When is Care a Choice or a Necessity? (May 2008)
By Home Helpers, Jennifer Anastasiades

Some people are willing to acknowledge physical or cognitive limitations that result from aging, illness or injury. Others refuse to admit or accept the fact that they may be struggling to cope with everyday life. So the question becomes at what point is care a choice or a necessity, and when might a person's inability to cope be viewed as self-neglect?

According to Jennifer Anastasidaes, owner of Home Helpers, "Just because a person is aging or has a life-altering illness does not mean he or she is unable to cope and make informed decisions. Likewise, if a loved one is making what others might consider bad decisions, that doesn't necessarily mean family should jump in and take over."

Whenever someone faces limitations, it's important to help the person realize the extent of his or her needs. Often the person benefiting from the assistance does not realize all that is being done to help. As a result, the person is unlikely to find a reason to make a choice for care as his or her needs are being met. What the person may not see is that family are exhausted and overwhelmed by their new responsibilities.

Anastasiades recommends that family members talk and share their wishes. "We find that people tend to be more open about discussing possible care needs when the needs are not imminent. Doing so tends to give loved one's more control over important aspects of life."

For many people, care becomes a necessity when family is unavailable to help, when something unexpected happens or there's a problem. The clearer the specific needs of a person are, the more confidence family members usually have in providing assistance and making care arrangements. Often the care provided by family is supplemented by professional caregivers, which helps ensure loved ones receive the care they need when and where they need it.

Many families struggle to figure out when a loved one can no longer cope and as a result neglects daily living activities and personal care needs. Self-neglect is when a person becomes unwilling or unable to care for him or herself and whose behaviors threaten his or her own health or safety.

Whether a person is at the point where care becomes a necessity as a result of functional limitations or a person is unwilling or unable to provide for him or herself, the indicators are often similar.

• A person's bathing, grooming, dressing and personal care behaviors become noticeably different or less frequent than in recent years.
• The home often becomes cluttered with junk, laundry piles up and the house becomes dirty.
• A change in eating habits often becomes apparent through sudden weight loss, a decline in overall well-being, and the cupboards and refrigerator are often bare or contain expired foods.

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