I can’t remember how the topic came up. I suspect it was one of the many times in the summer when I sat with a group of ladies on our patio, admiring the multiple colours of the flowers and turning our faces to the sun. Someone asked the question, “What is your favourite food?” Without hesitation, Mona said, “A sardine sandwich on multi-grain bread, with mustard and mayo.”
A started silence was followed by chuckles. “That certainly isn’t on the menu.” Our meals are delicious and our menu varied, but sardines wasn’t a hot item. The next week, I brought a can of sardines and told the story to a dietary supervisor. Several servers were in on the surprise, and that day at lunch, Mona was served her favourite meal with flourish. Grins were everywhere, but hers was the biggest.
It’s all about choice. Elders are at a time in their life when, of necessity, many choices are made for them. They aren’t able to live independently, so they have to move. That’s not a choice they would make. They can’t see, so they need help going to the toilet. They definitely wouldn’t choose that. Dementia has stolen some of their memory, so they can’t go for walks alone. No one makes that choice.
“An Elder-centered community honors its Elders by de-emphasizing top-down, bureaucratic authority, seeking instead to place the maximum possible decision-making authority into the hands of the Elders or into the hands of those closest to them.”1
“Decision-making authority?” What does that look like?
Here are some choices most elders can make:
· I can choose when I get up in the morning. I can choose to sleep until noon some days and get up at 3:00 a.m. other days if that’s what I want. I can go to bed when I want to.
I can choose what I wear. If my style is lipstick and pearls, you will honour that. If I’m more of sweatpants type, that’s okay, too.
I I can choose what I like to eat. Even if I have dietary restrictions, there are ways to get around it if you are creative—and if you care. (Did you know that chocolate cake, with the icing, can be mashed and 2-3 creams mixed into it, to make pureed chocolate cake? It tasted delicious. Doesn’t look too great, but if you love chocolate cake but are at risk for choking if you eat solids, it’s a tasty substitute.)
I can choose what I want to do. I don’t have to attend activities. If I want to sit in my room and read a book or snooze, that’s alright. If I enjoy music or art, or model trains or gardening or watching tennis, those opportunities are there for me. I just need to tell you what excites me, and you will find a way to make it so.
I can choose what my room looks like, and what is in it. Those items that are important to me are with me in my space.
· I can dream. What did I used to love, that seems no longer possible? If people who love me are creative and committed, how can they make it happen, or perhaps a version of it? (I'm thinking of the elders we took away for a cottage experience several years in a row. Or the woman in her nineties I saw on a video who, with the use of a special cart, was able to ride a horse again.) What do I wish I could do, and how could you make it happen?
Maybe it’s as simple as a sardine sandwich.
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Care Partner Wednesday--The Issue of Choice