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The “rugged individualist” concept from our pioneering days and the time before we had social and industrial welfare programs creates a certain dissonance when we find ourselves in need of the current health and social service systems that we have today. After all, in this global economy no one is really self sufficient any more. We are dependent on oil, computers, toys, household items, food and clothes that are manufactured around the world. We don’t live in community anymore; we create our own communities by belonging to different social, religious, economic, friendship and professional groups.

So it is curious that it is still so painful for many of us to accept help when we need it because of functional or health changes in ourselves or our loved ones. As someone who was not used to asking for help in the past, here are some of the things that I have learned through my journey as a caregiver for multiple family members across generations.

1. You don’t have to be alone in your challenges. It is a choice to keep silent and not ask for support.
2. The love and support of others, even from afar, can be sustenance for the soul.
3. Sometimes when we accept help, we become more grateful for those around us who might also become friends.
4. While asking for help can be humbling, it is also enlarging because it allows others to be close to us. Sometimes people really do want to help.
5. Making one’s own decisions is really what autonomy is all about, so plan for your own preferences and don’t leave critical choices to others.
6. Let others know what your preferences are so that they can advocate for you in a situation in which you can’t speak for yourself.
7. Don’t keep secrets. Others can handle difficult times and if things get worse, those who care about you will be better prepared for the future.
8. Let others know when you want input and when you just need to vent.
9. Set boundaries, so that when you need to be alone you can have quiet time, as well as company when you need it.
10. Sometimes silence together is better than silence alone.

If we close the door to help, there is no room for other options. When we let others in just a little bit, there is room for both autonomy and independence.

We hope that your celebrations of summer and independence are filled with all that you want for yourself and your loved ones.

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Success Story: Independence – Maintaining Autonomy & Learning to Accept Help
by Barbara Harris, LCSW

Mrs. Smith was very resistant to having any help and insisted she did not want anyone in her home. Mrs. Smith’s intense sense of independence and her need for control made it difficult for her to accept the idea of help for either one of them. Our Care Manager went out to assess the situation and attempted to educate Mrs. Smith about the new demands she would be facing once her husband came home. The Care Manager helped her to understand that the best way to maintain her autonomy and dignity would be to accept some help, at least until Mr. Smith’s needs could be determined. She was finally willing to accept some help “for a few days.”

After a couple of weeks, Mrs. Smith became very agitated and found her husband to be much more needy than she thought he would be. She still did not want help and finally refused to allow a home health aide in her house. Without a home health aide Mr. Smith’s care began to suffer after only a few days. It became apparent to the Care Manager, who still had a good relationship with Mrs. Smith, that this situation was unsustainable. The daughter wanted them both to move to an Assisted Living facility in her state so she would be able to see them more frequently and oversee the help they needed. Mrs. Smith refused to leave her home. Believing there were no other choices, the daughter moved Mr. Smith to a facility close to her, leaving her mother alone in Florida, where she refused all help. She continued to allow the Care Manager to visit her, however because a trusting relationship had been formed between them.

After a few weeks alone, Mrs. Smith’s condition began to deteriorate. She wasn’t eating properly, her excellent grooming habits were becoming poor, and she still refused to move. After much work by the Care Manager about her realistic choices she finally consented to having a home health aide for limited hours. She ultimately grasped the reality that she would only be able to maintain her independence if she allowed someone to help her.

Mrs. Smith now has a live-in aide to whom she has become very attached, while still maintaining the independence of living in her own home. Mr. Smith is doing quite well in the Assisted Living Facility close to his daughter. It is rare that separating a couple is helpful, but in this case it proved to be the best result for all members of the family.

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