I recently returned from a family reunion in Wyoming and was struck by changes in extended family since the last time we were all together (5 years ago).  I have two aunts who are in nursing home care, my mother requires daily caregiving, and a once very close family is divided by disagreement about the best environment for their mother with Alzheimers.  It was enlightening in two ways; 1- how quickly lives can change when functional independence is compromised, and 2- how important it is to develop and ARTICULATE a plan for dealing with functional issues.   In the book I am currently writing I outline how to write a Vitality Directive spelling out the value you hold in having all of your needs (body/mind/spirit) weighed equally if you require assistance.  Since our standard of care is "medical model" focused (i.e. focused on the illness or deficit) rather than person centered it usually results in the physical needs being met without regard to things like emotional well-being, self-efficacy, and self reliance.   There is a tendency to take over for an individual without regard to what they can and should be doing for themselves.  There is also a tendency to have no expectations and offer few if any opportunities for the individual to contribute/give to others.  We need to take a lesson from the disability industry which understands a disability does not define a person, and that the environment created for them dramatically impacts outcomes. 

Is there someone in your life who requires care?   Take a moment to look at the whole environment.  Does it foster self-reliance?  Does it avoid rewarding dependency?  Does the individual have expectations equal to what they are capable of giving, or have ageist assumptions (or illness focused assumptions) robbed them of opportunities to contribute to their own needs or the needs of others?

How about you?  Have you ever given thought to how you would like to be treated if you were ever in need of assistance?  Be assured you won’t get what you need from the medical industry.  Their primary responsibility is to address the disease/illness/disfunction.  It is up to you to create an environment that addresses the other dimensions of well-being.