by Joanna Smith on Aug 10, 2010

When I listen to clients that I work with–of almost any age–they all say the same thing:  “I want to maintain my independence” .  The other description you may hear more frequently these days is “aging in place”, the ability of an older person to remain in their own home with appropriate services and maintain their independence.   Their families say the same thing :  “we want them to stay as independent as possible. “ This last month, I have heard these words on at least six separate occasions.  What does it mean to be independent?

For many people, as they age, they fear “losing their independence”.  For some that means not being able to drive any longer; for others it means having to live with a family member who provides care for them; for still others it means having a “stranger”, a caregiver outside their family, assist them with care at home.  Frequently clients may say to me “I’m doing ok, I manage to stay independent with the help of friends and family.”

Family and friends  can be very puzzled by this comment, because they see the situation so differently.  This last week one of the members of the Healthcare Liaison Credentialing program  put it succinctly:  “If someone is living at home and relying on friends and family to provide care, are they really “living independently”?

It’s an interesting question.  The difficulty here is that friends and families—with their myriad responsibilities and activities—frequently feel pushed—by themselves or guilt or another family member– to provide care that taxes their emotional and economic resources to the limit.  Their family member may be living independently, but at an enormous cost to others in the family system.  There is a delicate balance of needs that must be accommodated.  It frequently takes a healthcare advocate with an  unbiased set of eyes to identify where the balance is and see if it can be shifted so everyone’s needs are taken into account.

Perhaps the ultimate goal as we age should be to look at our entire community of support–our friends and family–address their needs as a whole, and reach a compromise plan.  So then the goal is not independence, but interdependence.