Mrs Jones, this chicken is the freezer is from 2002. Do you want us to throw it away?” I asked.
“Oh no,” said Mrs. Jones. “ I just sautee it with some butter and seasoning and it tastes fine.”
“But it’s ten years old, It can’t possibly be good for you.
“I’m 92, it can’t be that bad.”
And that’s when I began to think about surplus safety.
Culture changing expert Dr. Bill Thomas argues that when dealing with elders, we focus almost exclusively on the down side of risk, and in doing so, inadvertently remove the possibility of upside of risk — the opportunity for growth and new experiences. As a result we create environments with a “surplus of safety.”
This concept has caused me to rethink my job as a Senior Move Manager — someone who specializes in creating safe physical environments for elders.
Part of my job is advising against throw rugs and for chairs with arms, for placing things needed every day on shelves where they can be reached without a stool, and more. Ever mindful of the devastating impact of a fall, I urge clients to downsize sufficiently so their belongings will fit in their new surroundings, and ask them not to be present while we unpack so they can avoid the stress of move day. I want to protect them, because they haven’t moved in 40 years and I help people move every day, so I know what is best for them.
But do I?
Relocation Stress Syndrome (RSS) is the name given to the physiologic and psychosocial disturbances that result from transferring from one environment to another. At first, psychologists believed that this occurred primarily in involuntary transfers to long term care settings, but today scientists agree that RSS can occur in moves to many settings and even when moves are voluntary and planned.
The symptoms of RSS are loneliness, depression, anger, apprehension, dependency, confusion, anxiety and withdrawal and can affect anybody who moves to a new home. Minor characteristics include changes in sleeping and eating habits, insecurity, lack of trust and need for excessive reassurance.
When experiencing relocation stress, the process depends on a number of variables, such as age and stage of life, personality, number of losses, amount of preparation and the degree and type of support before, during and after the move. RSS is experienced until a sense of control is regained.
Given the support we provide before, during and after the move, involvement by Senior Move Managers and family members must decrease the likelihood of RSS, right?
But here’s the rub. When we take excessive control of the move to maximize the outcome, are we taking control away from our clients and parents?
Another culture change advocate, Kort Nygard, tells the story of a man in a long term care setting who asked for something meaningful to do. How did he define “meaningful?”
“Where if I screw up, something bad happens.”
Are we so focused on helping clients and parents achieve “good moves” that we reduce their opportunity for risk and control? If control over one’s move is so important in minimizing RSS, are we inadvertently contributing to the very thing we want to avoid?
I agree that being in an over cluttered home, with potential physical hazards, can decrease one’s sense of control. But you and I have that choice — the opportunity to make bad decisions. Shouldn’t our clients and our parents have it too? Are we patronizing them by urging them to do what we want because we know best, even when it conflicts with what they want? The fact that things don’t fit in a new home does not mean that clients didn’t part with a great deal. Instead of helping them feel good about what they did accomplish, are we making them feel bad about what they didn’t?
The desire to help clients and parents have a good move while maximizing their sense of acheivement and control is a conflict that seems inherent in what Senior Move Managers do. Let’s remind ourselves to not “over-protect” our clients.
As expressed succinctly by Kort’s friend, part of what makes life meaningful is knowing that what you do matters and has consequences. Retaining the right to make decisions, even bad decisions, is a key ingredient of being in control.