How to allow risk in dementia care (Originally featured on Elizz.com)

Parentification is a term used to define the role reversal that happens when you act as a parent to your own parent. This is often seen in adult children, especially when there is a diagnosis of dementia involved. It is common to want to protect your parent from risk and harm. However there is a thin line between being an appropriately concerned caregiver and one that is overly worried, controlling, and smothering.

When an adult child steps in too quickly to do things that a parent can still do for themselves, the parent may tend to push them away.  And just like when parenting, an adult child can sometimes act like a helicopter and hover too much over a parent. I was that daughter even though I had the best of intentions at heart.

On one occasion, I recall my Mom calling me out on my helicopter behaviour, “I know you love and care for me but please don’t treat me like a child, I can do things myself.”  My interference was unwelcome and I had overstepped a boundary. I realized my Mom had a right to her choices and the right to risks—even with her dementia.

How do you avoid parentification in caregiving?

To avoid parentification, the best rule of thumb is to allow your loved one to function on their own without interference for as long as possible. As a family, we took a couple of approaches that proved to be successful in enabling risk for mom. Letting go and allowing her to be independent was initially difficult. We learned to wait to be needed and not jump in and take over.

The other strategy was to facilitate from behind the scenes—we created a dementia safety plan and orchestrated support from friends, tenants, relatives, and a cleaning lady to keep eyes on the situation when we were not available.

What does managing risk in dementia care involve?

The framework tool for managing risk in dementia care allows you to assess, enable and manage risk with persons with dementia. The framework has 4 steps:

Step 1 – Understanding the person’s needs.

Step 2 – Understanding the impact of risks on the person.

Step 3 – Enabling and managing risk.

Step 4 – Risk planning.

Step 1     Mom likes cooking, cooked all her life for the family and it’s important to her to continue looking after herself and preparing meals.

Step 2     She’s left the stove on a couple of times and burnt a pan. There’s a risk that a fire will start and cause harm to her and her tenant neighbours.

Step 3     Install an automatic stove shut off device that turns off in five minutes if no motion is detected near the stove.

Step 4     If further problems occur with cooking, we will explore alternative options such as using a microwave arranging for someone to cook with Mom, or having meals delivered.

At the end of the day, this is all a fine balancing act.  The trick is ensuring your parent is properly safeguarded without you being controlling or overbearing. At the same time, it is important they have the opportunity to live life to the fullest while managing risks positively.