I’ve often wanted to construct a study whereby emergency responders proceed to the scene of a crisis without red flashing lights, sirens blaring, adrenalin pumping, horns alarming, while preparing for the worst. I wonder if the outcomes would be just as good, if not better, if the response—while swift—were calm, perhaps with soothing colors and beautiful sounds helping clear a path through the streets.
Does chaos breed chaos? Could an environment of calm and assurance meet an urgent need more effectively than one of anxiousness and upset? In my life, when I slow down in the midst of a crisis, deep breathe and think for even a moment about the next steps, it serves me well.
Often in our advocacy work we find ourselves assisting families in the midst of a situation where they are expected to make very big decisions in a split second for themselves or a loved one. Often, it is true there is absolutely no other choice than to jump in feet first and make these big decisions in a hurry.
Other times, however, the situation is seemingly out of control because of “risk interpretation.” One of the issues we support families through is the over-medicalization of a person’s life. Well-meaning medical experts often lead people this way, pushing for solutions designed to minimize their own risks or support their own views when in fact many families are able and willing to take on the risks for themselves if they know all of their options.
When making a decision regarding a person’s care, risks should be conscientiously dissected and weighed to get to the right plan for him or her. Many of the risks we hear about have to do with falls, finances, medication management, isolation, end-of-life care, rehabilitation in a facility versus at home, dementia care, and institutionalization. While these risks are common, there is no magic formula for calculating the best route for someone, which further complicates matters, increases stress and raises questions.
What rights do we have to take risks for ourselves or for others? Who decides what risks are allowable? Working closely with many families and individuals in emergency situations over the years, we have learned that even when you are in the midst of a situation that might seem to require immediate action, it is fine to slow down and take the time to figure out the answers to these questions.
We meet families who say, “Mom fell once on the steps so she is going to have to move out into assisted living,” and we meet just as many families who say, “If Mom falls again and is on the floor all night, it would be the way she would want to go and that is a risk we are willing to take.”
We meet families who say, “Our doctor of 30 years wants me on this new medicine and he has always been great with us so we will do as he says,” and we meet just as many families who say, “I will not add another pill to my regime because all of these pills are not good for me. I want another opinion.”
Who is right? How do you know what to do? Do falls occur less often in assisted living? Is polypharmacy a huge issue for the health of an adult? It takes less chaos and more calmness to obtain answers to such questions in an effective manner.
Another thing we have learned over the years is that our clients may not make the same decisions we would make for them or for ourselves. Sometimes we see no downside to a situation when they see it as a huge risk, and sometimes we see huge risk where they don’t. Our job is to empower families to get what they need in order to sort out the risk/benefit profile.
It would do us all well to remember, it is OK to take that deep breath and slow down in order to make a decision and it is OK to ask everyone involved to slow down so you are not responding out of pressure but out of discernment. If you find yourself in a situation where the risk is unclear or all of the options are not presented clearly, simply ask those around you to give you more information and some time to reflect. Be prepared to demand it. It could be riskier not to.