The Eyes Have It Or…

Why Seniors May Not Comply With Medical Orders

I was recently diagnosed with a slightly elevated pressure in one eye and blocked oil glands in my eye lids. This experience has given me new insights into the process of compliance with medical orders. First, a context; I have been disgusting healthy. My doctor could not believe that I took no prescription medications! This diagnosis came as a shock.

Blinking exercises were ordered. I had to adjust my daily routine to fit these exercises in four times each hour. It took me a week to find spaces in my day to do these as I exercised, cooked, wrote these blogs, and worked with clients. It took more than effort, it took my energy. I was so tired! I was also determined to make it work. Fortunately, I was only incorporating routines related to one diagnosis; what if I faced that on multiple diagnoses?

Many seniors face simultaneous, lifestyle adjustments related to various conditions. Pile these adjustments on top of each other and you have a recipe for exhaustion in mind and spirit. At first I was frustrated with myself at being tired. Then I realized that I needed to be patient with myself; incorporating takes time. I imagined myself folding the exercises into my life as one would fold ingredients into stiffly-beaten egg whites; carefully and methodically. When caregivers observe a senior in frustration or despair; we should recognize it as a normal expression of adjustment-related low energy. Caregivers can work with them to find ways to make adjustments “fold” more smoothly into their lives.

Two eye-soaks a day were ordered for me to unclog the oil glands in my lids. I collided with mechanics! Heating the washcloth in the microwave required many attempts to get it just the right temperature. Handling and folding the hot washcloth presented other issues. Arranging my early morning and bedtime routines for “soak space” was another process. Sometimes, the time would get away from me and I couldn’t do it. Sometimes I got involved in something and forgot. Creating a new routine also takes time, planning, energy, and patience.   Seniors need those too.

Consider your senior facing a new medical routine. Do they forget sometimes? It’s not dementia it’s a new part of their lives. Does your senior express despair? I’m not surprised; after many attempts with hot washcloths, I wondered if I would ever get it right. Caregivers can help by pointing to all they accomplished earlier in their lives. Caregivers can affirm that forgetting in the beginning is not unusual. Caregivers can support their senior by discussing ways to make the process workable.

Lubricating eye drops were ordered for me. That’s a skill I never needed before. What a comedy of errors!       I didn’t know drops could run in so many directions, everywhere except my eyes. It took many attempts to get it right. Practice was my key to success. My determination supported my practice. My incentive fueled it all.

How many seniors need to learn a new skill to comply with a medical order? Many do. Have they given themselves an injection before? Do they know how to apply a supportive bandage or appliance? Do they know how to care for new dentures? Skills take practice and time. Seniors may say “I don’t want to bother (or) it doesn’t matter” to caregivers. What they are really saying is; “I’m struggling to learn a new skill (or) I need guidance and encouragement to become successful”. Speak to the emotions underlying the struggle. Offer confirmation, affirmation and support.

Caregivers become frustrated when they see the new dentures sitting on the counter, or mishandling of injection equipment. We often attribute these failures to stubbornness. Caregivers see these failures in terms of their consequences; receding gums or infections are serious. The learning curve on a new skill is also serious. It really takes several sessions to help a senior learn a new skill. I was only given 5 minutes by my doctor! Our job as caregivers is to help the senior get around their learning curve. Part of that process is to call on their determination and review their incentives. What are your seniors’ incentives? When have they employed determination in their earlier lives? Review their success history with them. My determination came wrapped in an incentive; I will have a second grand child in two weeks. I want to see these children grow up. I want to participate in their lives; for that I need eyes. The eyes have it.



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