Surviving Caregiving

Can You Be Too Careful?

Last updated: Dec 23, 2013


It's a natural impulse to want to protect those who are frail or have dementia. We want to keep our loved ones as safe and well as possible. Unfortunately, when it comes to older adults, keeping them safe isn't always the same as keeping them well.

You can be too careful, believes University of Edinburgh professor Charlotte Clarke. Head of the School of Social Science, she mounted a theater performance and workshop, based on almost 90 interviews with people who have dementia and their families, to illustrate how focusing on safety above all else can actually have hidden risks.

The problem comes in when you see the problem before the person. The person becomes their diagnosis ("Alzheimer's! Must keep safe!" "Stroke victim! Must keep safe!") Finding that fine line between protection and overprotection can be really hard.

As you try to find it, consider the potential costs of overprotection, say Clarke and others:

A social cost: By not letting the person to drive or walk, for fear he'll get lost or fall, we set him up to lose important social connections. Better: Figure out ways to help make social outlets possible (using GPS, being escorted, finding other social outlets, for example).

An anxiety cost: By doing everything for someone who has Alzheimer's -- setting the table, fetching the slippers, cleaning the house -- we make life easier for her. Yet a lifelong emotion of purposefulness usually remains. The resulting disconnect ("I feel like I should be doing something, but I don't have anything to do") is known to raise boredom and behavioral problems.

A sense-of-identity cost: We all long for meaning and purpose. When we're marginalized, safeguarded away from activities and interactions with others, what's left? Who are we? What's our purpose?

A quality-of-life cost: The net effect of being guarded like a fragile egg or sidelined because of a diagnosis is that it's not much of a life. And yet many older adults' lives are prematurely nipped for such reasons. Peter J. Whitehouse, M.D., writing in the ChangingAging blog, points to dementia-friendly communities and intergenerational programs as exceptions we need more of -- ways of reimagining the cognitive challenges of aging to focus on relationships and the recognition that "we all need the same sense of purpose and passion in life regardless of the labels that others attach to us."

That view raises the quality of life for everyone touched by it.