07/03/2025
Independence – Do we really appreciate what it is?
As we prepare for the weekend activities that are planned for this 4th of July or Independence Day, I am reminded of how I as a hospice worker must honor independence on a daily basis. I am wondering if I and my staff keep that responsibility at the top of our care the way we should.
The definition of Independence according to the Cambridge Dictionary is “the state of wanting or being able to do things for yourself and make your own decisions, without help or influence from other people.” When I talk to people about advanced directives and Medical Power of Attorneys, I often refer to these documents as a way to maintain independence, even though someone is put “in charge” of making decisions for you, when you no longer can, the advanced directives are directions you provided for what you want, so they really are just honoring the decisions you already made, therefore allowing you to be independent in your care.
In end-of-life care, we often see the struggle one experiences with the feeling of “lost independence”. In general, people don’t like being a “burden” to those who are caring for them, the changing of role from caregiver to the one being cared for is a difficult transition for many. Think about A mother who is the Matriarch of the family, and plans all the gatherings, has all the history in her head of the family and neighborhood, is now weak and confused and needs to be cared for, she struggles with not being able to cook and clean and hostess like she has for decades. On the other hand, caregivers who know this person as the matriarch, all knowing and all-powerful super mom, now see her as weak, confused, small and helpless and it is difficult to accept that the end is near. Afterall, they only know her to be strong and in control, and now it is changing.
Both sides struggle with the changes that are occurring, and neither one wants to see it, but really has no choice. This fact alone guides me as an end-of-life care giver to remind them of the fact that “you are honoring wishes” already set forth by the loved one. You are not making decisions for them, they already did that, you are simply keeping those decisions intact. Once a caregiver realizes this, it is a little easier to carry the burden of MPOA, especially for those who are so emotionally attached.
I have had the honor of being that person for someone and I carry the role for others who are still alive and well. I take the role very seriously, and often ask questions about what they want and what if? We can laugh and keep it light in these discussions, but then I solidify in my mind with a “serious” is that really how you feel? If things seem complicated, I request things in writing to support the decision as theirs in the event it is questioned later.
I value my independence as well, and I have my things in place to ensure my wishes are upheld. I speak with my MPOAs frequently and we have the same discussions to empower them with the knowledge of what I would want or not want in the event something should happen. As a hospice worker, I understand the challenges that may arise, how people may accuse, threaten or challenge anyone making decisions on my behalf, and that is why I am very vocal about my decisions. I have documentation to support my wishes, and I encourage everyone to do the same. What better way to celebrate independence. I assure you, the first time you discuss this with your loved ones, you will create your own fireworks!
So happy Independence Day! Make it great, create wonderful memories, and do something to maintain your independence by getting your affairs in order. Select a Medical Power of Attorney, document your medical decisions in a way that they know what you want, and discuss it when you make changes. Assure that your independence is maintained every day of your life. It’s your right to do that, but you are responsible for making it happen. We don’t have the knowledge of when we might need this in place, so best to be prepared. It’s not only best for you, but a gift for those left to take care of your needs when you are unable to do so.
“Independence is loyalty to one’s best self and principles.” ~ Mark Twain
