What Does Independence Really Look Like in Later Life?

When an older adult starts needing help at home, it can be difficult to know how much they should continue doing for themselves. That’s because stepping in too quickly for a loved one takes away opportunities to stay active and use their existing abilities, while too little support could make everyday tasks difficult or unsafe.

In this guide, we look at what independence means in later life and how care homes support residents in continuing to use their abilities.

Why Doing Too Much for a Resident Can Reduce Independence

It’s often quicker for a carer to do a task themselves, especially when a resident takes longer. But over time, repeatedly taking over gives the resident fewer opportunities to use the abilities they still have. Without regularly using those skills, some tasks can become even harder to manage and independence will decline further.

This point is particularly relevant to mobility. That’s because an elderly resident who stops walking regularly can lose a lot of muscle strength, becoming less steady on their feet. Following an illness or time in hospital, they might also need support to gradually become active again.

Arthritis can make fastening buttons difficult without preventing a resident from dressing themselves. In that situation, a carer can help with the buttons and leave the resident to manage the rest, so they don’t have to endure the pain of using their fingers.

Care staff also need to identify when giving extra help is only temporary. After an illness, for example, your loved one might initially need more assistance than usual, with staff gradually stepping back as they recover.

Ways Residents Can Stay Independent in a Care Home

Residents can maintain their independence throughout a typical day in a care home. Depending on what your loved one is able to manage, this could include:

• Getting ready in the morning – A resident who struggles to stand in the shower might use a shower chair but continue washing themselves. Place clothes within easy reach if bending is difficult and staff can help with fastenings that reduced dexterity makes awkward. The resident still completes the parts of their routine they can physically manage.
• Moving around the home – If your loved one walks safely with a frame, staff can make sure it is within reach when they stand up and that their usual routes through the home are clear. After a fall or a noticeable change in walking, reassess mobility so staff can provide the appropriate level of assistance.
• Eating independently – Difficulty eating does not always mean a resident needs a carer to feed them. A plate guard can help a resident scoop food onto their fork using one hand, while cutlery with a thicker handle is easier to grip for some residents with arthritis. An occupational therapis can recommend suitable equipment when more specialist adaptations are required.
• Managing personal belongings – Residents can keep items they use frequently within reach so they can find them easily. For a resident with dementia, labels or photographs on drawers can make clothes and belongings easier to locate without asking a member of staff each time.
• Choosing how they spend their time – Residents can decide which care home activities they want to join and continue hobbies they already enjoy. Where possible, they can also keep up social plans outside the home, such as meeting a friend for coffee or attending a regular local group.
• Going out of the care home – A resident who previously walked to the local shop might still be able to make that journey with a walking aid or staff member. Where longer distances have become difficult, using a wheelchair for part of an outing can preserve the resident’s energy for the part they want to enjoy.
• Using phones and other technology – Increasing the text size on a mobile phone helps a resident with reduced vision, while saving family members as favourites removes the need to search through a long contact list, allowing them to stay connected to loved ones. A resident who needs help starting a video call can still have the conversation privately once they are connected.
• Making their own decisions – Independence also concerns decisions about care itself. If a resident has the mental capacity to make a particular decision, staff should always respect their choice. A diagnosis of dementia doesn’t automatically mean a resident lacks capacity. Staff will assess capacity in relation to the specific decision being made.

When Safety Starts to Affect Independence

Sometimes a resident wants to do something that now carries greater risk.
A previous fall might make walking without assistance unsafe, for example, or changes in memory could mean they no longer remember how to use a particular appliance safely.

That does not automatically mean the activity has to stop, because care staff can look at what is causing the risk and decide whether an adaptation would allow the resident to continue. A resident who is unsteady outdoors might manage a garden walk with their frame and a carer nearby. If getting in and out of the bath has become difficult, suitable equipment could allow them to continue taking part in their own personal care.

Some decisions require a more formal assessment. When needed, an occupational therapist can assess how a resident manages everyday activities and recommend equipment or changes to their environment. And a physiotherapist can get involved when mobility or balance is the concern.

But when a resident has capacity to make a particular decision, they can also make choices that involve some risk.

Care homes need to balance their duty of care with the resident’s rights and wishes, recording how they will manage identified risks without unnecessarily restricting independence.

Maintaining Independence With the Right Support

Staying independent in later life won’t look the same for every resident and autonomy can fluctuate as health or mobility changes. The key is knowing which parts of everyday life your loved one can still manage and giving them the opportunity to keep doing them.

When you’re choosing a care home for your loved one, pay attention to how staff talk about what residents can do.

Ask what would happen if your loved one needed some time to get dressed themselves or wanted to keep walking with their frame after a fall. Staff should be able to explain how they would assess the situation and what support they could put in place to keep your loved one doing as much as they safely can.