When We Don’t Like Their Decisions


Written on April 30, 2013 – 7:58 am | by Audrey Miller

A refrain that I have been hearing/sharing over the last few days is ”we may not like their decisions, but it is their decision to make” ( as long as they are capable). Every day as capable adults we take risks, whether it is walking when the light is red or opening the door to talk to a sales person. We knowingly calculate the risk, the cost/benefit analysis and the implications and consequences of making or not making the decision. The decision to act and to consciously make a choice, where there are possible negative consequences, I call ‘ informed risk’. For example, crossing the street against the light has an inherent risk- getting struck by a car or getting a ticket/fine by the police.

Further to my blog last week, you may recall that I am working with a lovely older woman who was involved in a serious car accident. She suffered numerous fractures of her lower limbs. After a lengthy period of hospitalization and rehabilitation, she was discharged home. She has lived by herself in a bungalow since her husband died over 20 years ago and has prided herself on her independence. She was completely self sufficient in all of her activities of daily living (adl) prior to this accident.

Her treating occupational therapist had recommended attendant care as well as a number of assistive devices to enhance her safety and mobility. She was medically advised not to bathe but rather to use the shower and to have stand by assistance available to her. She has refused daily assistance from the personal support worker which was approved and paid for by her insurance company; she refused to have the grab bars installed into her bathroom, as she didn’t like their look. She understood the inherent risks in her NOT accepting assistance. Now let’s fast forward to last week.

Determined to prove to herself that she could still manage on her own, she attempted to take a bath. She slipped and fell and now has broken her non dominant arm (humerus). The emergency response system, which she did agreed to have installed, was on night table; she was unable to get a telephone and call for help.

As helping professionals, we are frustrated. We are hopeful that this client will change now recognize and accept assistance; all tools to ‘enable’ her. We all want the same end result for her –which is to help her resume her abilities and function, in order to return to, or as close as possible, to her pre-accident state.

Informed risk- as long as individuals are capable of making their own decisions, we may not like their choice, but it is their decision to make…..and sometimes this is difficult for others (whether it be family or professionals) to accept. I invite your feedback.
-Audrey Miller

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