When people are suddenly disabled, hospitalized or entering a care facility, they are often subjected to something called an assessment.  The care providers make a list of what the patient can and cannot do, have or eat/ This group of "professionals" frequently meet around a conference room table piled high with manila folders and sticky notes. Lots of coffee and donuts because making these decisions require stamina to run through the "cases" and make decisions about what will make life easier, hopefully for the patient and certainly for the staff.

If I sound a little cynical about others making judgment  or assessments about a patient without input from the patient, it is because I am. I was sitting in my mother's end of life room visiting when the director stopped by to tell us that they had done an assessment and this would be the plan of care from now on.

I was livid that our input was not asked for nor included in how my mother would be allowed to spend the rest of her life. I was her advocate, daughter and fairly smart woman but was not invited to the conference room to hear the discussion. Nor was I asked by them for my opinion on what things she could do and had done in the past.

What a difference it would have made had the director, social worker, nurse or advocate ask Mom what she wanted. The most ridiculous thing "the professionals" decided was that if she played cards daily it would strengthen her hands. Mom hated playing cards and had no patience for board games, and had for the last 91 years.  She would have cared for the green plants or done hand exercises with me, not "some 12 year old kid who won't be here tomorrow" as she called the constant flux of CNA's.

By focusing on what you can and want to do, you communicate to others, that you are in control of your life.  Help your loved one make a list of inner resources, likes and dislikes and areas of strengths.  The more choices any of us have in life and approaching death, the less stress we have.

Certainly there are activities that are no longer possible, but if the interest is there, perhaps the patient can adapt or find a way to still maintain some control over choices about their care.