The Space Between Safety and Independence

"A life designed to be safe but empty of anything they care about."

This is the final sentence of the fourth chapter in Atul Gawande's notable book, Being Mortal. The chapter, entitled"Assistance," is about more than just the state of assisted living communities in the United States. It is about a tension that is ubiquitous in the lives of older adults – particularly those who need some degree of support as they navigate both the promises and pitfalls of aging.

Safety versus Independence. Security versus Autonomy. These are indisputably very human needs—indeed for all ages—but sometimes in the care of older persons it seems as though we can have one but not the other. Does she need a caregiver at all times to keep her from falling? Maybe I should take over managing his medications so that we can be certain he doesn't miss any doses. Perhaps we should give up playing bridge… it seems like it is getting too hard for him. As Gawande's book explores, when we focus myopically on safety (either physical or psychological), there are profound costs to independence. And yet if we choose the opposite path and maximize independence above all, we risk neglecting everyday security.

If you've never heard of the Village Landais in southern France, consider reading about it. It is a "dementia-friendly" community where there are no locked doors, no strict routines, and an abundance of freedom. Although it has only been open for five years and definitive research is pending, early reviews indicate that its residents are living much more positively and holistically than they might otherwise. And fewer rules and barriers haven't sacrificed safety and health. The organizing principle is simple: enabling independence can nurture safety and security.

This does not mean that we throw caution to the wind. Creative balance means that for some activities, that balance needs to tip toward safety in order to maintain independence. For someone who is either physically or cognitively no longer safe to drive, for example, giving up driving actually preserves independence. Serious injury in a car accident would disrupt that balance and limit independence far more than stopping driving in the first place. The key to innovations like the Village Landais is that all of this occurs in the context of a community of support. It is far less concerning to give up driving when you have a phalanx of family and friends ready to be your chauffeur.

Achieving a healthy balance between safety and independence – well, it takes a village. But we don't all need the Village Landais. The Alula caregiving platform will help you customize your village, according to your personal needs and wishes. Join us - build your network with Alula, and find your balance.