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Sticky nooks and crannies

Decision-making as we age gets sticky.

Studies have found we older adults are less able to hold on to multiple thoughts, and as a result have increasing difficulty with decisions. Possibly related, and even more interesting, is research indicating older adults do not like to make decisions. They (make that “we”) may tend to bypass the decision-making process altogether using “choice delegation,” “referral” or “avoidance.”

Referral and avoidance don’t need much explanation, but I’m curious about “choice delegation.”

I think of it this way. Decades ago, when my father died, my husband and I invited my 82-year-old mother, who lived independently in an adjoining state, to move closer to us. That was an easy “yes” decision for her.

I recall she said, “I‘ll let you make the choice about where.” I immediately began looking for an assisted living environment that I thought suited her need for comfort and social connectedness, creating a scrapbook of options. In reflecting on her use of “choice delegation” with me as her designee, I see the process more clearly. Now I realize my mother’s preference would have been to live with my husband and me in our family home with its sunny covered patio and a resident lap dog.

We did not give her that choice. We had no downstairs bedroom at the time, and I think we believed her dependence would quash our independence. Had we posed to sell our home and buy one with a downstairs bedroom and adjoining bath, I am fairly sure she would have immediately embraced that idea.

But we did not offer that option, and she did not ask about it, which might be a good example of “avoidance” on the part of everyone involved. Had we used “referral,” i.e. engaging an outside source, perhaps a geriatric care professional or valued friend who could help us array all the alternatives, the outcome may have been different. Or not.

Decision-making as we age is full of sticky nooks and crannies that involve an individual’s past decision-making experience as well as situational finances and current or anticipated health care needs.

The stickiest/trickiest part in later-in-life decision-making may be to “avoid avoidance.” I have always believed there is a decision-making window in thinking about where to live in your final years, and once it closes your chance to personally decide what happens next is gone.

Here's my think-around-the-corner advice for older adults poised to make a lifestyle decision. Begin by honestly asking yourself what you want. If your late-in-life goal is to be close to family, say that. Out loud. If your goal is to remain as independent as possible for as long as possible, say that.

Keep the choice narrow at the beginning. It starts with, “Should I go, or should I stay?” Next in the hierarchy of decisions is, “Where should I go, if I choose to go?” That’s the point when you might delegate or refer.

All the experts I have encountered suggest, “Ask for advice, but make your own choice,” followed by, “Trust your gut.” That goes for almost any kind of decision you are making. Take it one step at a time. Don’t get stuck.

Sharon Johnson is a retired health educator. Reach her at sharjohn99@gmail.com.