Competence is defined by Merriam-Webster as “the quality or state of having sufficient knowledge, judgment, skill, or strength (as for a particular duty or in a particular respect)”. It’s not an easy subject to discuss, but it’s better to know the basics and prepare than to find yourself or a loved one in an unfortunate situation.
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Understanding Competence
We can hear the term “competence” in regards to jobs and perhaps even schooling. If we have proven our competence in something it means that we have the skills and knowledge to be able to perform that action with a high outcome of success.
The term is also used for our elderly, in regards to whether or not they have (or continue to have) all or some of the life skills needed to continue living independently on their own. For example, an elderly person may no longer have the competence or be competent to drive, or drive after dark. This is fairly common after a certain age and accommodations need to be made for the individual, so that they do not continue to drive unsafely. This alone may not necessarily mean they need a round-the-clock nurse.
7 Things To Take Into Consideration
Knowing that there are indeed situations when an individual may no longer be able to well care for themselves, what are some things we should consider?
Respecting Independence
If you aren’t a senior, imagine living your whole life, working hard for respect, for independence and taking care of yourself and perhaps even other people. You have done things for yourself for years, made decent choices and become very adept at certain skills. You are proud of yourself and the life you’ve lived. Now imagine your grown children treating you like a child. How humiliating, demeaning and embarrassing this would be. This disrespect happens all too often with our elders and only serves to provoke agitation, even in the most sensible person.
Giving respect to our loved one, who has built their life of independence, is the very least we can offer. Sometimes when we love someone, we just want to do what is best for them and we can cross the line of becoming patronizing and controlling.
PRO TIP – If there are actions or decisions that need to be taken for the safety of the individual, they are done in a respectful and loving way.
Never Jump To Medical Conclusions
We can worry that if the individual is of a certain age and making poor decisions, that they are exhibiting the signs of Alzheimer’s or dementia. Never jump to these conclusions without an official medical diagnosis and certainly don’t make decisions based on your assumption.
PRO TIP – If you have concerns, speak with a doctor or have your loved one see a doctor, especially if they are exhibiting numerous or potentially unsafe symptoms.
Things To Watch For When Gauging Competence
Ability to comprehend information
Does your loved one have the ability to understand fully information that they either have been given or have always know or already learned? Can they explain or relate the information to themselves?
Ability to understand the importance of information
Do they have the ability to understand how the information affects them, the world around them and their choices?
Ability to make reasonable choices based on current options
Does the individual actively show they make sound decisions, based on the present list of options?
Ability to understand consequences (for themselves or others) of their choices
Do they exhibit understanding of how their choices may affect themselves or other people?
How To Assess Possible Competence Issues
Try to look at overall behavior, not just specific examples. Looking for a pattern of behavior will be more effective in determining overall competence. Remember, one or two bad decisions do not necessarily mean your loved one is incompetent. You also don’t have to agree with every decision they make. If you’re out to dinner and they order an ice cream sundae as their main course, this doesn’t have to mean they make bad choices. If you’re noticing that all they are eating lately is ice cream, this could be a sign of something deeper.
Competence can be specific to a skill. Remember our example of driving at night? It could be that the individual no longer is able to care for their home or do yardwork for themselves; they are no longer physically competent to do so. The appropriate solution to this is to have hired care come in and perform these tasks for them.
Appropriate solutions. Because competency can affect different parts of our lives, appropriate solutions should be sought and taken. Broad, sweeping solutions for minor or specific issues is both inappropriate and harmful to the individual and potentially to your relationship with them.
More serious symptoms. When we look at the varied symptoms that can occur as we age, the more frightening are the symptoms in which safety is compromised. Is your loved one forgetting to take their medications or leaving the home without weather appropriate clothing? These kinds of decisions should provoke us to make a doctor’s appointment for an assessment of the individual.
For some sage advice and guiding principles for families facing decisions related to competence, read Making Decisions for Elderly Parents.
Wrap Up
The more we understand about how to assess competence with empathy and love, the easier it will be if we need to make difficult decisions in the future. If you have questions or concerns about yourself or a loved one, please speak with a medical professional.
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Do you have questions about how you can better support your loved one while they age in place in South Florida or regarding homecare in general? Please contact CareGivers of America here: Contact or call us toll free: 800-342-4197
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