How to Foster a Sense of Control and Independence in Patients


Article Categories: Tips and Tricks & CNA Skills

Having independence and a sense of control is one of the most important aspects of a person’s dignity. This is true especially for patients who are battling a serious disease or a chronic illness.



Loss of function, limited mobility, confusion, and other difficult health conditions make patients unable to do some of the things they used to have no trouble with. For many patients in this stage of adjustment, the undesired changes open the door to depression. They lose their sense of normalcy and with it, their self-worth and confidence.

Nursing assistants are in the position to help patients be independent and maintain a sense of control because they provide personal assistance and help perform activities of daily living.

Here are some pointers to keep in mind:

1. Consider who they were and what they did before the illness.

Before they were patients, they were doing what they do best. They have careers and a role in their families and circle of friends. Imagine limiting this privilege because of long-term illness. For many, the acceptance of having a health problem is still a fuzzy idea, and CNAs need empathy to preserve the patient's independence and sense of control.

2. Offer assistance instead of insisting on your help.

Be very clear that you are there to assist your patient whenever needed. CNAs can make the mistake of doing everything for a patient, because it takes less time than watching and waiting for patients to finish a task on their own. The huge downside to this is that it takes away the patient's independence. It makes patients feel like a burden. Instead, offer your support and convey your presence instead.

3. Ask permission.

Other than a sign of respect, asking permission from the patient gives them control over their own health and environment. Knock and wait for a response before entering the room. It's also best to get the patient's approval before touching their belongings, starting a procedure, or moving them.

4. Involve the patient in decision-making regarding their health.

Keeping a patient an active part of the healthcare team is one of the best ways to maintain their sense of control and independence. This technique is not without challenges, though. Some patient’s might insist on doing something unhealthy or that can negatively affect their treatment. Should you encounter this kind of problem, discuss it with the nurse and together you can plan ways to encourage the patient.

5. Let your patient perform self-care and take over if they are unable to finish.

There are activities such as bathing, for example, that can be very tiring for a patient. While you make sure they are comfortable and safe, you also want them to do things on their own. The best way to handle such a situation is to have the patient start bathing and then ask to wash areas they can’t reach.

6. Provide options.

Presenting patients with things to choose from is a great approach to balancing independence and control between you and the patient. For example, when a confused patient has a hard time picking appropriate clothes to wear, provide a couple of outfits to choose from. This way, the patient will have the final say and still choose suitable garments.

7. Ask about the patient’s preferences, needs, and wants—and respect them.

Let’s say a patient prefers to dip their butter croissant in ketchup and your stomach turns thinking about the flavor combination. If they have no dietary restrictions, go with a patient’s request. Also, make sure you don’t react in a way that embarrasses them.

8. Allow activities as long as they are safe.

Consider this: Your patient usually takes a walk to the garden every morning, but after feeling weak from a recent surgery, they can’t manage going out on their own. If the patient has been cleared for that activity, you can suggest that they use a wheelchair and accompany them in their routine.

Promoting independence in patients and giving them a sense of control can be a difficult journey because, as nursing assistants, your instinct is to protect patients, provide all-out care, and finish tasks on time. But if you give it the right mix of freedom and supervision, you will uncover a powerful tool to help patients feel good about themselves and continue striving for a quality life.

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