Empowering vs Enabling in Care

We often talk about empowering and enabling older people in relation to their care. Most people would see the two as pretty much the same thing, just with a slightly different slant.

In many cases, they are.

However, for some people, enabling can be very disempowering. Furthermore, it can be counterproductive in a longer term care plan.

For example, Jim wants to do a jigsaw puzzle that he has had for many years.

The home is very supportive and would like its residents to take as much control over their lives and activities as possible. They empower Jim to find a quiet spot and ensure that he has time to spend on his pastime. Jim is happy that he has been able to organise this and there have been no obstacles that could not be overcome. Jim is now ready to undertake his task and looks forward to taking his time in completing the Jigsaw that he has had for such a long time.
Once he starts, he takes his time in putting the pieces together. He enjoys the concentration, trial and error and the sense of achievement when a piece falls into place.  Staff engage with him and put even more pieces into place. Suddenly, this is no longer his project – even worse, when he has gone to bed other staff add more pieces and by the following morning large “chunks” have been filled in.

Jim has inadvertently had the pleasure of the project taken away and his interest has now gone. In other words he was empowered to start the Jigsaw but – in a well-meaning effort to “enable” him, staff have disempowered and disabled him.

Sounds a little silly – but it happens.

I think our commitment to Empowerment is not in question.

However, it is the enabling aspect of care that can be very difficult to achieve successfully.

For example, we try to enable residents to remain as mobile as possible for as long as possible. That’s why we have care plans with specific mobility plans, schedules and assessments.

When a resident is finding mobility a little more difficult, there is a strategy to cope with this.If staff decide to use a wheelchair today (they are busy and walking is very slow), they are not helping.

The following day the resident will tell staff that she needs a wheelchair – and so on – until the resident is now unable to mobilise as they previously did any longer.

This is where “enabling” becomes very “disabling” and ultimately disempowering.

I am sure that you can think of many more such examples.