The Right to Choice: Everyday Decisions Matter

What time did you wake up this morning, and what did you have for breakfast? These simple choices might seem trivial, but for someone living in a long-term care community, everyday decisions matter immensely. The right to choice is a cornerstone of Residents’ Rights, affirming that each resident retains autonomy over their daily life. Honoring a resident’s preferences in meals, routines, and activities isn’t just about being polite – it’s about preserving their dignity and self-determination. When we empower residents to make their own choices (from what to wear to how to spend their afternoon), we send a clear message: “This is your life, and your voice counts in every moment of it.”

Why Daily Choices Are So Important:
Choice is a basic human right, and exercising that right has tangible benefits for older adults in care. Research shows that when residents have greater choice in their daily activities and care, they experience a deeper sense of purpose and control, improved well-being, and higher overall satisfaction. Autonomy boosts self-esteem – it allows residents to feel like active participants in their own lives rather than passive recipients of care. In fact, even seemingly small decisions (like deciding between tea or coffee, or choosing a favorite outfit) can significantly enhance a resident’s comfort and happiness. By contrast, taking away choice can make someone feel helpless or infantilized. Respecting preferences – whether it’s what time to take a bath or which music to listen to – means respecting the person’s identity and history. It affirms that their likes and dislikes still matter, because they do.

Promoting Choice: Tips for Staff and Families:
Creating a culture of choice in a care community requires commitment from caregivers, management, and family members alike. Here are some practical ways staff and families can promote daily choice and empower residents:

• Offer Options in Daily Routines: Avoid one-size-fits-all schedules. Enable residents to choose their wake-up and bed times, meal selections, clothing, and activities whenever possible. Flexible scheduling (for example, allowing a resident to bathe or eat at the time they prefer) shows respect for personal rhythms.
• Honor Preferences, Big and Small: Take note of each individual’s likes and dislikes. Does Mrs. Garcia love a cup of coffee with two sugars at 6 AM? Make it happen. Does Mr. Johnson prefer a shower in the evening rather than morning? Try to accommodate it. Consistently honoring these personal preferences in daily care significantly enhances comfort and satisfaction.
• Involve Residents in Care Plans: Include residents (and their families, when appropriate) in planning their own care and routines. Ask for their input: “Would you rather have your therapy before or after lunch?” or “What activities are you interested in this week?” By using “I” statements in care planning (e.g. “I like to have my breakfast in my room”), staff can tailor services to each person’s desires.
• Empower Frontline Staff: Encourage caregivers to listen first and adjust their care approaches to each resident. Nursing assistants, dining staff, and activity coordinators should all feel supported in honoring resident requests. Leadership can cultivate this by celebrating examples of staff who went the extra mile to meet a resident’s choice.
• Educate and Involve Families: Families and loved ones can be great advocates for resident choice. They should share the resident’s habits, history, and preferences with staff – that favorite strawberry ice cream or the fact that Dad enjoys a short walk every evening. Family members can also support choice by respecting the resident’s decisions, even if they differ from what the family might prefer. Remember, the resident is in control of their life. For instance, a son might wish his mother would attend every social activity, but if she prefers quiet time or selects only a few activities, that choice should be honored. Families can partner with staff to gently encourage engagement without overriding the resident’s wishes.

Honoring the right to choice is about infusing person-centered care into every day. It means never forgetting that a care community is home for its residents – and in one’s home, personal choices define daily life. As advocates (be it as staff, family, or residents ourselves), we must champion the idea that autonomy doesn’t disappear with age or a move into care. By supporting everyday decisions, we uphold each resident’s dignity and identity. The ripple effect is powerful: a culture that celebrates choice leads to happier, more empowered residents who feel respected and heard. In celebrating Residents’ Rights Week, let’s recommit to making every day an affirmation of autonomy – because every decision, no matter how routine, is an opportunity to say, “You matter, and it’s your choice.

Jeff Harley