independence-article | Spring Chicken

Independence defined

What is meant by independence?

No-one is really independent, not even a multimillionaire. In fact the more wealth you have the more possessions you have, and the more you depend on other people to maintain your private jet or your holiday homes but the way in which the word ‘independent’ is used in our mission is the ability to continue to do things for yourself which you take for granted in your twenties, thirties and forties and which become increasingly problematic in your seventies, eighties and nineties.

Independence can be defined by setting out its opposite and the International Classification of dependence identifies three levels of dependence, set out below.

High dependency (24 hour care)

At least one of the following:

  • Unable to get to or use the toilet
  • Bed bound or chair bound
  • Needs help feeding
  • Be often incontinent and needs help dressing
  • Or have sever cognitive impairment

Medium dependency (care at regular times each day)

  • Either needs help preparing a meal or putting on socks and shoes

Low dependency (care less than daily)

At least one of the following:

  • Needs help to wash all over or bath
  • Cut toenails
  • Shop
  • Do light or heavy housework or have considerable difficulty with household tasks, for example making a cup of tea


  • Not classified as high, medium or low dependency
Why is independence important?

The first point is that maintaining independence is an important contribution to feeling better but it is also vitally important in allowing freedom, for independence is about freedom.   Increasingly, medical treatment is being classified with respect to the impact that it has on the person’s ability to function better and therefore maintain or regain abilities.

It is also important to note that drug side effects can themselves be an important cause of loss of independence and need to be included in the checklist of things that have to  be done.

What can others do to help?

The focus of medical care is changing from simply diagnosing and treating disease to achieving outcomes that are important to patients and to the people who have the disease.

Let us take a simple problem which, if it occurs, leads to a person being classified as being of medium dependency – namely, the ability to put on socks and shoes.

Here are our key questions when this problem occurs.

  • Why has this occurred now? Has some new disease developed that might be causing the difficulty in bending and reaching the toes and feet?
  • If not, are the existing diseases being well treated?
  • If the answer is yes, could there be side effects of the drug treatment that we are overlooking that are making this difficult?
  • If the answer is no, can the person be helped to regain the suppleness and skill needed to put on socks and shoes?
  • If the answer is no, would a shoehorn and Sock-Aid be helpful in overcoming with the problem?

It is vitally important this approach is taken because difficulty with putting on socks and shoes is a problem in itself that may progress to hitter problems.

What can you do?

Do not assume that any problem occurs with self-care is due to ageing.

Try our five questions and the relevant solutions.

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