Gladys continually tried to escape her facility. Even though she lived in a pleasant environment with caring staff, good food and a variety of activities, she used every opportunity she could find to get away. Staff were at their wit’s end, and her family worried that she would hurt herself or get lost if she found a way to exit the building.
A care conference, with the doctor, the nursing staff, her care partner, family and the activity director came together to try to look for answers. All kinds of solutions, including restraints, both medical and physical, were discussed.
“I hate the thought of restricting her, or drugging her. What kind of a life is that?” asked one daughter.
“I agree,” said another, “but we also want her to be safe. No one seems to have a solution that brings ‘safe’ and ‘happy’ together.”
“Aside from trying to escape, what does she do in a day? Does she like to participate in activities?” This remark came from the physiotherapist.
The activities director answered, “There are a few things she likes, such as time in the garden, but that’s only in good weather, of course. Mostly she stays in her room, looking out the window.”
The nurse looked thoughtful, and turned to the family. “I’m wondering if there’s an unmet need we’re not seeing. Tell us a bit about her. What did she love to do in her later years?”
The daughters looked at each other and answered in one voice, “Garden!”
“From Victoria Day weekend until October, she filled every space with flowers, and had 
pots of vegetables growing as well. She’d take a bowl out and pick her salad from the garden, and always had fresh flowers on the tables. In winter she had a plant stand with all kinds of growing things.”
The nurse smiled. “I think we’ve found Gladys’ unmet need. She’s not trying to escape, she wants to go outside and grow things.”
“She can help with the gardening in the raised flower beds in the spring, but for now, maybe we can grow some flowers in pots in the lounge. It’s sunny in there.”
It wasn’t a magic fix and other interventions needed to be used as well, but Gladys loved planting the seeds and watching them sprout. The activity director bought some blooming plants as well, and when Gladys headed for the door, everyone redirected her to the “garden.” When spring came and she could wander in the enclosed garden, she stopped looking for outside access altogether. Her need to be among growing things had been met.
Finding the unmet need means understanding the elder. If they are able to express and understand their feelings, this helps, but often that isn’t the case. Here are some questions which may lead you to an answer.
- Are they bored? What meaningful activity could be added to their lives?
- Are they missing something that was important to them (such as Gladys and her garden.)
- Are they lonely? Even surrounded by people, they may be missing family or close friends.
- Is there untreated pain?
- Are they struggling with the activities of daily living (eating, bathing, dressing, mobility, toileting and continence.)
- Is their environment too chaotic?
Looking for ways to support your elder must be multi-faceted. Finding and meeting unmet needs must be a part of a holistic approach. Medications and other interventions may need to be considered. However, sometimes the answer can be as simple as planting seeds and admiring a pot of flowers.