Individual autonomy, cooperative empowerment, and planning for long-term care decision making

Advance planning by the elederly for long-term care decisions promises to enhance personal responsibility and autonomy while improving their quality of life. Such planning becomes an extension of the concepts of client empowerment and self-care and is based on the ethical principles of individual autonomy and freedom of choice. These have clear implications for the content and process of advance planning, including the activities of "effective deliberation" and "moral reflection." A sense of self-respect and the provision of care-provider support and social resources become key ingredients in this process, leading to the development of the concept of "cooperative empowerment." Broader risk assessment methodologies are proposed to encourage the planning process, which can be given direction by the development of a personal planning guide and workshops. Attention must be drawn particularly to the importance of human values at the core of personal decisions and life plans.