Transition into Long Term Care

Moving is a stressful experience for anyone, at any stage of life.  Coming into the shared living experience of residential care is a major change, especially when someone is moving from his or her own home.  

Many people tend to under estimate how difficult this transition can be and find they are unprepared in a crisis situation.  

We recognize that the period of adjustment for Residents and their family members is different for every family.  It can take some Residents three to six months to adjust to their new surroundings and new way of life.   

Guilt is the number one emotion felt by family members when an elderly person moves into a home.  It is normal for family members to wonder whether or not they have done the right thing and whether or not it was the right time.  These feelings become particularly pronounced when the new Resident opposes the move, or if there is another member of the family against "institutionalization".  Family members can better cope with the feelings of guilt by understanding and accepting that they can no longer give the care that is required, and that placement is an act of love.  Placing someone in a facility can come with some relief because the staff looks after the day-to-day needs.  Time can now be spent focusing on quality visits rather than worrying about daily care needs.  It is important to realize that you are still able to have an active role in the care - providing feedback and direction to the staff to help them get to know your family member and to act as their advocate. 

Planning ahead is important.  Ideally, the process of going into a residential care facility will be one in which the new Resident participates.  If they are included in the decision-making, it is easier on them and easier on you as well.  Giving a choice provides a sense of control over one's life, which is so important when an individual is experiencing a loss of independence.  To make this major decision, time is necessary for everyone involved to prepare emotionally. 

PLAN AHEAD:

-      Research various options, types of care centres in your area - Health Authority websites offer details about what is available by region.

-      Ask questions of the Professionals and of friends - having answers to questions will help remove the fear of the unknown.  Contact the local Alzheimer Society, family Doctor, look into Caregiver Support Programs, and speak to friends who have looked after older relatives.

-      Be realistic about what you are able to do - know your limitations.  A caregiver who is reaching the point of exhaustion runs the risk of becoming ill and reaching a crisis where providing care becomes impossible.  Unfortunately in these situations, you will not have time to plan and options will be quite limited. 

TALK ABOUT THE DECISION:

-      With family members and friends.  Be open about it.  Remember that family dynamics that existed prior to admission very often continue after admission.  The need to manage these dynamics does not disappear. 

-      Talk openly about the decision and the upcoming move.  Many families are so upset themselves about the change that they avoid talking about it.  But older people need to talk, and need to know what to expect.  They need reassurance that while the move may be difficult and life will be different, the support, love and understanding of family and friends will always be there.  Initially these conversations are quite difficult, however, once they begin, they get easier.  People with dementia can, and should be given the opportunity, to participate in making decisions about care - they can still express what they think and what they want, even if they may not remember the conversation.  

-       Talk sooner, rather than later.  Don't wait until crisis and the move is tomorrow.  Planning ahead allows the family to handle the situation sensitively and the transition to be smoother.

-       Focus on the positives - talk about programs, activities and opportunities for social contact at the facility.  Remind your family member that health and independence may even improve because of the structured care provided. 

TOUR FACILITIES:

-       This is your best opportunity to explore the options and get a 'feel' for the various residential care facilities.  Prepare a list of questions ahead of time related to your family member's situation so that you can choose somewhere that will best meet their needs. 

WAYS TO HELP YOUR FAMILY MEMBER ADJUST TO THEIR NEW HOME:

-      Bring in personal belongings.  Hang pictures on the wall, bring in a favourite chair, bed side table and bed spread.  Familiarity helps residents feel comfortable in their new environment.

-      Allow them to make decisions.  Ask how they want the room laid out, where pictures ought to be hung and what sorts of items they may want brought from home.

-      Talk about and acknowledge their feelings.  Providing a safe place to express their feelings can be quite beneficial for both parties.  Be certain to take the time to listen - sometimes it takes older people longer to assemble their thoughts and if they are not given the time to express themselves, they may have a tendency to clam up. 

-      Talk to the staff about your family member's likes, dislikes, routine, and any other information that will help them make the person feel more comfortable.  Introduce yourself and your relative to other residents.

-      Some families put together a "Biography" and put it up in the Resident's room.  It can list information that is important about that individual - what they like to talk about, what their life has been like, who the important people are in their lives.  It also may act as a source of pride for that Resident.  The senior years are a time of reflecting back on the life one has lived and searching to find meaning in that life. 

-       You can help by encouraging your family member to make friends and get involved in the activities at the facility.  Families might consider joining in some social and recreational activities. 

-       Learn about the Resident's medical and mental health concerns.  This will help you understand, respond and support your loved one.