By Lisa M. Petsche
The time has come. You’ve had to do the up until now unthinkable: place a relative on the waiting list for a long-term care facility (commonly known as a nursing home).
Many people don’t understand that this is a difficult decision. A damaging myth still prevails that families “dump” frail older members in nursing homes to free themselves of the inconvenience of caregiving and get on with their lives.
Quite the opposite is true. It’s typically a last resort, pursued after burnout or some other crisis has occurred.
Painfully, your relative is likely to express anxiety and anger, accompanied by feelings of loss. She or he (the latter will be used from here on) will need time to grieve and adjust — as will you. Following are some ways to help with the transition.
- Plan to spend admission day together. Tour the facility to become familiar with the environment.
- Bring personal belongings – a throw for the bed, a houseplant or photos of favorite people and places, for example.
- Ask what kind of toiletries and other personal items need to be supplied, and what type and amount of clothing is recommended.
- Inquire about the activities schedule.
- Find out if there are private spaces for visiting.
- Share as much as possible about your relative’s routines, likes and dislikes. Also provide the following information to help staff engage him in conversation and build rapport: birthplace, past vocation and leisure interests, significant life events and important people in his social network.
- Notify relatives and friends of the facility’s address and phone number and encourage them to call, write or visit. Offer to join them for the first visit.
- Visit often, especially in the early days, to provide support and reassurance. Develop a regular pattern so your relative knows when to expect you and can anticipate your next visit. Alternate days with other family members, and telephone in between visits, if you can’t get in as often as you would like.
- Be prepared that your relative may have many complaints initially. If a concern seems legitimate, discuss it with staff and do some advocating if necessary. Otherwise, provide a listening ear, allowing him to vent. Be attuned to underlying feelings and empathize with them.
- If your relative asks you to take him home, gently but firmly reinforce that he needs more care than you can provide. Reassure him you’ll be returning soon, and plan what you’ll do together. If it’s feasible and you intend to follow through, remind him that he can come home for a visit. Don’t make false promises.
- To make it easier on both of you, time visits so you can depart when your relative is beginning a meal, heading off to an activity or going to bed.
- Get to know the staff, in order to develop a partnership of trust and mutual sharing. Show your appreciation if you’re pleased with their care. When you have a concern, express it calmly, ask for their perspective and let them know what you would like to see happen.
- Get to know other residents and family members. Attend the next family council or support group meeting.
- Re-create routines from home, such as playing cards, watching a favorite TV program together or sharing a meal.
- Bring in special foods – a home-cooked meal or favorite take-out treat.
- Plan activities outside of the institution. Go for a walk around the neighborhood or to a nearby park, or take a drive. If your relative uses a wheelchair, register him with the local accessible transportation service. Then you can take him shopping or to community events.
- Continue to include him in family celebrations. If your home isn’t accessible, choose a restaurant that is, or ask staff to help you plan a gathering onsite.
- Spend time with friends and relatives who support your decision regarding placement. Family members of other residents as well as staff – especially the social worker – are also valuable sources of support. Initially you may need lots of reassurance that you have made the right decision.
- Learn to manage the inevitable feelings of guilt. Remind yourself that your relative is benefiting from around-the-clock professional nursing care, therapeutic programming and companionship. Just because you are no longer the hands-on caregiver does not lessen the importance of your role. With the heavy responsibility of primary caregiving lifted, you can focus your energy on meeting your relative’s emotional needs and enjoying your time together.
Lisa M. Petsche is a medical social worker and a freelance writer specializing in health and elder care issues.