Transitioning From Primary Caregiving: How to Adapt Your Role in Long-Term Care

By Lisa M. Petsche

When a person moves into a long-term care home, not only they but also their caregiver can find the transition difficult.

Caregivers lose a companion and the rhythm of their days changes significantly. They must schedule visits in order to spend time with their relative. Transportation may pose challenges, especially if they don’t drive.

Feelings about the situation may include sadness, anxiety, anger and guilt. Caregivers may wonder if they made the right decision. They may worry about their relative’s ability to adjust. They may also worry about how well he or she is being cared for. And they may wonder what role they now play in their relative’s day to day life.

If you find yourself in this position, read on for some suggestions.

Relating with Care Providers

  • It’s important to perceive and position yourself as an integral part of your relative’s healthcare team. Here are some ways to go about this:
  • Share as much as possible about your relative’s routines, likes and dislikes, and any tips that can help make care provision easier.
  • Educate yourself about the roles of the various healthcare professionals, and ask about their goals and plans for your relative. You may need to adjust your expectations or negotiate changes to the care plan.
  • Let staff know how involved you wish to be in terms of hands-on care, and discuss what is possible. (Facility policies may prohibit you from doing certain things, such as using mechanical lifters.)
  • Get to know the staff, in order to develop a partnership of trust and mutual sharing. Show your appreciation if you are pleased with their care.
  • Think twice before you criticize. Some family members initially find fault with virtually everything professional caregivers do, in an effort (often sub-conscious) to assert that no one can take care of their relative as well as they can. This makes it hard to establish constructive relationships.
  • Address a concern directly with the relevant care provider. Express it as calmly as possible, and in a timely fashion. Involve the person’s supervisor only if the issue doesn’t get resolved.

Relating with Your Loved One

  • 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 your relative to vent. Be attuned to underlying feelings and empathize with them. Discourage him from dwelling on the negative, though; change the subject if necessary.
  • 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 he shares a room, inquire about private areas for visiting.
  • Develop a regular pattern of visiting so your relative knows when to expect you and can anticipate your next visit. Telephone between visits if you can’t get in as often as you would like.
  • When you visit, bring something, such as a newspaper, flowers from your garden or a favorite food.
  • Re-create routines from home, such as playing cards, watching a favorite TV program together or sharing a meal.
  • Show interest in your relative’s daily activities. Join him for some special recreational events.
  • Keep your relative up-to-date on news about friends and relatives, and continue to involve him in family decision-making.
  • Plan activities outside of the facility. 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 your relative in family celebrations. If members’ homes aren’t accessible, choose a restaurant that is, or ask staff to help you plan a gathering onsite.
  • If feasible, arrange for your relative to come home for a few hours.
  • Keep in mind that just because you are no longer the 24-hour caregiver does not lessen the importance of your role. With that heavy responsibility lifted, you can focus your energy on meeting your relative’s emotional and spiritual needs and enjoying your time together.

Final Thoughts

Spend time with friends and relatives who support the move to long-term care. 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 this was a good decision. Be patient and give yourself and your relative plenty of time to adjust.

Lisa M. Petsche is a medical social worker and a freelance writer specializing in health and elder care issues.

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