The Nursing Home Decision: Tips
for making the ‘right’ decision.
Entering a Nursing Home can be a difficult decision for everyone
concerned. Let’s face it, no one really looks forward to moving into a
Nursing Facility. In all my years working, I don’t think I have ever heard
anyone say, “Oh goody, I finally get to go to an Old Age Home!” However,
there are circumstances that warrant a move to so that an elder can get
the care and support that they need, both physically and emotionally.
Planning can make both the move and the transition, easier for the elder
and the family.
Confront your own feelings.
The Caregiver can experience many feelings when making a decision to move
an elder. The caregiver may feel that they are letting the elder down or
deserting someone that they should be able to care for themselves. Thus,
it is important to not make promises that may be impossible to keep. It is
not wise to promise anyone that you would never place them in a Nursing
Home. If you ever find yourself in this situation, simply promise the
elder that you will do whatever is best for them.
Placement Assistance from the hospital.
Sometimes it is easier for the Caregiver to move an elder into a nursing
home from a hospital stay. There are a variety of support services
available in this situation, that are not otherwise accessible when making
the move from the community. If the elder is in a hospital setting, your
most valuable resource is the hospital social worker or case manager.
When patients are in the hospital, they are assigned a Case Manager for
appropriate discharge planning. It is important for family members to meet
with the Case Manager as earlier as possible. You may want to call a
family conference and ask the Case Manager to meet with the elder,
Caregivers, and interested family members to discuss all possible options.
If nursing home placement is decided upon, the Caregivers may need to time
to consult an attorney, complete paperwork, and check out various
Making the move...now or later?
Some families have the opportunity, due to family and community support,
to postpone the decision process for a time. When choosing an appropriate
time for moving, and if a progressive disease such as Alzheimer’s Disease
is the diagnosis, there are two options. The first is choosing not to move
the elder into a skilled nursing facility until the last minute. The delay
allows the elder to enjoy familiar surroundings, spend more time with
family, and perhaps take care of personal business, until they are no
The second option encourages the elder to move into a facility while they
still are able to be active and have their cognitive faculties. Moving
into a facility early can be beneficial in several ways. First, the staff
and employees who work with the elder, both formally and informally, will
learn the elder and their eccentricities, while the elder still has the
ability. In addition, the elder will be able to experience more fully, the
facility, activities, fellow residents, and get to know employees and
caregivers, while they are able. Whatever you decide, choose a facility
that is easily accessible to the family members that are most involved.
The decision to place an elder is a difficult one -- and is even more
difficult when it is unplanned and made in a hurry. It is important that
the adult child feel comfortable with the decision. There are many tools
that can help a Caregiver decide when the time is right for long term
placement. It is important to have all of the available information; talk
to the elders’ physician to gather prognosis and illness information. Talk
with hospital social workers to gather their feedback about the elder, as
well as insight about the various placement options.
Obtain information from other professionals working with your elder such
as physical therapists, home nurses, and nursing assistants. If your place
of employment has an ElderCare information and referral source and/or and
Employee Assistance Program, now may be a good time to give them a call.
They may be able to offer assistance in finding out what the various
choices are, as well as offer counseling and support for you as an
Stay involved in the care.
One of the things I like to tell Caregivers, is that the decision to place
an elder in a Nursing Home is not an all or nothing decision. If an elder
moves into a facility, family members can still assist the elder in many
tasks including: personal care, bathing, feeding, and taking care of daily
tasks. In fact, it is beneficial for the elder if the family continues to
provide hands-on care. It allows the elder to feel connected to the
Caregiver, and encourages continuity of care.
Accept what is.
Don’t expect from the elder what they cannot do. If your elder was never a
joiner in group activities previously, they probably won’t start now. I
sometimes hear caregivers say, “If only she would...she would be so
happy”. One of the simplest things to do, yet somehow the most difficult,
is to keep our expectations in check. Keep your expectations realistic.
Make your own choices.
There will always be those who will tell you what they think you should
do. If all sources point to a particular decision, and you are not
comfortable with it, then act on what your heart tells you. As was stated
earlier, there are many tools that can help you decide, but the final
decision must lie with you and your family members. In a nut shell; talk
to many sources - pray about your choices - and then do what you think is
right. If you follow this rule of thumb, you and your elder will stand a
better chance at a successful placement, when the time is right.
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Articles written by Gardner Riel, owner and founder of ElderLink.
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