Families find placement of a loved one in a long term care facilities (Rest Home or Nursing Home) difficult even in those cases where it is clearly in the best interest of the person and other family members. Invariably, they experience feelings of frustration and a sense of failure at “giving up” care for an impaired loved one. The guilt can be overwhelming. Many caregivers, particularly spouses, experience grief and bereavement over the loss
This is especially harder when their loved one may feel abandoned, angry, and confused about the placement. It may be difficult to explain the need for the move to the Alzheimer’s resident who continually pleads with the family to be taken home. Caregivers may doubt the timing and appropriateness of their decision. They need support, especially if they are being criticized by other family members for placing their relative in a long term setting.
. How well the caregiver copes depends on past relationships, their feelings about care giving responsibilities, unresolved conflicts, and the support available both before and after placement. Many care givers overcompensate for feelings of guilt, anxiety, or helplessness by spending an inordinate amount of time in the facility, continuing to help with bathing, dressing, and feeding the loved one just like they did at home.
Both resident and family will need time to make the adjustment to the placement. Specifically, the resident will need to:
- “Learn” his place in the facility, i.e., his room, his roommate, the dining room, etc.
- Adjust to new and unfamiliar schedules
- Cope with a very complex environment, including people he considers strangers or “sick””.
- Trust that staff will not harm them and will care for them.
An established routine and a sense of security will be important for the newly admitted resident. Expect a period of distrust and suspicion. Allow the resident time to get to know the caregivers. Tolerate behaviors which may be reactions to the new environment. Both resident and family may need to express grief, anger, or sadness about changes they can do nothing about.
Let families share their knowledge and experience about their relative. Many of the behavior problems associated with Alzheimer’s disease were very likely noticeable at home. The caregiver may be able to offer “unique solutions” to the problems, even suggesting ways to prevent problem situations from occurring. Additionally, let the family share a bit of their relative’s history and personality to address their need to preserve his dignity, past accomplishments, and history as a productive, competent person.
Caregivers, especially spouses, may need help in the resolving feelings about old promises: “I will never put you in a nursing home…” Remind the individual that the resident ’s needs are very different now than when that promise was made. THE RESIDENT IS NOW A VERY DIFFERENT PERSON WITH VERY DIFFERENT NEEDS. Families may need to be reminded of the very positive aspects of the facility care.
Finally, families need the assurance that staff will view their loved one not just as debilitated and dependent, but as one who can benefit from individualized attention and the opportunity to use to support the resident in completing a task no matter how long it takes or how imperfect the job. The resident’s increase in self-esteem will be ample reward for him and his family.
Micha Shalev MHA is the owner of Dodge Park Rest Home and The Adult Day Club at Dodge Park located at 101 Randolph Road in Worcester. The facility is holding two FREE support group meetings a month for spouses and children of individuals with dementia and/or Alzheimer’s disease. He can be reached at 508-853-8180 or by e-mail at m.shalev@dodgepark.com or view more information online at www.dodgepark.com
