For Families: The Initial Transition

Posted by Dr. El - January 8, 2009 - Communication, Tips for gifts, visits, Transitions in care - 2 Comments

I recently met a new resident who demanded almost constant attention from her loved ones. Her family visited daily for hours at a time, and she’d call them soon after they’d left and tell them she was lonely. Trying to please her, they were exhausted, frustrated, irritable, and terribly sad. I reminded her tearful daughter about the recommendation of flight attendants for those traveling with people in need of care — put on your own oxygen mask first. For many families, the road to the nursing home has been long and difficult, and it’s okay to take a breath now that your loved one is here.

It reminded me of my work with a wonderful 50-something man with Multiple Sclerosis, who spend most of his time in his room, hanging out with Jaime, the private aide his wife had taken a second job to afford.  He was very depressed about his situation.  Moving to the nursing home, he felt his life was basically over.   “George,” I tried to persuade him, “come out of your room and join the activities.  There are some really nice people here and fun things going on.”  But no, he was fine talking with Jaime.  Until his frantic wife, collapsing under the stress of her work schedule, finally dropped the second job, and Jaime.  George emerged from his room and tentatively attended the trivia group I thought he might enjoy.  He went back again the next week, and then added word games to his recreation schedule.  He started meeting people, making friends, and cracking jokes.  And his wife, who had recuperated from her burnout, was able to visit more frequently now that she wasn’t pulling double shifts at work.

The first weeks and months at a facility are hard on everyone, no matter what the particulars of the situation.  Residents are often frightened and can feel abandoned despite regular family contact. Families frequently feel guilty about the move, as necessary as it might be.  One of the benefits of a nursing home for the residents is the social environment — meeting new people, attending recreational activities, and making connections with others in similar situations.  I often suggest that family members accompany their loved one to activities they might like, to help break the ice.  Another benefit of a nursing home is that, to a large extent, it gives the resident back their independence from relying heavily on their family as caretakers. It creates more opportunity for family members to enjoy each others company without the tensions of day-to-day caregiving.