Emotional Issues of Long Term Care


	Emotional Issues of Long Term Care You have just decided in favor of peace of mind and the well being of someone you love. You have just decided to ensure that this special person has 24-hour medical care, eats every day, takes medicines at the right times every day, has the companionship of the nursing facility staff and other residents, is comfortable, safe, and has entertainment and activities to stay as vibrant as possible as long as possible. You've made a hard decision. But you're not the first person to have made it. Look around at the nursing facility, at all those residents, and remember that the majority of them have families who love them very much. And those families have made the same hard decision you have just made. It's a good decision, but it may take some adjustment for both of you. NO PLACE LIKE HOME A nursing facility is designed to give quality care to every resident. Although it is not a private home, it can have a feeling like home; it can become pleasant and comfortable after a brief period of adjustment. Almost everyone goes through extreme change at least once in a lifetime. Moves, losses, new situations and surroundings always carry some stress. You may be relieved to know that studies of geriatric residents in nursing facilities suggest that individuals handle the move to a nursing facility much like the way they handled other changes in their lives. That means that some people adjust more quickly than others. Adjustment will come easier if there are familiar items in the new room. Photos and personal mementos can reassure the resident and make the room more personal. (For safety reasons, rugs, runners, or carpets are not permitted.) ROOM RESTRICTION For safety reasons, residents are not usually allowed to keep certain items in their rooms: over-the-counter medicines, atomizer sprays, matches, candies, irons, etc. Other items - such as refrigerators, space heaters, and fans - require approval. Ask the administrator or Director of Maintenance for details. The safety and well-being of everyone is foremost in the minds of the people who operate and regulate nursing facilities. In fact, many restrictions are the result of federal and state laws that regulate nursing facilities. No matter the origin of a restriction, the nursing facility resident may initially resent being denied something he or she is used to having. Imagine having to ask at the desk for an aspirin. The resident may become frustrated or angry. If you become the target of the anger or frustration, try to remember that the emotion is caused by the situation, not by you. CAUSE AND EFFECT As you have witnessed, aging is a frustrating process. Our bodies do not move as fast as we want or do exactly what we want. Certain body parts don't work anymore, and we may forget things. Some people gradually accept these changes, while others rail against them, frustrated and angry. Often they shut out those who love them, trying hard to cope but having difficulty acknowledging and enjoying the good things that continue in life. As with all of us, adjusting to a new situation can intensify these negative feelings. The resident may direct these feelings at you, because you are seen as responsible for the new situation. These feelings may also be directed at the nursing facility staff and other residents. This reaction is normal and may be temporary. Your choices are to match anger for anger, to deflect it, or empathize. You can listen to the complaints until the resident has vented his or her frustration, and then guide the conversation toward some thing or event that the two of you can enjoy talking about together. You can also assist the resident in talking with staff members who can provide professional help. AN UNEASY BEGINNING When a resident complains about elements of the nursing facility, you should, of course, pay attention. Ask questions of the staff, other residents, and more experienced family members of a resident to find out for yourself whether the complaint is justified. But many people who have loved ones in nursing facilities have come to realize that some residents complain about the treatment in an effort to exert control over their loved ones. If there is any doubt that a complaint situation is not being properly handled by administration, the state ombudsman of the Department of Aging can be asked for assistance. If you feel at all guilty about your decision to put someone into a nursing facility, you might be easily manipulated into doing whatever it takes to alleviate that guilt. In reaction to the guilt, people have been known to personally deliver three meals per day, change the sheets daily, pick up and deliver laundry daily, and take on other unnecessary tasks that do not prove love or devotion, only assuage guilt. CARING FOR YOURSELF It is in your best interest to - as soon as possible - develop a healthy attitude about deciding to admit someone to a nursing facility. You need to stay mentally and physically healthy in order to give the resident your best. Eat well, exercise, tend to the rest of your family and to your friends, continue your hobbies and your own life. Give time and attention to the resident, but avoid the feeling that he or she has exclusive rights to your time. A PERIOD OF ADJUSTMENT The first day can set the tone for a resident's nursing facility stay. You should plan to be there for several hours because there are forms to fill out, questions to be answered, and a certain amount of waiting while arrangements are made. Your role in helping the resident to understand new information, indicate preferences, and ask questions will be vital. WHAT THE RESIDENT NEEDS The new resident needs to be reassured that he or she is still part of your family, and part of your life. You do not need to spend every waking moment at the nursing facility, but instead, make sure the time you spend there is used well. Most people agree on several specific suggestions for visits: Take your time Play games such as cards or dominos Accompany the resident to specific activities Listen Write cards and letters for those who are not able Reminisce about cherished moments by helping to organize a scrapbook Read aloud from their favorite books, newspapers, or magazines Help them set up telephone schedules to family and friends If your loved one is physically able to leave the nursing facility for a period of time, take him or her to the park, church, to visit a friend, out to eat, or somewhere he or she suggests. Make sure you check the resident in and out with the nursing staff. If it is impossible for the resident to leave for awhile, make sure you share events he or she cannot attend by bringing photos or videos. YOU MADE A TOUGH DECISION Considering your options, you made a hard decision. But it was a good decision, as most of the professionals you are dealing with right now - as well as thousands of families who have made the same choice - will agree. You are providing your loved one with all the advantages of a nursing facility: the stimulation of being around people and activities, structure, supervision, and around-the-clock care and monitoring by a professional, experienced staff. REFERENCES: When Love Gets Tough - The Nursing Home Decision, Doug Manning, In-Sight Books, Hereford, Texas, 1983. Talking with Your Aging Parent, Mark Edinberg, Shambhala, Boston, 1987 You, Your Parent and the Nursing Home, Nancy Fox, Geriatric Press Inc., Bend, Oregon, 1992. The 36 Hour Day - A Family Guide to Caring for Persons with Alzheimer's Disease, Related Dementing Illnesses and Memory Loss in Later Life, Nancy Mace, Peter Rabins, MD, John Hopkins University Press, Baltimore, 1991. A Consumer Guide to Long Term Care Services Home Page