Difficult as it may seem, in today's modern and high-tech world, some of our old and misguided beliefs still endure (read: sigh). One of those beliefs is that "all" nursing homes and assisted living facilities are dismal places to live - they smell of urine, the food is terrible, and living conditions are inhumane.
Although this may be the case in a small percentage of nursing homes and assisted living facilities, I believe that most of these facilities are working hard at keeping conditions at or above the standards of State and Federal guidelines. Yet, it still remains the case that when a loved-one's health is declining and a choice must be made as to whether that elder can or should remain in the comfort of his/her own home, families struggle with which choice is best for their loved-one.
Let's explore areas that families review when faced with such decisions - it might help you to better understand what your clients are facing. And remember, empathy is a good thing in our business.
The decision making process revolves around several key components: money, safety, and emotions.
You might think that money is the easiest to deal with, yet most folks have no idea what an assisted living facility would cost for one year; nor would they know how to calculate what they qualify for in a nursing home. The assistance of a professional is surely needed in those situations. And, if the family was deciding on home care, clearly the family could easily contact a Visiting Angel office to help with the cost associated with our provision of care.
Safety is certainly foremost in all family members' minds; whether it's protecting their loved one from falling, safety concerns like turning off the stove, or struggles with mobility like reaching a telephone in an emergency - the safety and protection of our loved-ones is always first in our thoughts. It might be wise to have a professional, such as an occupational therapist, perform a safety assessment on your loved-one's home. Typically, they are not very expensive and oftentimes packed with useful information. A safety assessment can help a family with the feasibility of remaining in the home or how much it might cost to bring the home up to reasonable safety standards.
Finally, we can all sympathize that the emotional side of making the decision to either remain at home or move to an appropriate facility is never easy. Many elders will not want to have such a discussion (and quite frankly, most of their loved-ones won't relish in such a talk either). So, it is best broach the topic slowly. Plant the seed for such a move. Allow the senior to bring up the topic at a time best suited to their emotional state.
Understand that an elder may have feelings of grief at the potential loss of their home, especially if they have lived there for many, many years. There will also be feelings associated with their loss of independence. Just think back to the many articles that have been written about "taking away Grandpa's car keys." This loss of control is a very difficult hurdle to cross and must be handled within one's own timeframe.
Have you ever moved residences? If so, try to remember back on how difficult it was: logistically overwhelming (all that packing, all that needless stuff you had accumulated over the years - what to keep, what to get rid of), leaving your familiar surroundings, leaving your friends and having to make new friends (or face the prospect of being alone), and the list goes on and on and on ... The stress is potentially enormous.
Making the decision to leave one's home and enter the next (and most likely last) phase of one's life is extremely difficult. We can only speculate how hard this must be for our elders to do - some handle it well, others poorly. Yet, we all must handle it at some point in our lives. If the family is close-knit and communicates well, the decision making process will be easier; mind you not easy, just easier. If the family is not very close or there is much dissention among the kids, this process could potentially be long and arduous. Either way, it is best if the senior is able to come to grips with the situation at hand and ultimately make the final decision as to where to live.