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Making the Nursing Home Decision
Categories: Caregiving Articles, Senior Care Tips | Posted: 5/14/2014 | Views: 4333

The decision to enter a nursing home is one of the most challenging a caregiver must face.  It is also a time of great stress often for the person entering a nursing home.   While the quality of life in nursing homes varies from place to place, hardly anyone is excited about the prospect of leaving their own home.

Our parents cared for us and now we naturally want to take care of them. But their circumstance may not allow us to do so. As adult children, we can drop in frequently to check and do chores for them that they can no longer do for themselves. This will work for a while, and we may even decide to bring in a home care agency if we are lucky enough to have good choices in our area - but eventually the medical needs are going to increase and only one choice is going to remain, a nursing home.

Different Strokes for Different Folks

I have visited nursing homes only to see some patients that feel abandoned or who seem as if they were left there to die. A friend of my family, however, absolutely loves her placement in a local nursing home. She gets around in her electric wheelchair, going to all of the activities, and gets her hair and nails done weekly. She says that she is a lot less lonely than if she were still in her home. Not everyone reacts the same way.

Some people are so content that it alleviates the feelings of guilt that haunt the family members who may have to make these decisions. One woman, Mary, has always believed that she creates her own destiny and that if she chooses to be happy she will be. What a great attitude for an 82-year-old widow! I wish that attitude was the way all elderly felt when the decision to place them in a nursing home has to be made; on the other hand, that is far from reality for many.

Some elderly people may welcome the activity and structure of a nursing home and others may feel a deep loss of independence and privacy.  Some may want more social interaction naturally and others may not need that as much.  So, when making this type of decision, there is really not a "one size fits all" solution out there.

When and How to Make the Decision

A decision to place a family member in a facility is not made lightly. As we take many factors into account when making these decisions, sometimes it is taken out of our hands by emergency situations. The loved one’s physician should weigh in as well as friends and family. And the financial situation needs to be considered, hopefully not creating a massive turmoil for the decisions makers.

Often, now, with insurance companies limiting hospital stays, people are often discharged while still in need of significant and full-time nursing care.  The family may not be capable of taking care of someone immediately in this situation.

If you are considering it, getting the doctor's opinion and spending some time evaluating the person's capabilities can help inform your choices.  Studying their ability to perform "Activities of Daily Living" or "ADLs" can really help you to see the areas in which a person needs to be able to function.  Showing your results to the family doctor and discussing the issue with others in the family can be a good starting point.

Emotions of the Nursing Home Decision

You may feel responsible for caring for them at home as originally planned or you have the perception that others expect you to care for them at home. Families feel a wide range of emotions when faced with this difficult decision and agonize over their decisions for weeks, months and sometimes years asking themselves did we to the right thing? Did we do everything we could for them? They often feel a self-imposed judgment, feel like they have abandoned their responsibilities or experience grief over the physical or mental deterioration of the loved one. Selecting the right nursing home will be important to the caregiver’s sense of relief and possible the attitude of the patient.  Guilt is that crippling sense of emotion that says you have fallen short of an expectation or moral standard, whether it is accurate or not. When you believe you did something wrong you will feel as much guilt as if you really did commit some disputable act and this is often self-imposed.

Easing the Transition to a Nursing Facility

Acceptance of nursing home placement is sometimes made easier when everyone involved feels that it was the right step, therefore, communication with family is important. Don’t let the guilt make you feel bad about your decision and foster more anxiety. Instead use it to motivate you to continue to be involved in the person’s care, visit often, and do acts of kindness to make the transition go smoothly. Bring in personal items to make it feel like home. It is a sign of love to put another person’s needs before your own and you may feel a sense of duty in doing so but you can’t ignore the needs of the other people who depend on you or your own needs. You may feel that it is your chance to give back to them and you don’t want to feel selfish or let them down but it could very well be self-defeating to stretch your limits too far.

Things to Consider When Making the Nursing Home Decision

  • The person's ability to manage on his or her own
  • Is the elderly person experiencing lonliness and wanting more social engagement or is the person most struggling with independence?
  • What are your reasons for considering nursing care or not?  Making sure that you are looking at what your parent needs and wants and not just what is best for your emotions of guilt or doing what is expected of you.  Likewise, if you are hoping to reduce your engagement with the person - is there another family member who could take your place? 
  • What other options are available to you?  Home nursing, adult day care, family, friends?
  • What type of medical care is needed and can you realistically supply it?
  • Your parent's feelings on the matter
  • Have you made this decision with others in your family?
  • What is the quality of the nursing homes you are looking at?  Do you have other options like home care, hospice, etc.?


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