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It is important to remember that change is difficult; especially when it involves relocating one's life and possessions. The transition can be made easier with good communication. It is best if this communication begins early on - before a decision is forced by circumstance or illness. I have heard repeatedly from both children and seniors how the 'other one' does not want to discuss future care issues. Children say that their parent won't discuss it or accept that they may need care, and seniors say that their children cannot face seeing them age and become dependent. Often, at least one, if not both of them is afraid to broach the subject even though fears and concerns occupy their thoughts. There is no 'easy way' to discuss the issue. The reality is that it ranks among one of the more difficult things anyone has to raise and discuss with someone they care about. But, not talking about it does not make the problem or your concerns go away. Discussing it (if all involved are open to it) can create a sense of relief for both parties. Often we assume certain things based on our own fears rather than based on our actual knowledge. The only way to attempt to make things better is to begin discussions with your loved one. Timing is an important factor when raising this issue. Talking about it early on, before your loved one needs care or assistance, will allow you an opportunity to get a sense of what they want without them questioning your motivation (i.e. if this is raised when the person is already in failing health, they may perceive it as an attempt by their children/caregivers to institutionalize them rather than as concern for their future safety and health). Referring to someone you or they know who did not have the foresight to plan ahead may be a safe starting point to begin a conversation. If you are in the situation where your loved one refuses to discuss it, the task is more difficult and the issue may need to be approached from a different perspective or with the help of other trusted friends, relatives or medical personnel especially if health and/or safety issues become evident. Keep in mind when exploring issues and concerns that a competent person has the right to live at risk if they so desire and as hard it is to witness, it is still their right. No decision for placement of any kind can or should be made without the consent and knowledge of the person involved, if they are competent. When raising the topic of future planning, it is important to listen and be supportive - this can be a very frightening experience and both the caregiver and senior may experience a range of emotions throughout the process. Discuss any concerns, fears and feelings related to obtaining extra care and/or the possibility of moving. Stress the fact that when discussion begins early, there is much more choice available. Be prepared beforehand - if possible know the available options and costs before you raise your concerns. Present options thoughtfully and focus on what you see as the greatest need at the present time. During the discussion stay focused and concentrate on the senior - not what the family needs and wants. Try not to argue and stick to the facts. It is important to point out that if wishes are not known in the event of a rapid health decline, the options may be much more limited and the person making the decision may make one that the senior is not happy with because they don't really know what he or she wants. Needless to say, it is also much more difficult to make such a decision on someone else's behalf if you are not confident that you know what their wishes are. Be open and honest with each other and problem-solve together. Team work is often a helpful way to relieve some of the stress for all parties. Involve important/trusted family members in the process to assist with both emotional support and practical tasks. For most, there is truly 'no place like home' so if at all possible, you should first look at options to assist the person in remaining in their own home, albeit with help or support for as long as possible. Sometimes if these options have been explored first, it makes it easier for the senior to accept the possibility of moving into a care home. Start by researching the available services for seniors in their area. The local health authority may be able to help you with this. If relocation is the ultimate decision, it may involve selling the family home and many of the possessions in it. It is important to stress that moving will not erase the memories of their life that are connected to the house or its contents. Allow the search for, and move to, a new home to be a co-operative process. Involve the person who will be experiencing the change in the decision-making as much as possible. This will assist them in feeling that they still have control over their own life and future. Know your/their budget so you will know what is affordable before you start looking. Determine where the best location for a new home would be so that relatives can visit often and without difficulty and if able, your loved one can feel comfortable going out in the neighbourhood. Make a wish list (of what they want their new home to be like) with your relative recognizing that some things may have to be compromised. Take special note of what they are unwilling to compromise on. This allows you to be aware of what is most important to them. Work with them to compose a list of questions to ask while touring places. Take them to visit residences. Make a list of 'pros and cons' of each place when trying to decide which would best meet your/their needs. If possible, encourage a trial stay in the prospective residence before finalizing plans for moving. Talk to people you or they know who have been through this process already (for themselves or a loved one). They may be able to make some valuable suggestions on how to find the perfect home and how to help you or your loved one adjust to your/their new surroundings. Family support throughout the process is of paramount importance. To help decrease anxiety, suggest and offer to assist them in making a list of everything that needs to be done before moving day. It might be a good idea to assist your relative in deciding what things they can take with them and how to dispose of what can't be accommodated in their new home. Keep in mind the overwhelming experience sorting a lifetime of possessions entails. Help your loved one to maintain and relocate their memories. Focus on keeping furniture that will easily fit in a small space but will help them to feel like their new place is their new home. Help pack, arrange for storage and movers, assist with change of address notifications, be present on the day of the move and, if possible, help them decorate the room and settle in. Ensure the suite is cleaned and in good working order, if possible, before the furniture is in. You may want to spend your first few visits exploring and becoming familiar with the new neighbourhood together. Ask the home Administrator if they can match you/your loved one with a current resident with similar interests who can help with learning the routine and adjusting to the new surroundings. Many people are concerned that once they are in a retirement home, their family will not visit them. Sometimes the only way to reassure them that this will not happen is by continuing to visit and/or take them out as much as possible. You are still their "caregiver" but the way in which you provide care for them has changed. Knowing they are safe and well cared for will afford you more time to socialize and spend quality time together. Your visits can be spent enjoying each other's company rather than focusing on personal care and household tasks which may have consumed your time when your loved one lived on their own. Despite this positive change to your relationship, keep in mind that there will be an adjustment period and for a while a new place may not feel like home. It is important to be supportive and continue to communicate regularly and frequently with your loved one and residence personnel. Get to know the staff in the residence and the routine and help them get to know your loved one. If there are concerns, be sure to discuss them promptly with the appropriate staff. Allow your loved one to talk about their feelings with you; don't avoid "uncomfortable" discussions. Listen and don't fear talking about the past but, if negative or depressed feelings persist for a prolonged period of time after the move, in either you or your loved one, you may want to consider seeking out support or counselling from a trained professional.
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