Transition to long-term care

The process of moving a loved one into assisted living or a skilled nursing facility is a difficult one.  It is an emotional roller coaster for the person moving and the adult child.  Most frequently, the adult child experiences guilt while the parent experiences sadness and/or fear over loss of independence.  These emotional experiences that occur are referred to as Relocation Stress Syndrome (RSS).  RSS occurs at varying degrees and duration and it occurs at some level to all individuals that move into long term care.  This can span from one week to several months depending on the cognitive, emotional, and physical condition of the individual.  A smoother transition for the older adult can alleviate the guilt and other emotions experienced by the adult child as well.

Although the ideal situation would be for the older adult to remain at home throughout the end of life, that often is not a realistic solution based on physical or mental health issues or even proximity of the closest caregiver.  Below are some recommendations on how to reduce anxiety associated with the move.  First, have your loved one move into their new setting prior to actually requiring the services offered.  The more cognitively intact the older adult is and the more participation the individual has in the decision-making process, the easier the transition.  Second, maintain open communication.  Discuss the move and make sure that the older adult is well-informed.  Feeling “left out” contributes to the idea of losing autonomy and can increase the stress associated with the move.  Ask specific questions regarding concerns and fears to reduce the possibility of internalizing the move.  Third, the older adult should complete and sign the admission paperwork if possible.  This maintains autonomy and the feeling of control.  Fourth, have the individual tell you how he or she would like the room set up prior to the move.  Bring as many personal belongings as possible, particularly pictures.  The individual should be an active participant in the placement of his or her personal belongings in the room;  this creates a sense of comfort.  Encourage the individual to engage in activities at the facility on moving day.  This allows the individual the opportunity to meet new individuals, observe the operations of the facility, and will help reduce additional stress of watching belongings being removed from home and the chaos of being in the middle of a move.    

Unless significant anxiety is prolonged, the older adult should not be placed on medication to assist with this transition.  This only masks the issues resulting in unnecessarily medicating the individual.  Time, patience, and understanding is the best prescription.

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