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Monday, December 27, 2010

My parent wants me to hold on to the house while they "try out" a care facility

Many people who are dealing with that time of transition during which an aging parent moves out of his or her home into long term care will recognize this scenario. The parent agrees - either reluctantly or otherwise - that he or she can't live alone any longer. A suitable long-term care facility has been located. Now comes the time to move. Your parent balks, and instructs you on no uncertain terms not to sell her home because she might want to move back into it.

Now what?

First of all, realize that this situation is common. It's not just your parent who feels this way and it doesn't mean that you're doing anything wrong. In fact, the majority of seniors that I've encountered at this stage of transition want to hang on to their home as an escape route.

Secondly, understand that for your parent, this could be unbelievably frightening. Your parent is leaving his familiar home, neighbours, shops, sights and sounds. That is stressful enough, but then there is also the fear of what lies ahead. Many parents wonder if they'll be mistreated, forgotten or overly regulated. They feel vulnerable and powerless. This is where they are comforted by the thought that if it's as bad as they think, they can leave and just go back home.

What can you do? While there is no guidebook that's going to work for everyone, here are some ideas:

1.  Show compassion and patience. Try to understand how frightening or disorienting this might be for your parent. Acknowledge his or her feelings and let them talk about them. Stay upbeat.

2.  Explore all options for living arrangements. If your parent is adamantly opposed to living in a facility, look at options such as living with you or one of your siblings, or finding home-care assistance that will allow your parent to stay in his or her home longer. The most suitable option for any individual is always a mix of family dynamics, finances, geography and the specific physical and mental shortcomings experienced by your parent. Your parent should have input into the choice, as long as he or she is capable of doing so.

3.  Assuming that a facility is the best - or only - option, check out the facility thoroughly and let your parent know that you are doing so. Unless your parent's condition requires you to act hastily, take your time. Let them know that you are being careful and thorough on their behalf.

4.  Bring your parent to the facility for a walk-through before moving day. Let your parent see the place, meet some staff and generally have a look around. Get answers to your parent's questions.

5.  Some facilities (usually the higher end, expensive ones) allow seniors to try out the facility by staying over for a few nights before commiting to living there. If at all possible, take advantage of this and stay in close contact with your parent during the try-out. Most, however, do not allow a try-out period as they simply don't have the room or the staff.

6.  Agree with your parent that you'll hang on to the house for a set period as long as they agree to give the facility a real chance. There's no point to this if the parent just suffers through it, counting the hours until he comes home. It has to be a genuine try. Finances will usually dictate that this period must be short, as few seniors can afford to pay for full-time care and keep an empty house.

You must realize that #6 above is not always possible. Some aging individuals are not able to live alone for safety reasons. There is no point in telling someone who can't live alone that he or she can come home if they don't like the facility, because they simply can't. It isn't fair to trick them into moving, so be honest and gently but firmly explain why it's the only option.

7.  During the move-in period, set up a communication plan with your parent. For example, will you drop by each morning at 10:00? Will your siblings call each evening at 7:00? Will you come by for lunch? Make sure your parent knows when to expect to hear from you (or other relatives) so that he or she doesn't feel abandoned. Also ensure that your parent knows she can call you AT ANY TIME if she is abused or frightened or confused and make sure that you respond to any calls of that kind. It may take a bit of time for your parent to become oriented and comfortable.

8.  Help your parent choose and transport some cherished things from home to take to the facility, such as framed photos, favourite books, bedding, decorative items, radio or CD player, craft projects in progress, or small pieces of furniture (e.g. lamp, footstool, bedside table).

9.  Get to know the names of some of the staff at the facility so that you can have conversations with your parent about the people they interact with every day.

10.  When the house is going to be sold, give your parent an opportunity to decide who gets what personal and household items.

My experience has been that many seniors are afraid to make the change to facility living, but that many find that their fears were exaggerated. They actually like living there and their sense of relief is wonderful to see. Once a week or two has passed and the senior knows his way around and knows the staff, his comfort level increases immensely. I've heard a number of seniors report back that now they always have someone to play cards with, or they enjoy watching their favourite tv shows with the other residents, etc.

Emotionally, this is a tough transition for the senior and for his or her children.

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