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How to Cope with a Difficult Decision
At Fundamental, one thing we understand all too well is how difficult it is to
come to the decision that the person you love is ready for a long-term care
facility. Awakening to this emotionally difficult realization is but the first
of many steps, that, taken together, will guide you to a better way of caring
for—and therefore loving—your aging family member.
"Where Do I Begin?"
Begin as early as possible, maybe even before you need to. This is very
difficult and may sound and feel discomforting, but it will help you later when
the emotions that surround every decision feel overwhelming, as there are also
practical matters to consider.
It is not always the case, but it is not uncommon to encounter waiting lists at
some facilities. If you start looking at and assessing the differences between
facilities early on, this will not be an issue for you. You’ll also have the
opportunity to learn where your parent or spouse in need is most comfortable
living.
Know What You Need
How is your family member doing when it comes to mobility? Can he or she get
around with little or no assistance? What about nutrition, dressing, hygiene
and toileting? Can he or she be responsible for taking medications reliably?
What is her mental status? Is he more forgetful than usual? Is her speech
impaired? Is her behavior unpredictable?
His or her ability to perform activities of daily living (ADLs) as well as
interact with others is crucial to determining the level of care he or she will
need.
Take Notes
Observe every everything and write it down. Often, families entering this stage of
life feel overwhelmed by the details. Writing them down will help you stay
organized and stay focused. Here’s what you’ll need to look for:
First of all, emotions count. Keep track of yours and those of your loved
one’s. Take note also of memory loss, falls or other injuries, as well as any
type of functional decline. For instance, is your father losing his sense of
smell, taste, vision or hearing? Are his cognitive abilities waning? Does he
have a harder time recalling names or events? By keeping a journal and marking
down the dates of your entries you will be able to track important changes over
time.
Deciding What to Do
Togetherness is important in a decision as big as this one. Everyone in the
family should have a say and be heard, however the final say belongs to your
aging loved one — so long as he or she has the cognitive ability to do so.
Preparing Your Loved One:
The Most Difficult, Loving Talk You’ll Ever Have
If you think it’s going to be difficult to tell your parent or spouse that it’s
time he or she went into a nursing home, imagine how he or she will feel upon
hearing it. If things go well, your aging loved one will recognize their need
for outside help and accept what you have to say. But the emotions that
surround aging are complicated. Your loved one may feel that you are abandoning
him, that you don’t love her anymore or that she’s a burden. Be prepared for an
angry reaction.
Use these tips to help navigate the emotional waters that surround this
difficult, but essential time.
To begin, when you speak about your loved one’s care understand that he very
likely is afraid of his own decline and uncertain about what the future holds.
Ask him what he hears you saying. Let him know you understand and respect his
feelings. Reassure him of your love and make sure he knows you’ll be there for
him emotionally, but draw a distinction between the love you share and the
professional medical care he needs. Then move into the more pragmatic parts of
the topic.
Find out what personal possessions he would like to bring along with him. A few
small possessions will give him peace of mind and a feeling of control. But
there won’t be much in the way of personal space, so help him minimize the
number and size of what he brings.
Keep talking, especially as you get closer to the big day. Communication is
vital. It eliminates surprises. It keeps everyone focused. And it will go a
long way to managing the anxiety that everyone in your family is sure to be
feeling.
Finally, recognize that even the best-laid plans don’t mean that it will be
easy. Your loved one may still flat out refuse to go. In this event, be sure
that he can speak with his physician to determine what other options—if
any—exist, such as home health care. Your physician will help you work your way
through all these issues. Among the toughest issues to deal with, however, will
be your own emotions.
For many individuals, the hardest act to perform is leaving the nursing home
after dropping your loved one off, not just physically, but emotionally. It may
seem at this time that a storm of feelings is swirling about you, not the least
of which is guilt. It’s easy to feel lost.
Here are a few guides for understanding your own feelings:
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These feelings are not only complex, they’ve been building for quite some time.
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These feelings are heavy, and they exact an emotional toll. The trouble many
family caregivers have once their loved one is actually
admitted into a nursing home is feeling as though a
huge burden has been lifted—and then feeling guilty
about thinking that way. For one thing, it doesn’t make you a bad
person. Chances are you’ve been shouldering a bigger
responsibility than anyone would be able to sustain
long term. It’s natural to admit you feel some relief.
Secondly, you can feel relief and still love your aging parent or
spouse. They are not mutually exclusive feelings in
this case.
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Don’t be afraid to ask for help, both from within your family and from a
support group alike.
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Keep your perspective. This will be a trying time. Set aside some time for
yourself to do things that take your mind off this
difficulty.
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Learn to let go—even if just a little.
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Make time to tend to your own health. Exercise, eat well, sleep. You’ll need
to keep your energy up.
Embracing Your New Role
The change that’s about to take place in your relationship is significant, and
likely it will have a few bumps in the road that are uncomfortable, however
with love and persistence you can work through them. Here are a few insights
into the things you may need to be prepared to take on:
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Happily, you can return to being your loved one’s son, daughter or spouse
instead of caregiver. This will be a welcome change for
both of you.
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Be an advocate for your family member so that the physicians, nurses and
other professional caregivers understand what your
loved one’s needs and wishes are. But remember that
these people are here to help; avoid being adversarial.
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Make sure your parent or spouse’s finances are in order. You very likely will
need to become the manager of his or her financial
affairs.
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Help her through her transition. Remember, this is an enormous emotional
change. Not only will she be living in a group setting,
but she may even have a roommate for the first time.
Not to mention the fact that her lifestyle will change
dramatically.
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Reassure your loved one that she made the right decision and that things
will get easier. This is also a message that you will
want to take to heart yourself.
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Visit. Your presence will bring a smile to family member’s face. And it will
make you feel good too.
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