Category: Tips for gifts, visits

For Families: The Initial Transition

Posted by Dr. El - January 8, 2009 - Communication, Engaging with families, Tips for gifts, visits, Transitions in care

I recently met a new resident who demanded almost constant attention from her loved ones. Her family visited daily for hours at a time, and she’d call them soon after they’d left and tell them she was lonely. Trying to please her, they were exhausted, frustrated, irritable, and terribly sad. I reminded her tearful daughter about the recommendation of flight attendants for those traveling with people in need of care — put on your own oxygen mask first. For many families, the road to the nursing home has been long and difficult, and it’s okay to take a breath now that your loved one is here.

It reminded me of my work with a wonderful 50-something man with Multiple Sclerosis, who spend most of his time in his room, hanging out with Jaime, the private aide his wife had taken a second job to afford.  He was very depressed about his situation.  Moving to the nursing home, he felt his life was basically over.   “George,” I tried to persuade him, “come out of your room and join the activities.  There are some really nice people here and fun things going on.”  But no, he was fine talking with Jaime.  Until his frantic wife, collapsing under the stress of her work schedule, finally dropped the second job, and Jaime.  George emerged from his room and tentatively attended the trivia group I thought he might enjoy.  He went back again the next week, and then added word games to his recreation schedule.  He started meeting people, making friends, and cracking jokes.  And his wife, who had recuperated from her burnout, was able to visit more frequently now that she wasn’t pulling double shifts at work.

The first weeks and months at a facility are hard on everyone, no matter what the particulars of the situation.  Residents are often frightened and can feel abandoned despite regular family contact. Families frequently feel guilty about the move, as necessary as it might be.  One of the benefits of a nursing home for the residents is the social environment — meeting new people, attending recreational activities, and making connections with others in similar situations.  I often suggest that family members accompany their loved one to activities they might like, to help break the ice.  Another benefit of a nursing home is that, to a large extent, it gives the resident back their independence from relying heavily on their family as caretakers. It creates more opportunity for family members to enjoy each others company without the tensions of day-to-day caregiving.  

‘Twas the Week Before Christmas…

Posted by Dr. El - December 19, 2008 - Communication, Engaging with families, Tips for gifts, visits

And 83-year old Albertha assured me her family was planning to take her home for the holidays.

“Have you talked to them about it?  Have they called the social worker to arrange a pass, and meds, and transportation?”

“No,” she replied, “but they’re coming to get me.”

 

‘Twas the week after Christmas, and Albertha was glum.

“They didn’t show up.  I waited all day, but they didn’t come.”

Albertha spent Christmas day watching other people go out on pass and return, and seeing families arriving with food and gifts and smiles.

 

Now my patients and I start discussing the holidays a few weeks in advance, addressing wishes and practicalities, phoning families if needed, and getting the social worker involved.  We set up a hierarchy of plans.

 

Plan A:  Go home for the day.

Plan B:  Go out to a wheelchair accessible restaurant with family.

Plan C:  Have visitors come with food and go around the corner for coffee, if possible, just to get out.

Plan D:  Stay in with visitors and food.

Plan E:  Talk to family members on the telephone, discussing plans for a future visit, while sitting in a room festooned with cards and holiday decorations.  Attend the nursing home holiday party.

Plan F:  Have a small holiday gathering in the room with nursing home friends after the facility party.

 

Since then, my people know what to expect from the holidays, even if the expectation is that their family might not arrive as hoped.

Throw Me a Party

Posted by Dr. El - December 4, 2008 - Anecdotes, Communication, Tips for gifts, visits

Over the years I’ve worked in nursing homes, my sister has come into the building exactly once. That experienced so disturbed her that she subsequently waited outside in her car, phoning on her cell when she’d arrived to meet me.

 

My sister isn’t unique in her reaction.  Nursing homes are places we like to avoid, unless we are called to work in one.  Which is one of the reasons why visitors are sometimes sporadic, with some family members afraid to come at all.

 

When it’s my turn to be in a nursing home, throw me a big room-warming party.  Make it an open house all day long. Hang up balloons, serve coffee, seltzer, and finger foods, and put on a little Barry White.  Invite my relatives, neighbors, and friends, and show them how to visit me in my new digs.