By Esther Goldstein, BSc, BSW, RSW
It is important to remember that change is difficult—especially when it involves relocating one’s life and possessions. But it is best if good communication begins early on, before a decision is forced by circumstances or illness.
Children often say that their parents won’t discuss matters or accept that they might need additional care, and seniors say that their children can’t face seeing them age and becoming dependent. Often at least one if not both parties are afraid to broach the subject of later-life living, even though fears and concerns occupy their thoughts.
Broaching the subject
The reality is that talking about bringing in extra care or transitioning to retirement living ranks among one of the more difficult conversations to have with someone you care about. But not talking doesn’t make the problem or your concerns go away. Discussing the subject (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 on actual knowledge. The only way to attempt to make things better is to begin discussions with your loved one.
Timing is everything
Talking about transitions early on will give you the opportunity to get a sense of what your parent or loved one wants without them questioning your motivation (e.g., if this is raised when the person is already in failing health, they might perceive it as an attempt by their children/caregivers to institutionalize them, rather than as concern for their future safety and health). Using examples, referring to someone you or they know who did not have the foresight to plan ahead, might be a safe starting point to begin a conversation. If your loved one refuses to discuss moving to another setting then the task will be more difficult, and the issue might need to be approached from a different perspective or with the help of other trusted friends, relatives or medical personnel, especially if health or safety issues become evident.
When exploring issues and concerns, keep in mind that a competent person has the right to live at risk if they so desire, as hard as it might be to witness. 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.
The topic of future planning
It is important to listen and be supportive. Moving out of one’s home can be a very frightening experience, and both the caregiver and senior can experience a range of emotions throughout the process. Here are some useful steps to take.
Discuss concerns, fears and feelings
These might be related to obtaining extra care or the possibility of moving. Stress the fact that when you start talking about the topic early, there are far more choices available.
If possible, find out about 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, try to stay focused and concentrate on what the senior—not the family—needs and wants.
Stick to the facts
It is important to point out that if a person’s wishes are not known, then the options will be far more limited in the event of a rapid health decline.
Be open and honest
Be honest with each other and problem-solve together. Team work is often a good way to relieve some of the stress for all parties. Involve important and trusted family members in the process to assist with both emotional support and practical tasks. For most of us, there is truly “no place like home” so, if at all possible, you should first look at options to facilitate your loved one remaining in their own home, albeit with additional support, for as long as possible. If these options have been explored first, it sometimes makes it easier for the senior to accept the possibility of moving into a care home.
If relocation is the ultimate decision, this might 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 your loved one’s life that are connected to the house or its contents. Allow the search for a new home to be a co-operative process. Involve your loved one in the decision-making as much as possible so that they feel in control of their own life and future.
Things to think about
Before you start looking for a new home, take the time to understand your/their budget so you know what is affordable. Pinpoint your preferred location—an area where relatives can visit often and without difficulty and, if able, your loved one will feel comfortable going out in the neighbourhood. Together, make a wish-list of what your loved one wants their new home to be like, and discuss which items are definitely required and which might be open to compromise.
Work with your loved one to compose a list of questions to ask while you tour places together. Make a list of the “pros and cons” of each place to help decide which would best meet their needs. If possible, encourage a trial stay in the prospective residence before finalizing plans for moving. Talk to people you or your loved one knows who have been through this process already. They might have some valuable suggestions on how to find the perfect home, and how you and your loved one can adjust to the new surroundings.
Family support throughout the process is of paramount importance. To decrease anxiety, make a list of tasks. Help your loved one to decide what possessions to take with them and how to dispose of those that can’t be accommodated. Keep in mind that sorting through a lifetime of possessions and memories can be an overwhelming experience.
Tips for family members
Focus on keeping furniture that will easily fit into a small space, but will make your loved one feel at home.
• Pack, arrange for storage and movers, organize change of address notifications, be present on the day of the move and, if wanted, stay to help your loved one to decorate their room and settle in.
• Ensure the suite is cleaned and in good working order before the furniture is in.
• Spend your first few visits exploring and becoming familiar with the new neighbourhood together.
• Ask the home’s administrator if they can match your loved one with a current resident with similar interests who can help them with learning the routine and adjusting to their new surroundings.
• Recognize that there will be an adjustment period.
• Get to know the staff and how they navigate their system.
After the move
Many people worry that once they are in a retirement home, their family will not visit them. Sometimes the only way to reassure them is by continuing to visit or to take them out as much as possible.
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, then consider seeking support or counselling from a trained professional.
Esther Goldstein’s 12 years of work as a hospital social worker in Toronto have led her to develop an interest in, and understanding of, the retirement home sector. Esther works full-time on the annual “Comprehensive Guide to Retirement Living” and its affiliated website, senioropolis.com.