Terry H. Cunningham

One of the greatest fears some older people have is that of being placed in a nursing home. You will note I use the word "some".  Not every older person has this fear.  The more people learn about nursing homes at an early age, the more they will understand the true purpose of the facility.  There are really two purposes for nursing home placement as I see it.  The first is for rehabilitation, a program that will assist an individual to get better and be able to return to his or her own residence, whether it be his/her home or that of a relative.  The second purpose of a nursing home is to provide a good living environment for someone who has physical needs and/or mental needs (i.e. Alzheimer's Disease) that can't be met at home.  In making this statement I am referring to the individual who can't utilize in-home assistance or a lower level of care such as a personal care type setting for whatever the medical reason may be.

Thoughts that may go through a person's mind can include the following:

* What will it be like, the old poor house I remember?

* Will I be treated with dignity?

* Is it just a warehouse where "old people" are placed and forgotten?

* What will happen to my things, everything I worked so hard for all my life?

* Who will care enough to come visit me?

Let's think about what nursing home placement entails.  What does the person have to give up by being placed in a nursing home?

* Family - daily, weekly contact  --Am I going to be deprived of this contact?

* Friends - lifelong.  -- Will they continue to visit?

* Church - Sunday school

* Home - All but a few possessions.

* Financial security for the spouse.

* Freedom to do things that I want to do such as - bathe when I want to, eat when I want.

* Freedom of choice - roommate - what about her/him; are we going to get along; what if we don't?

* Modesty - bathing, changing clothes

* Last of all my independence - What will it be like to have to depend on someone else for everything?

Now let's look at the positives:

* Security - Knowing that I will be safe, if something does happen I can get help right away.

* Burden - Knowing I won't be a burden to my children or grandchildren.

* Right to choose - many facilities work out bath time, what you want for dinner etc.

* Relief - knowing I will get my medications when I should.  I don't have to worry about meals, bathing, dressing, and there will be caring voices.

Make sure you check out nursing homes that are being considered.  Make an appointment and visit with the staff - not just the administrator, social worker or admissions director but make sure you take time to talk with the nurses aides.  The aides are the ones who will spend the most time with you or your loved one.  Visit at odd times after the initial visit.  Meal time is a good time to see how the patients who have difficulty eating are being treated (are they being encouraged to eat or just overlooked?).  Is the clothing of the residents clean, realizing there can be accidents?  Remember not everyone has to be dressed all of the time; maybe the patient prefers to be in pajamas that particular day.  Are the individuals well groomed, finger nails clean, hair neat, etc.?

Some things that will help a person make an easier transition include:

* Helping to set up an individual's room similar to the way it was at home.  Things to include may be favorite chair, T.V., radio, reading lamp, calendar, large numbered clock, family pictures, etc.

* Having family members around for the first few weeks can either ease the adjustment or make it more difficult (you have to work with the staff on that).

* Comfortable clothing is a must!  Why not try a jogging outfit ?  It looks nice, is modest and easy to put on.  Clothing that fastens in the back is good if the patient has behavior difficulties and is likely to shed clothing.  Lap robes for modesty and warmth are good.  Remember a person who is sitting requires warmer clothes than one who is up and about.

* Don't forget shoes with non-slip soles.

The more the nursing home staff knows about an individual, the better the adjustment will be.  Things such as:

DIET - What foods does he/she prefer or can't or won't eat.

MOBILITY -How well does he/she get around; vision might be a problem.

MENTAL STATUS - Is there confusion?

ABILITY TO CARE FOR ONESELF - What are the limitations?  Needs assistance with bathing, eating, dressing, etc.?

RELIGION - What types of services or pastoral care is available?

OTHER HABITS - Good and bad ones need to be known.

This is one of the  most difficult decisions some families will need to make.  If it can be done with everyone working together for the best interests of the patient it will be easier on everyone involved, especially the patient.  Remember too, caring for someone in a nursing home is extrememly difficult.  A pat on the back or a grateful word for the staff can also help with the care your loved one receives.