Saturday, March 23, 2013

Learn How to Cope With Placing Your Elderly Parent in a Nursing Home


Taking care of your elderly parent can be hard work mentally, emotionally, physically and spiritually. Many times roles are reversed and they become more childlike while you become more parent like. It's not an easy adjustment to make for your parent or yourself especially if he or she has been very independent all their life. Consequently, if you want to provide loving care for your parent and still take care of yourself there are many things you need to know.

TRANSITIONS

Acknowledging that this is a time of transition and knowing that things will not be as they once were is a good first step in care-taking. Because difficult and unsettling emotions surface keeping a journal to process them is helpful. Issues, disputes, and unsettled business can make for a heavy burden if you carry it alone. If you have a trusted friend, minister, rabbi or someone you deeply respect around you to discuss your feelings or simply listen without judgment your burden will be lighter. Your parent may also need a counselor or someone in which they can confide and share their feelings. Often the facility will make this service available.

In my own situation I needed to move my mother closer to my residence to manage her care in the assisted living facility. I could not give her the skilled care she needed. As I write this now it almost seems like moving her happened overnight without much forethought or concern. Indeed the opposite is true. I planned long and hard about it. Being the independent person she was, she resisted this move with all her might like your parent may do with you. She didn't want to go into a nursing home...period. Even though you may plan the move very carefully and with as much love as you can, be prepared for your parent to be angry, irritated, upset, resistant, and uncooperative. This was the case with my parent. Even though she traveled the 12-hour drive in a huge motor coach with 2 drivers she was very upset when she arrived. Be prepared. Even though you may put your heart and soul into making the transition as easy as possible it may be hard for your independent parent and you.

THE FIRST FEW DAYS AND AFTERWARD

The first few days can also be a trying time for both you and your parent. He or she is in a new place and has lost independence. They may lash out at you, the nurses, nurse aides, or other residents. For example, upon arriving in the nursing home my mom complained about everything including: her roommate's bathroom habits, the food, her inability to sleep on the bed, the aides checking her in "the middle of the night." But finally after several months she seemed like she had made the transition well. She and her roommate, "Ava", became great friends and she grew to like most of the staff. No matter how your situation unfolds this time may hold deeper meaning for you both. It can be looked at as an extraordinary journey into facing aging and possibly the death of your parent. Indeed it can be a time of facing your own fears about losing your parent and facing your own aging process.

BEING THEIR CHEERLEADER

Making major decisions for your parent may put you in the position of medical or financial advocate.. If your parent has a living will, and has named their durable power of medical attorney and durable power of financial attorney review those documents. If this is not set up you may want to consult a lawyer if you haven't done so already. Talk to your parent about this. Sure, these are difficult subjects but must be done! Parents may not be able to handle their own finances or medical treatments alone. You are there to assist and possibly take over when they need you to do so.

In my case, I drove my mother to many doctor's appointments, answered calls from the facility, and discussed her care with all of her doctors. I was her cheerleader too, encouraging her when she was down or depressed. This took enormous strength on my part because even though I loved my mother very much she was not a cheerleader for me as I was growing up. When I was five she began full-time "shift work" in a factory. Although I had wonderful grandparents caring for me they couldn't fill the void that mom created when she was gone. I had questions, concerns and problems as any kid does and they only multiplied throughout my teenage years. She wasn't a cheerleader for me when I needed her but now she needed me to act as hers.

Old wounds may open up. Processing them is significant to the care you can offer your parent and taking care of yourself. Strive to talk with your trusted friends, minister or rabbi. They are there for you. Encourage your parent to utilize the counseling services at the facility.

UNUSUAL BEHAVIORS

Don't be surprised if your parent displays unusual behaviors. They may be forgetful, may display dementia and get upset. He or she may have medical problems that color their day. At times it may be all you can do to visit or advocate.

Sometimes advocating proved to be more than I could give. My mother resented me for moving her and putting her in the "old age home." She had dementia and would say the most bizarre things. Once evening my mother called me a total of 15 times wanting me to help her locate my brother. You see if she didn't talk to him everyday this unwarranted fear set in and she imagined that he was lying dead in a ditch somewhere.

This type of behavior began to happen daily until the social worker of the facility called a "team meeting." My brother and I were present along with the head nurse, the physical therapist and social worker. They suggested that arranging a phone call between my brother and her at a specified time everyday might alleviate mom's anxiety. That time was 9:30 am. Then, she would call me around 5:00 PM daily. Everyone on the floor knew of this arrangement and helped mom make the calls. It worked out very well.

Don't hesitate to seek the help of the professionals at the facility. They have lots of experience and can often offer many suggestions that make life more pleasant for everyone involved.

DIFFICULT TIMES

There are going to be some difficult days. Your parent may not be feeling well, may be depressed or feel as it they have nothing to live for. You may have to dig deep inside yourself to find the compassion and strength to companion them.

In my own situation, there were days when I'd walk into my mother's room and she'd be lying on her bed with the shades drawn down. She had osteoarthritis in her left hip, which caused severe pain. On these days it was all I could do to comfort her. Providing energy therapy gave her some relief, which would enable her to get up off the bed, walk to dinner and the library. The hip pain was like fighting an old but familiar enemy because she was also fighting depression. She often spoke about how she wanted to die and go to her "permanent home." When I heard this repeatedly it began to affect me adversely. On one hand I listened with compassion for a time but I also had to detach lest I became depressed myself.

You will find that you can only do so much. You cannot stop the aging process but you can be there to listen, to advocate and to make like bearable for your aging parent.

MAKING GOOD MEMORIES

You and your parent can make good memories during this stage of their life. If you participate in the activities that the facility offers with your parent many times you will find that you actually enjoy yourself. If they are able to leave for outings encourage them to do so. There's nothing better than a ride on a lovely summer day, visiting family in their homes or lunch out. Do it as often as they are willing and able. You won't regret it. In fact these memories will be some of the one you treasure the most.

In my case, sometimes when I came to visit my mother was fully engaged in circle ball and chair exercises or playing a game of bingo. These were fun times and I would often participate. It was fun encouraging all of the residents to do their best to hit the ball. They enjoyed it too and often there would be plenty of smiles. On some afternoons, we sat outside on the benches under the awning of the building. These were among my favorite times as the trees and flowers were in full bloom. Other residents would come out too and we'd have lively conversations albeit loud ones as most of them were hard of hearing. Sometimes it would just be mom and I talking about our happy memories or retracing our family tree.

Again, help them get out and enjoy life as often as possible. The nursing home may have a van that takes residents out for activities. Help your parent find the activities they like encourage them to join in.

SELF CARE

Self care is a must for anyone that is a caretaker. Often care-takers don't want to take out time for themselves. This is not good thinking. In order to take care of others you must first practice self-care! What good can you possibly to your elderly parent or anyone else if you are emotionally, mentally, physically and spiritually depleted? The answer is: you cannot.

What brings you joy? What brings a smile to your lips? Is it a walk in nature? Time alone in meditation? Exercise? Reading a book quietly? Vacationing? Listening to good music? Gardening? Baking? Meeting up with friends? Playing with your pet? Enjoying time with children? Whatever fills you up do it! I created a comfortable chair in my home where I would meditate. I had a candle, prayer beads, scripture and other inspirational books on the side table. An iPod with meditation music and headphones were there too. Feeling God's presence with me on this journey sustained me through it all.

Those times when I visited my children and granddaughter were happy times that lifted me out of the caretaker-problem solver role. To see new life and the excitement it brings warmed my heart like nothing else.

I exercised by riding my bicycle when the weather was good. I promised myself that I would not take my cell phone on the ride and for that hour no one could contact me. It was I riding in nature. I'd ride out to my favorite spot on the trail and feel re-energized by the beauty surrounding me. Most of the time I felt as if I could face anything when I returned. I knew I had to do what was life-giving for me so I could be there for her. This and the support of friends, my spiritual director, good books and faith was what helped me through this time of my life.

FINAL PASSAGE

It is very hard to witness your parent weakening and becoming frail. Not many of us want to face losing a parent no matter how ill they are. You may bargain with God, deny the situation, become angry or very sad. This is a time of life that all of us face someday. But your parent may be looking toward the next life and being out of pain. When thinking of them instead of yourself you may be able to accept their impending death.

"She had been in the emergency rooms of local hospitals over 25 times in the year and a half that she was here," I reasoned. At 92 she was tired of fighting this hard battle with the arsenal of drugs and invasive procedures. She was ready to go home. But was I ready to let go? Well, whether I was ready or not, it was going to happen.

You may think of how you could have or should have done things better or differently. You may think about how you could have been kinder, gentler or a better problem solver. All these thoughts may go through your mind. If you've done the best you could do and were there for your parent, then you should have no regrets. Sure, it's still hard and you may be grieving but time does help. Also, to honor the memory of your parent you may consider donating to a charity, planting a tree in your yard, or spending time volunteering in your community. These activities help others but they do help you as well. Above all, know that you have walked a difficult journey and give yourself time to heal.

A very good website to visit for further information on care-taking is http://www.agingcare.com

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