There is no ‘right time’ to place a relative into residential care. But once an older person begins to struggle with basic everyday demands, it can have a dramatic impact on their mental health.
Steve Amos, Dementia Lead at Priory Adult Care (formerly Amore Care) discusses his personal experience of placing a relative into residential care.
For some families, there is a natural ‘right time’ for placing somebody into a are home. This may be based on a number of reasons. Perhaps the safety of the person is compromised by their health, vulnerability, dementia or physical frailty. Or maybe the care-giving relatives have come to a crisis point where they feel they are unable to carry on.
For me, when my mother had dementia, I knew the time was right. She had moved from her home into an Extra Care service and the right next step was to move into residential care because her needs required this. However my sister, who lived further away, experienced tremendous guilt at not being there for mum over the recent years.
Other families may never see the ‘right’ time. Although they understand that the person is struggling on a day to day basis and that community-based care may not be working effectively, feelings and emotions can override objective reasoning which is more difficult to process. This can be especially true where a son or daughter has made the promise of never ‘putting’ their parent into a care home.
For the relative who is providing intense daily support to their loved one, the decision about the ‘right time’ can also mean a personal uprooting. Being a carer is a constant commitment; it becomes the purpose for getting up every day, your ‘job’ and duty. When the relative moves into a care home, it can leave a big void. The role disappears overnight; there is no more purpose and routine in the same way. What does the caring relative do?
Six steps to deciding when the time is right
These conflicting issues about when is the ‘right time’ can make a difficult decision even harder. But there are steps you can take to help make it easier:
- Research the illness or health problems of your loved one. Access some training related to their condition through the many Carers Centres.
- Map out the journey that your loved one is likely to take. Most health conditions in older age are ‘long term’ and will see deterioration over time. Prepare yourself and your relative as far as you can so that there are no surprises. If there is a crisis such as a fall or deterioration and a care home is needed, being prepared may make these events more manageable for you and your loved one. If you are anxious and frightened, this can be felt by the person moving into care.
- Understand the reality of what you’re going through. For people with dementia, their journey will be progressive and there will be changes that families find difficult to accept for example not remembering their son or daughter and grandchildren and so on. Families can find good training courses through Carers Centres, the Alzheimer’s Society, Age UK or MIND. If you are considering an Amore Care home, our Dementia Coaches provide a session on understanding dementia to families and friends to help aid the transition.
- Visit care homes in your area, even before you need to consider using them. Use any number of leaflets on ‘how to choose a care home’ to ensure you have done everything possible to choose the right place. Choosing a home that does not work out brings other significant challenges. For me, it is far better to avoid the crisis where your loved one has an immediate move or is admitted into hospital and then to the care home. The person has had no control over life’s events and little chance to adapt their thinking and feelings; nor a chance to say ‘good bye’ to their home and possessions.
- Get to know the staff. When you have found one or two homes you like, make several visits and begin developing a positive relationship with the manager and staff. You might be in a position to support their fund raising efforts or volunteer. Talk to other relatives and find out what the strengths of the home are and what needs to improve. Reports from regulators, such as the Care Quality Commission, Regulation and Quality Improvement Authority, and the Scottish Inspectorate can also give good information on this.
- Understand this is a transition. If and when your loved one does move into a care home, see it as a transition and not a ‘putting’ in experience; offer support to staff using your own knowledge and expertise in looking after your loved one. The positive relationship you have developed will serve you well. You are in a great position to monitor the quality of care your loved one receives but as a relative, we often want perfection. Accept that this may not happen but work out what ‘good care’ looks like and be content with this. In the relatives mind, rarely can the care given by others exceed your own.
Making this decision is enormously difficult. It needs careful planning, and both the person moving into the care home and relatives need time to adapt. Following these steps can help you reduce the risk and begin to feel comfortable when the right time does arrive.
For more information on the specialist services Priory Adult Care can offer, please call the enquiries and referrals team on 0808 208 2147 or click here to make an enquiry.