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Patients, Families, and Facilities: Making it Work

When a loved one enters a long-term care facility (nursing home), there can be such a huge mix of emotions: relief, sadness, anger, anxiety, excitement — and these are just a few. As you begin to think about this transition, it is also important to think about a few key questions.

  1. How does your loved one feel about nursing facility placement?

  2. How does your family feel about nursing facility placement?

  3. How do you feel day to day as you care for your loved one and now as you envision this shift to nursing facility placement?

There are many emotions floating around, yet everyone should have the one common goal of Excellent Care! While how families approach an admission into the nursing home varies, there are three main emotions family often feel.

Families can feel anger when admitting a terminally-ill loved one to a long-term care facility.

The Ticking Time Bomb

What the family feels: ANGER

Often times, when families move loved ones into a facility, there is anger. Anger at the healthcare system, other family members that are not as involved, and even at a society that does not support caregiving in the home. Anger and resentment can abound during this stressful time and it can be expressed as explosiveness, yelling, striking out, or even personal attacks against the nursing home staff.

What can you do if other family members are experiencing these intense feelings?

  • Validate their concern.

  • Avoid escalating the situation by remaining calm.

  • Ask for help from the nursing facility supervisory staff.

  • Know that for a while all of these interventions may not be enough. When a defense mechanism is taken away, a person experiences pain and is unable to express themselves for a while.

  • Have patience. A lot has changed for your family.

When admitting a terminally-ill loved one to a long-term care facility, families can feel fear and aprehension, which can hamper the pursuit of excellent end-of-life care.

The Chicken Littles...(the sky is falling!)

What the family feels: FEAR

Change is hard. It is scary and losing control of a situation can be devastating to some family members. Perhaps your sister has been caring for your father in her home for several years and is now needing to move him to a nursing facility for various reasons. There can be a lot of fear as she hands over his care.

There are ways to support everyone involved when feelings of fear bubble to the surface. Expressions of fear can include distrust, multiple surprise visits to the facility, numerous daily calls, and/or constant second-guessing of the nursing facility staff.

What can you do if other family members are experiencing these intense feelings?

  • Anticipate the needs of your loved one and be present for all involved.

  • Create a respectful dialogue between nursing facility staff and family members.

  • Normalize and validate feelings and support both the staff and family members.

Families and caregivers, when admitting a loved one to a long-term end-of-life care facility, can feel as if they are losing their role and importance within the family.

The Holly Homemakers

What the family feels: HELPLESSNESS – LOSS OF THEIR ROLE

We all want to feel like we belong and that what we are doing in life is vital to those around us. When a family member enters a nursing care facility, family members can feel lost as they have to create a “new normal” and create new roles. Often times, these feelings can be expressed as doing most/all ADLs (Activities of Daily Living) for the loved one, giving a lot of advice to staff, coming to the facility and staying for hours, and/or continually cleaning.

What can you do if other family members are experiencing these intense feelings?

  • Talk with staff at the facility about assigning appropriate tasks that your family member can perform.

  • Ask your family member about tips for caring for your loved one. Ask for their advice.

  • Encourage them to let your loved one perform as much of their own self-care as possible.

  • Help them to name the emotions they are feeling.

During this time, it is vital to remember that so much change happens so fast that there will be a lot of emotions and some are positive and some need patience and love to work through. Each person’s perception is their reality and it is not personal to you or the staff. They are struggling just as everyone is and validating these feelings and saying, “I am sorry for all of this” can go a long way. It is not admitting you have any fault; it is just speaking the truth that what your family is going through is hard and there is sadness that needs to be expressed.

One day at a time and keep the goal in mind: Excellent Care.


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