Tips May Ease the Pain of Making Decision

The decision to move a relative to a long-term-care institution can be one of the most difficult you’ll ever make.

Elizabeth Isenhart and Sally Smith, health-care professionals at Keswick nursing home in Baltimore who routinely counsel families on this subject, offer these suggestions for easing the experience:

* Avoid making the promise, “I’ll never put you in a nursing home.” If a parent or spouse asks for a vow, promise that you will do your best to see that he or she gets the best care possible.

* Once your loved one is admitted, recognize his grief. Don’t deny the enormity of what has happened. Let him talk about his loss the way you would let a grieving person talk about someone who has just died.

* Visit when you are comfortable with the idea and in an “up” mood. If it hurts to visit a loved one who has severe dementia and who doesn’t recognize you, avoid visiting for a while while you regain your emotional strength.

* Don’t over-visit. Don’t become an excuse for the patient not to get involved in his new home.

* When visiting a patient with dementia, keep in mind that his reality is not the same as yours. Don’t expect to sit down and tell him how things are at home. Go for a walk or a ride, if he’s willing, or talk about something that doesn’t require him to use his memory.

* Be advocates for the patient, but don’t overdose on a loved one’s complaints. Check out complaints with a nurse, but don’t try to make things perfect at the nursing home. An institution is not a home no matter how you cut it, says Smith.

* Don’t get sucked into a guilt trap. When a parent says, “They drag me out of bed at 5 in the morning and feed me cold food,” recognize this as the anger stage of grief.

* Remember that this is probably not the first time you have felt guilty over the patient. If a parent had a knack for stirring guilt in younger days, you may be prone to it now too. Remind yourself that you’re doing your best.

* If you take a patient home for a holiday visit, be prepared for some surprises. People with dementia, once settled in, come to view the nursing home as home fairly quickly. If, after 20 minutes, your loved one starts talking about wanting to go home, she probably means the nursing facility.

* Give yourself time to grieve your loss and your parent’s or spouse’s loss and to get over the loneliness.