Dr. Val FarmerDr.Val
Rural Mental Health & Family Relationships

The Nursing Home: A Family Affair

November 27, 1995

"I have always resisted the idea of nursing home care for my elderly mother. Now we are faced with an impossible situation where we can no longer care for her. As a family, we feel a lot of guilt about placing her in a nursing home. What do we need to do so that the nursing home experience is positive for her?"

The attitudes of the resident and the family are crucial to a positive adjustment. You have painful, agonizing reasons for doing what you are doing. Fortunately we have a wide range of options for the elderly short of institutional care. I'm sure you've considered or tried them all. Families and the parent need to face facts squarely and talk openly about the reasons why nursing home care is the best option.

A nursing home may be the best place to solve difficult problems of ongoing medical and physical care, supervision and rehabilitation. The elderly spouse, sibling or adult child who can no longer manage the demands of care can get relief so their health and well-being doesn't suffer.

Nursing homes are tools to help the elderly with important functions so they can focus and accomplish personal goals. Just like glasses, a hearing aid, a wheel chair or a walker helps to keep a quality of life, a nursing home provides needed care so the resident can do what he or she is still able to do.

Who is really responsible? True, nursing homes provide significant medical care, rehabilitation, protection and support. However, their primary function is helping residents keep their quality of life: their zest, their optimism, their personal integrity and dignity and their resolve to stay engaged in life. That effort succeeds much better when the family stays involved with their loved one. They should still see themselves as the significant caregivers - with nursing home personnel as assistants in that cause.

Nursing homes are not extensions of hospitals. They are extensions of family.

Nursing homes can be - and most are - stimulating places that are safe and secure. They should respect human dignity and allow as much autonomy as possible. The feeling of autonomy and control makes a huge difference in resident satisfaction. A dedicated staff with sensitivity and love for the elderly can supplement the family involvement with high quality service and attention.

At one level, all that has changed is the parent's place of residence. Families can do the same special things together as before. Too many families become intimidated by the facility and the staff. Nursing homes are flexible in dealing with pets, having a party, and permitting residents to leave for lunch or weekends. The visit should be as normal and natural as a visit in a home.

Family involvement. Visits by the family and friends sustain the elderly. If the staff could voice their biggest frustration, it would be toward those families who thoughtlessly neglect their responsibilities. A large part of the sadness, lack of meaning and loneliness you see in a nursing home is a result of family neglect.

Sometimes neglect unfolds gradually and subtly as the family’s reliance on the nursing home for physical care shifts to emotional care. It is easy to step to the sidelines and assume that emotional needs are being met too.

Love and devotion by family members brightens the day, lifts the spirit and gives meaning to life. Family connection is something the staff cannot provide. Frequency of visits, phone calls, remembrances, letters and personalized attention are ways for the family to express devotion and concern.

Family and staff partnership. The visits and obvious love a family shows to their loved one has a positive effect on the staff. Staff members will have the tendency to treat or react to the resident as the family does. When they see love freely given, they find it easier to go out of their way to extend that love when the family is not there.

Time should be spent communicating with staff, in person and by phone. The staff appreciates hearing key points about habits and personality. They want to hear family concerns and share their frustrations about special problems. Often the staff relies on families to see progress they themselves can't measure because of daily contact.

The staff can become attached to the resident and many want to share their joys, frustrations and even grieve with the family. Their work takes on meaning when it is appreciated and recognized. The staff gets a needed morale boost when family members support them in doing their jobs. Create and nourish a feeling of partnership.

Nursing homes are necessary. They are the last choice in a continuum of care. They are an extension of the family.

It is family involvement that makes the difference between a life that is empty and sterile and a life filled with love and stimulation. The decision to place a loved one in a nursing home can be an act of love if the family continues to feel and meet their responsibilities.