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What's Inside
March, 2008
Caregiving continues after the move
by Bonnie Sandler, SW
Your loved one has moved into a residence. It’s the continuation of an emotional journey. You feel comfortable with your choice but you feel a sense of loss mixed with relief and guilt. You wonder what your role is now that others are caring for your family member.
Your tasks may change but your role as the primary caregiver remains. This involves less of a hands-on approach and more care management. In effect, you are the eyes and voice of the resident.
Once you’ve had time to breathe, you might notice things that upset you. Where are the promised fresh fruit and vegetables? Are the activities as stimulating as you were led to believe? Why are the residents in front of the TV seemingly oblivious to the program? Where is the physician who is supposed to be there weekly?
You begin to question whether you made a good choice. The last thing you want is to move your loved one again.
If a placement counselor was involved, you should go back and discuss your concerns. Placement counselors rely heavily on client feedback. Are the concerns valid or unrealistic? Was the counselor involved in the preplacement meetings? Sometimes discussions with the placement counselor can clarify confusing messages, or intervention from the counselor may clear up misunderstandings.
As a family member, you may find it difficult to express your concerns to residence managers because you don’t want to appear difficult.
But this is where your role as a care manager comes in. If you feel that your loved one is not receiving all that they should be, it’s time to speak up!
Take the example of snacks. Your loved one might like to snack more often than at regularly scheduled times. In a pre-placement interview you may be assured that this isn’t a problem, yet when visiting you may notice such special requests are forgotten. If it falls to your loved one to remind staff, it often won’t get done. Safety and health issues may restrict your options — if you bring fresh fruit, for instance, you may notice it kept in the fridge instead of in an open fruit bowl, to keep it from disappearing and being found uneaten days later. You may want a small fridge in your mom’s room, but who’s going to monitor it?
A residence may not be able to provide the same kind of individual care that was given at home. There are rules to maintain efficiency. This does not mean that you can’t fill in the gaps on your own. Include a stimulating activity during a visit. Bring special meals or treats. Take your loved one out to eat or shop. Check the activity schedule and plan your visits for when there are none; your visit will be the activity.
Visit at different times of the day, including mealtimes. Is your loved one eating? Do they need assistance? Do they seem to be enjoying their food? You might be surprised to find that suddenly they’re eating salads, which they always resisted. Network with other families so you can keep an eye on each other’s loved ones. When babysitters are hired, parents go to great lengths to supervise the care of their children, including placing cameras around the house to monitor what goes on. Why should adult children or spouses be any less vigilant about making certain that their loved one is properly cared for?
Small personal care homes and larger residences will vary on the services they provide. While a small care home can offer a cozy personal approach, it does not have the same resources that a large facility will have. For example, in one large high-end facility, the residents expressed their dissatisfaction to their children about the menu, which included hot dogs. The adult children passed this complaint on to the director, who in turn set up a meeting with the chef and the residents. The chef now meets with the residents regularly to work on a menu that meets residents’ needs and tastes.
Speaking up about your concerns right away can make all the difference as an effective care manager. The response will speak loudly about the residence’s atmosphere and quality of care, and can go a long way towards peace of mind for you and your family.
