The day before the Russians invaded in 1944, Margrit and her mother packed all they could carry into two small suitcases and, leaving everything else behind, fled their Baltic homeland, leaving everything else behind. At the docks they found a boat that would take them to a refugee camp. They were the lucky ones. Of those who stayed, some were killed, others sent to Siberia where they died. Margrit and her mother waited two years in the camp before being sent to work on a Manitoba farm.
Now 85, Margrit is a widow, living alone in the home that she and her husband bought in 1960. She has dementia and arthritis. She cannot remember to take her medication on her own. The arthritis pain in her knees is so bad that she climbs the stairs on all fours. Her only visitors are the care workers we put in place, two to three hours a day, seven days a week.
“I suppose someday I will have to move from here,” she told us on a day when the pain in her knees was particularly bad. “Maybe it is time to start thinking about it, but not now, now I can still manage.
“How can I leave here,” she said looking out her kitchen window, into her garden,” I am rooted to this place. This is my life. How can I pull it up and move away? What would I do somewhere else? What would happen if I didn’t like the people?”
At some level– probably many levels– Margrit knows it is too much for her to be living in her own home still. But at this point, heart trumps head and fear trumps reason.
Margrit’s story is not uncommon. It can be terrifying for someone to have to consider making a drastic and permanent change. And for their caregivers watching and worrying about a mother or father trying to grapple with this decision can cause despair and burn out because it can seem like there is no way out. This is often where Diamond Geriatrics is called in to assist. With patience and compassion, we can usually find a way to help
Making the decision to move is a process; it is not something that someone will decide in a day. As we talk to someone, we make sure we really listen, and not just try to convince them of what we believe. We acknowledge fears and sadness–remembering that what is being processed is grief. When we help people with moves, we often spend a lot of time talking about where they are, and why it is hard to move, reminiscing. At some point during those conversations, we also let them know there can be some positives–we begin to help them look ahead. Sometimes we remind them that there may be times when we have to let our heart rule our head.
Many older people have a very outdated idea of what Seniors Housing looks like. When we take clients for a visit, they see something much different than what they had feared. We stay for a meal, and often come back for more visits and activities, maybe a bus ride. We remind people that they can try a residence for a few months, and maybe not sell their home or empty their apartment immediately. We remind them it is not a prison and that the door swings both ways. Sometimes this transition can take a couple of months; but with the proper support, this transition can occur with dignity and care.
The thought of moving and the worry about how to deal with belongings is often the “hump” that someone must wrap their head around. We sometimes bring in a downsizing specialist–people or companies who help seniors pack and move and disperse things– to talk to them and explain who they can help and how it all can be organized. They begin to form a relationship and the person feels they can rely on the downsizers.
For someone with dementia, at some point the disease may make it impossible for them to agree to a move; they feel safer saying no than agreeing to a change. Even for someone who is cognitively intact and who, like Margrit, knows they should move, they just cannot make the decision, and it is almost a relief when someone else finally makes it. This person may be the family doctor or another professional.Sometimes our work is supporting a son or daughter to help them finally say, “dad, we have had enough and cannot do this for you any longer.”
The decision to move is often made for someone after they have had a fall or illness that puts them in hospital. If they become very unsafe and are deemed by a doctor to be incapable of making an informed decision regarding how they should live, the Public Guardian and Trustee may be called on to take over and make that decision, or a doctor may determine that a substitute decision maker is necessary.
In most jurisdictions, people have the right to make decisions (such as regarding their living arrangements) for themselves until they are deemed incapable of making those decisions. This is the case even if family members feel that those decisions put their loved one at risk. Family can encourage or even push for their preferred decision, but if the older person is adamant about not moving, the family can’t force a change.This is where professional assistance can help.
Almost 70 years ago, Margrit was once forced to suddenly leave all of her possessions and head into the unknown. Her story is not everyone’s, but for those considering the transition from home to care or a seniors residence, there may be some emotional similarities. Our heads tell us that our loved ones would be better and safer where they have support. But our hearts understand that the compassionate thing to do is to recognize that this is a transition that may need outside support. Let Diamond Geriatrics be there with you every step of the way.We can help you set up and monitor systems to keep someone safe at home, or find the right housing, plan your move, and help you with settling in after. We can bet here with you every step of the way.
Nursing Homes and Assisted Living: The Family’s Guide To Making Decisions and Getting Good Care
Nursing Homes and Assisted Living takes family members and seniors through the whole process of moving, starting from when someone first starts thinking about it to how to talk about it, how to choose a home, preparing for moving, the move, and what happens after. By covering all of the the practical and emotional issues which are encountered during this difficult and stressful time Nursing Homes and Assisted Living helps you get the best care possible. Find out why the American Journal of Alzheimer’s Disease and Other Dementias “recommend(s) this book without reservations.”
Nursing Homes and Assisted Living is available through bookstores and online.