Karen McPhail, RN, BSN, MSN, CCM, CDP
Relocating a Loved one with Dementia
Relocating a loved one to a care community is never easy and is even more challenging and stressful when they have dementia. The nature of the disease process unfortunately makes it virtually impossible to put in place the normal preparation steps that would often ease a change such as this for the individual. Many family members, although knowing that a move is the most appropriate step to take for safety, comfort, care support, hygiene, behavior management, engagement, and more, are often filled with fear and worry, stressing over what the day of the move will bring and the subsequent days to follow. Will they adjust? Will they be happy? The wellness blog this week will try to provide some helpful guidance and support in making a move and hopefully lessen some of the stress and fear involved in this process.
A successful relocation like most things in life is all about planning. Having a concrete and realistic transition plan in place will make all the difference. Hopefully, prior to making a decision on a care community for your loved one, you have done your homework to ensure that they are being placed in the most appropriate setting with guidance from a clinician. Getting guidance from an RN care manager is very helpful in this regard since general relocation specialists, although helpful in many ways, are not usually clinicians and cannot always understand the clinical components that do need to be critically considered for a successful transition, placement, and best long term fit. In addition, relocation specialists are directly compensated by care communities for placements, while care mangers are not and are therefore able to ensure based on experience and without any bias the best and most appropriate fit.
Here are some simple guidelines to ease the process and prepare properly:
1. Show yourself compassion!
It is normal to have some guilt and sadness over this change. Give yourself time to grieve and express these emotions. Sometimes having some counseling sessions or attending a support group can be best in this regard. Dementia is a tough journey and often best travelled with support and guidance.
2. Trust you instincts!
Do your homework and seek guidance and information before making a change, but do not second guess yourself! Remember that you know your loved one best and that you are making the best choices possible for them!
3. Set a realistic timeline and schedule
Never feel rushed or pressured into a decision! Take your time, assess all options with guidance, and then move forward with confidence. If an urgent move needs to be done due to safety concerns, seek out the support of an RN care manager to help you look at all the options efficiently and effectively, but in an expedited manner since you need to be able to make an informed choice and feel good about the outcome at all times.
4. Less is often More!
Do not think out of guilt that your loved one needs to have a 2 bedroom apartment to be happy as less is often more with dementia! A smaller space will cue them, limit frustration, anxiety, and be easier to naviaged. Remember their needs are now going to be different than in the past take your cues from them.
5. Create a familiar, frustration free environment!
Request the floor plan in preparation for relocation and ensure that you plan for clear walking patterns and no overcrowding in terms of furniture layout. Again, a care manager can assist with this and in coordinating a moving company, establishing a transition plan, transportation, arranging for charity donations, and customized, turn key apartment set up. You want to achieve a familiar, stress-free environment to navigate and to bring them comfort and security. Surround them with familiar items that will tap into long term preserved memory, especially at eye level. Remember safety along the way, avoiding glass items, fresh plants, items with sharp edges, etc.
6. Remember: Planning leads to success!
Try to ensure that your loved one is removed from the moving and packing aspects, as they will generally not be able to comprehend, process, and cope with this process as they would have done so in the past. Enlist help! Have a family member, a friend, or even a private duty caregiver assist with keeping them occupied while preparing for the move and during the transition of possessions and set-up. Have familiar and positive activities planned and extra items on hand for use in case needed by these individuals.
Ideally, transition your loved one mid-morning so that they can be greeted, perhaps enjoy a special lunch shortly after arrival, and then an engaging activity. Coordinating an onsite beauty shop appointment or other a favorite activity in advance to connect can also be helpful.
7. Be realistic about adjustment period and visitation!
Seek guidance and input from an RN care manager and the care community staff on when it is best to visit after relocation. Some individuals need an initial adjustment period prior to family visiting due to repetitive or challenging behaviors. Once stable and fully adjusted, having a routine schedule for visitation is encouraged if this is possible.