A move into an eldercare community can be stressful and sometimes traumatic.
One unique phenomenon I observed while working with families during such moves was the collapse of the process in its final stages. All involved lost weeks, sometimes months, and money, but the original need driving the search — finding a residence for the senior — remained.
I explained the phenomenon to my associate, Dennis Tafoya, Ph.D., who has written several books related to organizational crises. He viewed the matter from a stakeholder’s perspective and concluded there were at least three unique issues influencing the situation.
As a result, we uncovered a new way to look at a dynamic “entry and joining” process.
What follows are strategies outlined for each stakeholder: the family, the prospective resident and the new community. When these strategies are launched, the investment of time, money and energy results in a richer, more fulfilling process.
Strategy No. 1: Managing separation anxiety
Moving into long-term care is a dynamic process marked by transitions and unknowns. Family members are separating themselves from a loved one, the senior is embarking on a new venture, and those working in the community are accepting a new resident with whom they have no history.
Family members may find themselves immersed in a range of separation issues:
- Repeated thoughts/discussions about being separated from loved ones
- Resistance to developing new relationships
- Reluctance to accept or feel comfortable in a new environment
- Unwarranted complaints of physical or emotional stress or pain
- Or, even a general fear of unknowns associated with separation
Strategies are available to manage separation anxieties. In addition to pharmaceutical interventions (managing acute symptoms) and support groups (providing alternative thinking and experiences), there also are more targeted management strategies to ease separation anxiety.
Some family-centered actions to take include:
- Treating the anxiety seriously and react with understanding and patience
- Staying calm and sympathetic, and acknowledging these feelings are normal
- Practicing short-term separations. Schedule occurrences where the individual and family spend time apart
- Providing reassurance of regular communication
Separation anxiety is a potential issue for anyone in a family’s social network. It is a stress point that contributes to the delay or termination of decisions at important points in a process. Mismanagement of this transition can create financial or emotional burdens for the family, while putting the client’s health and well-being at risk.
Strategy No. 2: The prospective resident embracing their “attachment profile”
“Attachment” is central to the prospective resident’s personal ownership of this change process. How people attach to others or the matters that define their lives is related to a variety of issues, including:
- How people perceive and deal with others, including their desire to do so
- The ability to communicate emotions, needs and interest in listening to others
- The capacity to deal with social processes (e.g., conflict, collaboration)
- Preconceived notions and expectations about others
These and other traits contribute to define a person’s “attachment profile” — their capacity to actively manage portions of their life. Awareness on the family’s behalf is one path toward attachment management but, so is self-awareness on the part of the prospective resident.
Making a move to an eldercare community is not always an easy transition, yet success is achievable by managing some of these attachment traits:
- Ensure answers to the senior’s questions are based on facts. People with professional experience in industry speak from fact-filled positions. Seek them out.
- Have a clear understanding of the senior’s needs, wants and desires. This is not a time to guess or to have a false sense of reality.
- Be open to change. A move is just one of many life experiences – touting numerous benefits to one’s lifestyle and healthcare. Openness to change increases the likelihood one can realize the most benefits from this experience.
- Establish a concrete conviction. This is a conviction to act and a basis for action; a manner to demonstrate personal choices and decisions.
When a person has an intention to act, their attachment profile contributes a bias toward knowledge acquisition, an understanding of personal desires and openness to change. Grounding the “attachment profile” in realistic information increases the likelihood that decisions regarding the transition to a new lifestyle will be rich and rewarding.
Strategy No. 3: The community as interventionists
When distress marks the capacity of the individual to accept and move to a long-term care community, one competency the community staff could add to their “reception process” is wrapped in their capacity to build flexible interventions, shaped to meet the profiles of the senior and their family. Here are strategies that could be incorporated:
- The down-to-earth intervention
This approach includes one to two family members and the senior in a discussion regarding the move; issues, needs, concerns, etc. Someone from the community staff is present, but as a facilitator.
- Classical intervention
This method includes family decision makers and a community onboarding team. The goal is to develop information, isolate concerns and address incomplete or missing information.
- A family-focused intervention
This model assumes the distress regarding the prospective move into a community is linked to the family, e.g. good and bad habits or communication patterns. This intervention addresses the family’s informational, social and emotional needs or concerns.
Interventions can work to the benefit of all involved because they disrupt passivity and avoidance routines with an interjection of proactive, hands on, practical approaches to problem-solving and decision-making.
Viewing a move into long-term care as solely dependent on a key individual does not reflect the dynamic nature of this life-changing event. All stakeholders involved have roles to negotiate and things to learn. Our role as practitioners is to facilitate this process however we can within the limits of our professions.
Lindsey Poeth has 20 years’ experience in the healthcare, consumer goods and electronics industries, with a major focus on pharmaceutical market research. She is a certified senior advisor with Oasis Senior Advisors in Pennsylvania.
