Transitioning into long term care

Transitioning into long term care

Welcome to part 3 of our transitions series from Central Otago Community Educator, Donna Watt. This edition explores the tough decision to transition our loved one into long term care and using safety as the indicator that the time has come to look at transitioning to a long term care placement for the person with dementia.

What does this transition look like for the carer?

This transition is possibly one of the toughest you and your loved one will face. You may have made promises in the past that you are beginning to suspect you cannot keep, and that is a very hard thing for both you and your loved one to cope with.

We find that putting safety considerations at the forefront of your decision can be a very useful way for caring partners to evaluate whether or not they are reaching the end of their capacity to care for their loved one at home. One question you might ask yourself is, “Am I still comfortable with the level of risk for my loved one?” You might consider if you are still comfortable leaving your loved one alone in the home. If the risk of falls is increasing, or your loved one is at significant risk of harm in spite of all of the cares in place, that may be an indicator that something needs to change.

Other factors can be changes in your loved one’s personality or behaviour that mean your relationship is being affected, or your capacity to care is limited by aggressive behaviour or other behavioural changes.

You also need to monitor your own well being. Are people beginning to ask if you are stressed, not coping or unwell? Sometimes family and friends note the warning signs before you do, so it’s important to take note of their concerns.

This is a very emotional time, and carers commonly feel a range of emotions from anger to guilt to grief. These feelings are normal.

This is a complex stage, and you are not expected to make these big decisions on your own. We are here for you.


What does this transition look like for the person with dementia?

It is important for you to express your feelings, opinions, and wishes throughout this stage. 

You may need to visit the doctor, who will examine you, and ask you some questions, and who will explain the situation to you. There is also likely to be a needs assessment done, and this will happen in your home (unless you have been hospitalised by a medical event). It is important that you are supported by a caring family member or friend during this time. 

You may be confused, angry, frustrated and very upset about any talk of going into care, and many people struggle to understand why this is necessary. These feelings and thoughts are normal.


How can the team at Alzheimer’s Otago help with this transition? 

We can offer guidance by explaining the process, who is likely to be involved in supporting your decisions, and we can suggest strategies to help you manage this very difficult transition. We can also offer advice on what you need to think about when selecting the care environment which will work best for your situation, and give you tips to help you manage the actual transition day itself.

Remember that you do not make this decision alone - many professional people will support the decision making process with careful and caring assessments. We will be here to offer one-on-one talk time, grief and loss counseling, and there may be support groups or we might connect you to others in a similar situation, to help you manage this stage of the journey.


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