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Episode 12: Moving from Home to a Care Facility – Next Steps

Caregivers Out Loud

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Once the decision has been made that placement in a care community is necessary, caregivers are often faced with the “what next” question. Because there are different levels of care and each community has a different ‘personality’, it’s very important to be as prepared as possible for the transition. 

In this episode, we chat with Kathy Ajas, who for the last 17-years has worked in the retirement industry, including independent living, assisted living, and short and long-term care. Together, we explore questions caregivers have when considering moving to a new level of care with their care recipient.

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Quotes

“Don’t feel guilty. Never feel guilty about reaching out. It’s truly a strength when you reach out for support.”

“A health event can happen very quickly and sometimes changes need to be made very quickly. Whether, you know, a person is living at home or they’re living within a community. So to always be aware of next steps and to have those conversations when, you know, what are the next steps?”

“Look after yourself. Make sure that you have some time, some rest and you have some care in place. And in order to get that care in place and that time for yourself to remain healthy and to be supportive of your loved one, the recipient of your care, reach out to Family Caregivers of BC.”

Resources

Online Tools and Apps

Route 65 was developed by EngAge BC, a non-profit operating arm of the BC Care Providers Association (BCCPA), in response to a visible gap in quality information about seniors’ living and wellness options in the province. On Route 65, seekers can find more information on independent living, assisted living, long-term care and home health care options. Route 65 also helps users navigate the seniors living and wellness continuum through their Glossary, Frequently Asked Questions and Resource pages, along with Walter, their 24-7 virtual concierge chatbot, who helps triage seekers to the most appropriate options. Contact 1-877-955-6565.

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Transcript

Bill Voice-Over

Once the decision has been made that placement in a care community is necessary, caregivers are often faced with the “what next” question. Because there are different levels of care and each community has a different ‘personality’, it’s very important to be as prepared as possible for this transition. 

Today we talk with Kathy Ajas, who for the last 17-years has worked in the retirement industry, including independent living, assisted living, and short and long-term care. Together, we explore questions caregivers have when considering moving to a new level of care with their care recipient. 

Before we dive in, let’s let Kathy explain some of the language that we’re using. As an example, we may use the term facility because this is the most common phrase you’ll hear when researching care. However, we will also be using the term community, creating a sense that in these different places, they are more than a facility – they are a home where a new community is built.

So Kathy, please help us understand the different levels of service and support that are available when moving from home to a facility. 

Kathy

[00:01:22] A person moving into independent living would be able to make decisions for themselves on their care.  They would be cognitively well enough to manage within a community.  They would be mobile enough to enjoy the activities in the community. 

Bill

[00:01:40] And take care of themselves.

Kathy

[00:01:42] Take care of themselves. Make decisions on their own behalf. 

Bill

[00:01:45] And then the next level with that would be assisted living, I guess.

Kathy

[00:01:50] That’s right, Bill. Next level is assisted living. Pretty much the same criteria in assisted living communities. A new resident would still be required to be able to self-direct their care. However, they could get some home supports typically provided by their community of choice. 

Bill

[00:02:09] Okay. Yeah. And then the long-term care as people’s needs increase.

Kathy

[00:02:15] That’s right, yeah. When a person requires long-term care, typically they would require to have medical support, home support overnight, nursing staff, 24-7. 

Bill

[00:02:26] For our listeners to the podcast, usually are mostly caregivers, this becomes useful information to them as they begin thinking about what next is for my responsibility here with my care recipient. Can you say a word, for example, about the assisted living and the long term care living? What expectations a caregiver might be looking to fulfill for placement?

Kathy

[00:02:53] So if the loved one, a family member is living at home and they’re managing okay with a little bit of home support, they haven’t had extensive falls and their cognition is okay to direct their own self care. However, if there are cognition issues at home where it’s becoming truly unsafe for the family member to be there alone and there have been multiple complex healthcare issues, then definitely long-term care is definitely more suitable. 

Bill

[00:03:25] One of the first needs they have is some of this very basic information that you’re providing. The other aspect of this now is for the caregiver themselves as they begin thinking about the future for their care recipient. But can you say a little bit Kathy, about what needs to be happening in the mind of a caregiver as they start thinking forward? Their care recipient may not meet any specific category yet, but say a little bit about what the caregiver needs to be thinking about and preparing for.

Kathy

[00:04:03] And you know, just a bit of advice to the caregivers, Bill, is not to wait too long.  It’s really important for us to be doing our homework, to be doing the research, finding out some answers. There is multiple organizations as small as family caregivers out there that can provide some information. So to reach out, whether it’s to the health authority in your region or whoever can provide those resources to you. 

[00:04:30] As soon as you start seeing that your family member or your loved one is requiring some care, to reach out to family caregivers, to reach out to your health authority, find out the process, find out if you’re needing some supports.

Bill Voice Over


[00:04:47] The decision to place your care recipient into the care of a facility can provoke stress and is often surrounded by conflicting values. To help with this transition, Family Caregivers of BC has an exceptional caregiver support team that can provide coaching, information and support as you explore the ‘what next’ question. Get the help you need, by calling our BC Caregiver Support line at 1-877-520-3267. Also, be sure to see the written resources and guides in this episode’s show notes. 

Bill

[00:05:28] So let’s stay for a moment with a caregiver, because so many of us who have been in caregiving roles, put this off for a variety of reasons. One is we don’t want to admit that things are deteriorating. And of course the second is that don’t want to admit that we can’t handle it. That the suddenly the pressure is rising significantly, as well as the emotional, the fear, the anxiety, and so on. Say some words about what you recommend to the caregiver at this point in time, in terms of anticipating what may be coming up for their care recipient.

Kathy

[00:06:08] It’s a very emotional time for caregivers. Bill, I think particularly during COVID. Your loved one may not be able to have the socialization, nor may you be able to have the socialization that you were used to. So not only is there, you know, there’s some, maybe some medical needs, some urgent needs happening, but there’s also that isolation for many people. So don’t feel guilty. Never feel guilty about reaching out. It’s truly a strength when you reach out for support. 

Bill

[00:06:40] Absolutely. So it’s two levels here, we’re talking about. One is seeking information for sure. But the other is just a matter of self-care to admit, I’m going to need some help here. I need to get on the phone, all kinds of issues can arise.

Kathy

[00:06:56] Some people that I know of have not left their apartments for months because they’re afraid to go out. So it does have a huge impact on people. 

Bill

[00:07:07] Yeah, physically, emotionally, spiritually. Sometimes they start getting aggravated with the system. You know, the system is strained also. And so it just adds to the caregivers’ burden.

Kathy

[00:07:20] Absolutely. 

Bill

[00:07:21] And then they find themselves being angry and then they stop calling. 

Kathy

[00:07:24] That’s right because they’re not getting the answers that they want to have. They’re going in circles. You know, it’s not the system, as you say, that’s failing, it’s because of overload, you know, and everybody could be on overload right now. So, being patient.

Bill Voice-Over

[00:07:41] A caregiver may need to accept that they can no longer meet the needs of the care recipient or that the situation is beyond their control. This may prompt feelings of guilt, anger, and sadness. This has been even more evident during the COVID-19 pandemic. In our Family Caregivers of BC COVID-19 provincial survey, over 40 percent of caregivers are providing more care, due to COVID-19, with half providing up to an additional 10 hours per week. 

[00:08:16]  Today, a year or two after the start of the pandemic, things are looking better, but in order to support both the care recipient and the caregiver’s wellbeing, we need to be aware of different care options. It is important to note, that there are publicly funded services and also privately funded services. For more information on residential living options, supports and costs in different health authorities within BC, please see the resources in our show notes. 

Bill

[00:08:53] In the process of making the next step in the short term, can you say a word about the cluster care and adding services to where my care recipient is now?

Kathy

[00:09:03] If a resident who is living in independent living there typically isn’t care included in that. The hospitality services in this feed. However, if there is a need for a family member, a new resident to have some services such as maybe a shower assist or maybe some companionship, family members or the resident can add those in that’s privately contracted with a care company. 

Bill

[00:09:31] Some people go, of course, get all concerned about that. Cost. You know, it’s a high priority for a lot of families, don’t have a lot of money. There again becomes important to do some investigating, right?

Kathy

[00:09:42] Absolutely because they may well qualify for a subsidy for the care to their, you know, based on their net income through their local health authorities. So to make those queries, make the calls and find out what’s available to you. 

Bill

[00:09:57] And it may not in fact, at the moment, be overwhelming or all that daunting, but you need to watch for the signs of when it might become. Can you give us some clues about that sort of, things to watch for?

Kathy

[00:10:10] Yeah. Sometimes Bill, things can happen really quickly. Cognition, usually, there’s a process and you can see what is happening. Things like a stroke. You know, if diabetes becomes worse, those types a things it’s so, a health event can happen very quickly and sometimes changes need to be made very quickly. Whether, you know, a person is living at home or they’re living within a community in congregate living. So to always be aware of next steps and to have those conversations when, you know, what are the next steps? What if this happens? 

Bill

[00:10:50] So the reaching out isn’t just about getting the information, although it’s needful. It’s about acknowledging I need to be in a conversation with somebody about this. I need to get some guidance even about what to think about, so that becomes an important step here.  And it becomes a matter then of that first acknowledgement that I, this is probably beyond me. I can’t even think straight because I don’t know about the cost. I don’t know about what’s available. I need to be reaching out. So what last thoughts here, Kathy, would you offer to our podcast listeners who are listening in, wondering with my care recipient, that would help me prepare for whatever might come up?

Kathy

[00:11:39] Well, number one, look after yourself. Make sure that you have some time, some rest and you have some care in place and in order to get that care in place and that time for yourself to remain healthy and to be supportive of your loved one the recipient of your care, reach out to Family Caregivers of BC. They have great resources. Reach out to your local health authority. They as well, we’ll be able to provide some information to you. And there are many non-profit organizations as well that can provide some information.