Making the decision to move a spouse or aging parent into long term care is one of the most difficult decisions families have to make.
Before we get into the nitty-gritty, it’s helpful to clarify what is meant by “long term care”.
Trust us, there are so many different ways to describe this form of housing, it can cause dizziness!
Technically, the current terminology is complex care; however, other more common terms used are long term care, residential care, and nursing home. What it really means – a facility that provides 24-hour skilled nursing care and supervision for people who are no longer able to care for themselves. Staff members administer medications and assist residents with daily activities such as eating, bathing and dressing. Only 1-2% of Canadians live in complex care facilities with an average age being 86 years old.
Eligibility for a government subsidized complex care facility is evaluated and determined by a case manager from a local health authority. Factors considered include the person’s health status, the family caregiver’s ability to provide the necessary care and support in the home and if the community resources currently being used are appropriate, safe and sustainable. Those assessed as having the greatest and urgent needs are given priority for admission to the first available and appropriate bed. Cost is a daily rate based on 80% of a person’s income. There are also private facilities where no subsidies are available.
During and After the Transition
Once a decision is made that the person needing care is considered 24 hour care, it can feel like having to “wait it out”. Some families feel this part of the transition is very difficult with the uncertainty of when a bed will be available and feeling they need to be prepared for a move at any time. Some families and the person being cared for experience increased anxiety and stress during this period.
Moving into a long-term care facility can feel like a rollercoaster ride for both the caregiver and the person being cared for. It is full of twists and turns, ups and downs and they usually happen very quickly. We know the drop is coming but the anticipation is often the worst! Even when the ride is over, our legs still feel a little wobbly.
One of those steps is getting to know the different facility options, regardless of whether a person is paying privately or accessing a publicly funded bed. Although there isn’t a guarantee that a family member can move into their “preferred” facility through the public health care system, there is still the option to get to know each available facility and to list a first preference. If and where possible, those preferences are honoured.
Determining which facilities best meet the needs of the person requiring care is part of the decision-making process with the case manager. Visiting different facilities is very helpful in figuring out best fit and order of preference. Ask your case manager how to arrange tours with publicly funded facilities and make an appointment for a tour ahead of time with the staff at the facility.
Doing some research includes making a list of needs and wants for care and comfort of the person moving, considering location of the facility and accessibility to the community and by family and friends, additional costs not included in the daily rate, etc.
A great checklist can be found on page 7 of the Ministry of Health of BC’s publication, “Planning for Your Care Needs: Help in Selecting a Residential Care Facility”
Consider starting your own personalized care plan which includes key biographical information and pictures showing life milestones with significant meaning, what a current normal daily schedule looks like, personal care preferences and a list of hobbies and other areas of interest. This really helps seniors and families to identify important things to focus on during the transition and will be a huge help to staff and family during and after the move.
Grab a journal and/or binder to keep track of key information and documents. You can also start by making a list of what bills/mail needs to be redirected and who is going to tackle this. It’s always helpful to connect with someone who has “been there, done that!”
Building a circle of support people is really important. Choose a team of people to support you, emotionally and physically as well as supports who have very practical skills including having cared for someone in complex care, legal and financial experience, excellent listener, etc.
If you are a joiner, think about a Caregiver’s Support group. There are several groups as well as some for specific diseases such as stroke, Parkinson’s and dementia. You can start by clicking here for a list of support groups on our website.
We know it is easier said than done; however, caring for yourself as a caregiver is one of the most important things you can do for yourself and your family member. Your role as a caregiver doesn’t end when the person you are caring for moves into complex care.
- Caregiving After Facility Placement – How might your role change if the person you have been looking after at home moves into a residential care facility? Those who have gone through this experience tell us that caregiving does not end after placement – it just changes.
- Facility Placement – Coping with the Move – very practical advice and strategies on transitioning a care recipient to residential care.
- Making Visits Count
- Managing the Transition to Facility Placement
- Needs Based Access to Facility Care: A Review
- Things to Do While Visiting Your Older Adult
- Considerations for a Move to Residential Care
Listen to the webinar here.
Download the Handout: Your Caregiver Journey print version here