No matter what the circumstances, moving to a care home can be an emotional time for both loved ones and their carers. For some, making that move may be as a result of illness or a fall, whereas others may start to need extra support more gradually.
Moving into a care home or nursing home is a huge physical and emotional adjustment. The decision to move into a home is often taken reluctantly. It can be traumatic for the person moving into the home as well as for a partner, close family or friends left behind.
Making plans early and getting the information and advice you need will help make any changes much easier and less stressful.
Having chosen a care home and sorted out the funding, there are things you can do to make sure the experience of moving and settling in is as good as possible. Read our top tips and then use our Practical Guide to making the move.
1. Plan ahead
Planning the move with the person themselves is vital. Even if there are question marks about whether a relative has the mental capacity to make decisions about the move, their views should be sought and included in the process.
Spend some time discussing what home comforts, keepsakes and small items of furniture will go to the new home. Perhaps invest in a tablet or laptop computer and get your relative up to speed on emails, Skype calls, browsing the internet, watching TV or listening to music. Spend some time sorting out things like name tapes and labels too!
2. Be positive
Moving to a care home can be an emotional time for both residents and their families, but there are things you can do to make it all a positive experience.
Emphasise the benefits it may have for the person; give them as much choice as possible and let them feel that they have some control.
Even if your parent is upset with you and not wanting to talk about the move, let them know as much as you can and try to make it their decision as much as possible.Point out different features and help your parent assess which ones might be most important to them. Age UK has a useful checklist on moving to a care home
3. Ask questions
Get the conversation started early about how and when the move will happen.
Ideally you will have accompanied your relative to see the care home and spoken to residents and staff about what it’s like to live there. There may be the chance for them to stay there for a trial period or a respite break. Whether or not they’re mobile, it could make them feel more settled if they know the layout of their new home.
Ask plenty of questions about what it would be like to be a resident there, routines, meals and activities. Ask staff how they help someone settle in.
4. Do some prep
Many homes will invite you to provide a life history book about your relative so they can get to know them. This can take time and if you can, it’s worth starting before the move is imminent. Photo albums are a great way that care staff can start conversations too. Read how to create a life story from Dementia UK
5. See the Care Plan
When someone first moves into a care home, a care plan is written, covering all aspects of their care. This will be in a folder and is left in their room. It is updated several times a day with comments by staff.
It will include things like when a bath is taken, any changes in medication, any falls or other incidents as well as feeding/sleeping/toilet patterns. You should look at it when visiting.
The care plan should be reviewed regularly and you should be encouraged to take part in the review if you ask. Talk to staff about what your relative would like. Perhaps taking meals in their room, or listening to particular types of music.
A little listening goes a long way to soothe fears and anxieties about the move your parent might have. Don’t dismiss concerns as petty or illogical, but show your parent with a touch or a nod that you are rally listening to them.
Listen to everyone else involved, too, like your siblings, partner, and children. Evenif they are not as close to your parent, not wanting to be as involved in the decisions being made, or have opinions you don’t agree with, try not to cut them out of the process.
7. Expect some fallout
It will take time for your loved one to adjust to the new surroundings. Be on alert for signs of depression such as loss of appetite, listlessness, poor hygiene and inability to enjoy simple pleasures. Most facilities have a mental health professional on staff, and you should tell them of any concerns you have.
8. Support for you
Make sure that you get some support from family or friends after you have left your relative in their new home and in the days, weeks and months that follow. Life will change for you if you are no longer caring full time.
Be prepared to feel guilty! Many people say this happens for a while afterwards. Don’t hold onto these feelings, talk to family and friends.
Dad moved in very happily – mostly because he was so lonely at home. I was worried he wouldn’t make any new friends at his age. But within six months I found a different man; taking daily exercise, going on outings, and sitting with the same gentlemen at lunch every day reminiscing about their days in the forces.A daughter writes about her father’s move to a care home…
A Practical Guide to making the move to a care home
The time has come. Your loved one is moving to their new home.
Here’s our practical guide on how to make the transition to residential care a good experience for all concerned.
On the day…
Your loved one may have forgotten the arrangement or be reluctant to move. Try to reduce their anxieties, and think in advance about anything that might cause conflict, so you can avoid it.
Most homes allow and even encourage residents to bring some of their belongings with them – photos, favourite ornaments and pictures, vases, small pieces of furniture. It helps make their new room feel more homely and familiar and provides talking points for carers and visitors.
On admission day, be prepared to stay for some time. Try and have the forms and paperwork filled out beforehand. Ask the home what they expect and what the routine will be.
Take a tour of the home and gardens together. Knowing where everything is, especially their own room, will make things a bit less stressful.
Knowing when to leave on the first day can be hard and emotional. Discuss this with the staff and get their co-operation if it looks like it might be upsetting. Leaving while your relative is distracted with a meal or an activity will sometimes make it easier for everyone.
Immediately after the move
This can be difficult and is different for everyone. Some care homes ask families not to visit for the first week or so to enable the person to settle in. Everyone is different and will cope in different ways, with the move and the fundamental changes that have taken place. Be prepared to bring grandchildren to visit or go out for a meal to provide some fun and distraction for everyone.
Coordinate with friends and family members to create a reliable stream of visits, calls, and correspondence. This will keep your parent from feeling lonely, spare you a lot of guilt, and create an information flow that keeps you up-to-date on how your parent is doing. If you can create a sample schedule before your parent moves, it can assist them feel better about the decision.
Stay in touch
Visit as often as you can – it really helps to get to know the carers and the way the home works. This makes it easier for you to talk to staff about your relative’s care and make suggestions.
Try to vary the times of your visits. This will help you see the different activities across the day/week, to meet different members of staff and to sample the food. Homes rarely impose strict visiting times.
If you live too far away to visit often, encourage your elderly relative’s friends to visit. Make sure you catch up with them regularly to see how things are going.
Call the home and ask to speak to a carer responsible for your relative that day. Ask for updates on their care, health, anything you are concerned about.
Most care homes have a programme of activities which may change each week. There may be an activities coordinator who you can speak to if you have suggestions to make.
If you have the time, inclination and skills, most care homes will be thrilled if you want to get involved in the activities programme (music – making and listening, reminiscing, games, quizzes, knitting, cooking etc).
You may also have contacts in the local community who would like to volunteer in the home. This could be school children coming in to sing to or talk to residents, a Scout group or team from a local company coming to do gardening, sixth formers coming in to help residents use technology. Anything which strengthens links with the local community and the outside world is hugely beneficial to residents of care homes and makes them feel more valued.
Some care homes are happy for you to bring in a dog or other small pet to visit and this can be really popular with the residents, many of whom have had to leave the pets behind when they moved in.
Most care homes have residents’ and relatives’ meetings every month or so. If you are able to make it, it’s a great way to hear about what is going on and to make suggestions.
The more you know about your relative’s life in the care home the better you will understand how their care needs are being met. Not happy with any aspect of their care? Then speak to the manager as soon as possible.
When you don’t feel your concerns are being addressed put them in writing to the manager and owner of the home. If your relative is unhappy and is not being cared for adequately, you should consider finding an alternative home for them.
If your concerns are serious you should write to the CQC or the equivalent care regulator in your country.
Don’t forget that our local hubs are packed with information. Here is more on care options for someone with dementia.
You may find this blog useful 10 things to prepare when a care home is the only option.
The late writer and editor Diana Athill wrote movingly about her own experience of making the move to a care home. It may be helpful.
What is your experience of residential care? Do you have advice for others or would you like to hear what others have done? Join the conversation in Age Space Forum.