Most of us dread the thought of permanently moving a loved one into a skilled nursing facility, and this sentiment doesn’t change for those who are fortunate enough to have a selection of stellar facilities to choose from. As caregivers, even though we are fully aware of our individual limitations, it means giving up a certain amount of direct oversight and control. We also know deep down that this move is an admission that our loved one has passed a certain point in their health where returning home or resuming even a few aspects of self-care is no longer a possibility. This transition is a direct dose of reality for everyone involved.
As with all changes in life, knowing what to expect ahead of time can be both emotionally and logistically beneficial. Amy Laughlin, BA, AP-BC, ADC, an Activity Professional and Senior Living Educator based in Rock Hill, South Carolina, has put together a comprehensive nursing home moving guide for seniors and their caregivers. Laughlin’s list explains residents’ rights, important questions to ask the facility prior to move-in, and tips for anticipating and preparing for a loved one’s needs.
Federal regulations, which are overseen by the Centers for Medicare and Medicaid Services (CMS), require that skilled nursing facilities (SNFs) provide the following to all residents:
- A room with a window to the outside for natural light and orientation to the time of day, weather and season;
- A bed of appropriate size and height;
- A clean, comfortable mattress;
- Bedding, which is appropriate to the weather/climate; and
- Furniture appropriate to the resident’s needs, including a separate closet or clothing storage spaces.
These regulations also require SNFs to provide a “safe, clean, comfortable and homelike environment.” In other words, the goal is for these facilities to be less institutional and more homey, so residents can bring items and personal effects with them to help create a meaningful and personalized living space.
Before Moving In
Be sure to visit the room your loved one will move into (or one very similar to it) to get a feel for the amount of floor and storage space there is. There must be enough room to maneuver a wheelchair or other mobility aid and for caregivers to safely transfer and care for your loved one. Check to see if the facility will remove and store the provided nightstand, chest or chair so that personal pieces of furniture can be brought in. If this is an option, make sure that none of these item encroach on a roommate’s space or limit mobility within the room. Asking for a floorplan and measurements (or taking your own) will help ensure your loved one’s belongings fit without crowding the room.
Ask questions about items and services the facility provides that are included in the monthly fee. The following are common questions that can reveal a great deal about what supplies may need to be purchased or left at home. It can also expose services and items that come at an additional cost.
- Are bedding and towels provided?
- Is the laundering of linen included?
- Does my loved one’s room have cable, and is it included in the monthly cost?
- What about local and long-distance telephone service?
- Is there public and/or secure wifi access available?
- Can personal laundry services be added for an additional fee?
- Is a corkboard or whiteboard provided for posting calendars, reminders and pictures?
- Do they provide a wall clock, TV or any personal care products?
- Can you bring a small refrigerator?
Every SNF is different. No family member wants to receive an expensive surprise when they get the first bill and discover that all the services they thought were included were optional extras.
What to Pack
Aside from making the decision to move your loved one into a SNF, helping them pick and choose what to pack and what to purge is one of the most difficult parts of this transition. Caregivers often help their family members sort through homes, garages and storage units full of belongings, furniture and family heirlooms. Most seniors have been collecting personal items for decades, and it can be difficult for them to simultaneously “lose” their home and most of their possessions.
Many caregivers enable their loved ones to hold onto some family heirlooms, seasonal clothing and décor, valuables, and other important belongings by storing them at their own home, dispersing them among trusted family members or renting a storage unit. This helps elders feel they still have access to their possessions or at least that these things have been passed on to individuals who will cherish and respect them.
Regardless of the approach you and your loved one decide to use, there are some important considerations and limitations that apply to each category of a nursing home packing list.
Clothing and Accessories
When deciding what kinds of clothing to bring to a SNF and how much, there are several practical matters that should influence your loved one’s packing list. Keep these things in mind:
- Clothing must be easy to get on and off and able to withstand lots of washing and drying.
- While the temperature inside the facility is regulated to a level that would be perfectly comfortable for most active adults, the majority of SNF residents tend to be cold-natured. For this reason, versatile layers are best. Make sure your loved one has warm and comfortable sweatshirts, vests or jackets that can be worn with every outfit, as well as cozy socks that can be worn in bed and non-skid shoes.
- The number of outfits they should bring depends on who will be doing their laundry and how often. A good rule of thumb is to bring at least a week’s worth of clothing—probably more just to provide for additional changes that may be needed. If possible, it is helpful if whoever does the laundry returns their clothes to their closet clipped or hung together as outfits, so they are ready to wear. This is easier for many seniors than having to match separate tops and bottoms, especially if cognitive impairment is a factor.
- Accessories are part of a person’s individual style and should be encouraged! Nothing too valuable or with sharp points or edges should be brought with, but if Mom has always worn bright scarves or glittery beads, make sure she has some she can wear every day. If Dad always enjoyed wearing hats, make sure a few of his favorites come with him.
- Women often want their purse close by, and men don’t feel quite right without a wallet in their pocket. Let them bring their wallet or a favorite purse if they feel uncomfortable without it. Even if outings are rare for them, it will help them retain a sense of control and independence in a world that is completely new, strange and scary. You could even put a few dollar bills or some change in it. Just make sure to take out all insurance cards, bank cards and credit cards first.
Personal Care Products
Most of us have our favorite soap, shampoo, lotion and toothpaste that we have used for years. This is no different for a senior who is moving into a nursing home. Even something as simple as providing their favorite brands and products can help them feel that their routine hasn’t been completely turned upside-down. Some of these personal care items may be available from the facility, but be aware that they may cost extra.
- Families generally provide these items, and facility staff should let you know when your loved one is running low. It can be helpful to keep a small stash of back-up products in a box or basket in their closet or bathroom to avoid running out at the last minute.
- Be sure to pick their favorite fragrances or well-loved brands. Although your loved one might be washed and bathed by someone else, using their products, especially familiar scents, can make the experience much more comfortable.
Linens and Bedclothes
- Basic linen, such as bedding and towels, is provided and laundered by the facility.
- Most individuals also love to have soft, warm blankets or quilts on their beds to add comfort, color and style. Consider packing one of their favorites from their home.
- A smaller lap blanket or throw is also nice to tuck around their legs or shoulders when they are sitting in an armchair or wheelchair. Make sure these items are machine washable and able to take a fair amount of laundering. A handmade crocheted blanket will not hold up to frequent washing and drying in the facility’s industrial machines.
Electrical Items & Technology
- In rooms without televisions, family members usually provide a small TV and sometimes a DVD player for their loved one. Clearly label both items, as well as the remotes, and don’t forget to pack spare batteries.
- If your loved one will have a roommate, consider purchasing wireless headphones so that they can watch TV at any volume and any time without disturbing anyone.
- Ask the facility if they allow extension cords. Some facilities completely prohibit them, since they can pose a trip and fall risk, but others allow them at limited times of the year (such as one for plugging in a Christmas tree).
- Many SNF residents love using their smart phones, tablets and laptops. If wifi is available at the facility, make sure you know of any passwords and fees associated with it, as well as if the bandwidth is sufficient to stream videos. If the wifi is not secure, make sure your loved one does not log into online banking websites or any other sites where their personal information could be vulnerable to hackers and scam artists. Depending on their capabilities, using parental controls to limit certain functionalities on the device may be advisable.
- All electronic devices should be clearly labeled with the resident’s name and, if possible, contain a GPS locator in case they ever go missing. Keeping a list of all items and their serial numbers is an excellent idea. Don’t forget to pack chargers and connecting cords.
- Plan to decorate their room for holidays and events. A small seasonal wreath for their door, holiday cards, and wall décor are great ways to remind your loved one of the holiday without taking up precious space on their nightstand or dresser. Window clings are an inexpensive and reusable decorative item that can be easily applied to and removed from a window or mirror. You may have to store seasonal items that aren’t currently in use if there is not enough storage space in their room.
- A favorite everyday door decoration is also a good cue for your loved one that they have returned to “their” room after a meal or activity. Many doors in the SNF look the same, but a personal touch will help theirs stand out.
- Fresh flowers brighten up windowsills and dressers. Just be sure to pick low-maintenance varieties that will not create any mess or artificial versions. If your loved one is assigned to a room with a less than ideal view from their window, this small touch can make a big difference. You and your loved one can create fresh or silk arrangements together as an activity.
- Your loved one should be able to look around their room and say, “These are a few of my favorite things.” It’s crucial to bring items that hold personal significance, promote happy reminiscence and stimulate the senses in some way.
- Family pictures are important and can be posted on a bulletin board, stored in a scrapbook or photo album, uploaded to a digital picture frame, or displayed as a collage on the wall. It can also be helpful to stick a small label under each photo or on the back to explain the name and relationship to your loved one of those pictured. This enables them to share their photographs without having the pressure of remembering names, faces and relations all at once.
- Another sentimental item to bring could be their favorite artwork or posters. Keep in mind that wall space in SNF rooms is limited, and the facility may have rules about what hardware is allowed for hanging frames and other wall decor. If nails are not allowed, poster tack or command strips may be helpful alternatives. Posters can be placed in inexpensive poster frames to make them look more polished, and the artwork can be changed out periodically at little expense. Numerous vendors sell affordable prints of famous works of art, nature scenes, military memorabilia, old movie posters and much more. The options are endless!
- A CD player and CDs or a MP3 player loaded with favorite music can also be a small but meaningful addition to a loved one’s room. Just as with the television, headphones of some kind are probably a wise investment for considerate listening.
- Other types of treasured items might include favorite snacks or treats (as appropriate to their current dietary needs), scented lotions, a stuffed animal or doll, sports memorabilia or team colors, a couple of favorite books, or small items from a personal collection.
- It is important to note that most facilities prohibit breakable items like china and glass, electric blankets, scented plug-ins, and, of course, any sort of open flame (candles), and weapons.
Days at the SNF can be long, especially at the beginning when your loved one is trying to remember new people and adapt to new routines while they struggle with their own loss of independence. The facility should offer a diverse and interesting activities program, but your loved one will still be able to pursue their personal interests and hobbies. One of the biggest parts of their packing list is ensuring they have the items they need to remain engaged and entertained.
- Newspaper and magazine subscriptions can easily be changed, and publications can be delivered directly to the facility.
- Many facilities have libraries of books, or the local public library might make direct deliveries. If your loved one is a reader, make sure they always have a couple of page-turners on their nightstand. If they are no longer able to read, even a book of inspirational stories or favorite poems can be useful for visitors to read aloud with them. You might also consider setting them up with an audio book on CD or downloaded to an MP3 player.
- If your loved one is religious, make sure they have their religious texts of choice, plus any associated items or prayer aids, such as a rosary, shawl, crucifix, etc.
- Provide a labeled tote or bin of supplies for their favorite art or craft, like knitting, crocheting or painting. Adult coloring has become incredibly popular with the senior population lately. They may enjoy one of these books and a set of colored pencils.
- For puzzle masters, large-print books of word-finds, crossword puzzles and Sudoku and jigsaw puzzles are a must. Decks of cards and smaller board games can also help pass the time or provide a structured activity for when younger family members come to visit.
- If your loved one enjoys writing and receiving letters, make sure to provide them with the materials they need. A couple of pens/pencils, a notepad or some stationary, an address book, return address labels and stamps are all musts. Even if they do not send or receive mail often, it’s good to keep a few writing instruments and some paper on hand just in case.
- An attractive wall calendar that is clearly marked with family members’ birthdays, holidays, visits and important events is a useful addition to a senior’s room. Even if they have difficulty keeping track of time, the staff and their visitors might be able to reference it and remind them of upcoming events and activities.
- A visitors’ book where people can sign in and say what they did together might be a nice way to remember visits and family time. An example of an entry could be: Saturday, April 16: Jennifer & Brad visited with you and took you outside to see the spring blooms and listen to the birds. You all drank lemonade on the porch and talked about gardening.
- All items must be clearly marked with your loved one’s name. Clothing and other items can easily be mixed up in the laundry. If the facility caters to residents with dementia or memory issues, belongings can be accidentally or intentionally stolen and end up in the wrong rooms. Use permanent marker on clothing and fabrics, and either purchase or make labels with your loved one’s name and room number so that all other items can be quickly and easily labeled. You can also iron or sew on decorative patches to identify clothing without them appearing like labels. Don’t forget to tag items like glasses, hearing aids, denture cases, personal care items, durable medical equipment like walkers and furniture.
- Remember that many people will be coming and going in and out of your loved one’s room daily. This includes caregivers, nurses, housekeeping staff, activities staff, visitors, volunteers and family members. At some point, items will go missing. Hopefully they have just been misplaced and will be returned, but, for this reason, do not bring anything of value.
- Some nursing homes take inventory of a new resident’s belongings upon move in. Ask if this is something that your loved one’s facility does, and if it isn’t, then consider creating your own inventory form to keep track of their things and better determine if something has been lost or stolen. Ask for the Admissions Coordinator or Director of Nursing to sign this inventory on move-in day. If an item disappears, you are much more likely to have the facility replace it if you have a documented move-in list.
Keep in mind that this is not an all-inclusive list. Bring the basics and see how your loved one fares for the first couple of weeks. Maybe they will need more clothes or an extra lamp on their nightstand so they can read better. Perhaps you will realize that they are no longer interested in a particular activity, so you can take those supplies away to free up valuable space.
This is a challenging time for both you and your loved one, and a room in a SNF is never going to be comparable to their long-time home. Treat this move as an opportunity to create a new home for them: a comfortable, safe environment filled with happy memories and fun activities. This is a place where your loved one can thrive and receive the higher level of care they need.