How best to transition the aging parent into the nursing home?

As the others wrote, each patient and each family is different. But I personally believe a few weeks without visiting is best (tho it is very hard on everyone!). If we are there daily for hours on end, the patient will never adjust to the Staff and the Staff will not get a chance to know the patient as a person. In our situation, I went daily for the entire visiting hours period for 2 straight months. Other than meal time, I was by my dad's die every day, laying out his clothes, assisted bathing, entertainment, outings, everything. He was not able to make a smooth transition into the nursing home scenario and I was the culprit. This made it very difficult for the Staff since my father would refuse to let them do anything for him, but would bellow my name non-stop to come do whatever for him. I thought I was helping but what I was doing was hindering the Staff from being able to care for him properly. After a 6 month stay at home where I TRIED to care for him but he physically and mentally exhausted me (I ended up in the hospital for 8 days due to heart failure and exhaustion a few days after I re-admitted him to another nursing home ). This time I made myself stay away for 2 weeks to allow him to adjust and for the Staff to learn his personality, his ways. It was VERY hard but something I felt had to be done. It sounds cruel and it sounds unjust, but every ALZ patient is different and I knew this is what had to be done for my dad's personality. It appears as if we are just dumping them off, abandoning them. But we are NOT. We are doing everything in our power to help them, even tho others may think we are monsters and don't realize the pain we endure to do this. Do what you think is best for all of you, play it by ear, but do what YOU feel is right. I've learned to NOT say "we miss you so much, we wish you were home" kind of things. Instead we keep the talk general and light. I hope your family and your family member success.

I think it depends on the person and the relationship. My cousin, in his 80's, took care of his wife with Alzheimers at home as long as he could, and when he had to have her moved to a care facility he went there and fed her lunch every day. At that point she was totally bedridden and so the social aspect was not significant.

Your mother is correct. Dad will not adjust as well if family visits daily. I recommend that the family meet with the social worker for guidance, then set up a visiting schedule that takes "shared responsibility" into account. Even though you live at a distance, there are contributions you can make to your family caregiving scenario. It hinges on open and honest discussion of family values and caregiving needs as well as a willingness to contribute. Good luck.
Barbara M., Author

Its funny, my mother was never a social person either, but she's found her niche in the NH and has become quite a social butterfly. It helps that she has a private room. Could this be looked into for your dad? When my mom wants to be alone, it's a godsend.

I am going through this right now. Rehab wants to release my dad and I have to find somewhere for him to go. I have read everything on this subject and have visited some places but it is not an easy decision at all. I am down to 2 nursing homes and am going to visit again this afternoon. I know what I am trying to avoid is the "why am I here? take me home" from him. This will be the hardest thing for me to hear from him and I and my siblings know it. My brother and sister think it is best for him to go in(brother has MS), and I am not opposed to the idea, just not looking forward to the guilt, anxiety, and his not wanting to accept the idea. I know it cannot be avoided but I am really trying hard to! Support from this site has been very helpful and I thank you.

Everyone adjusts on their own time table. It would be good for him to develop a schedule there however family can call or send cards in between visits. It's not really necessary to visit daily or several times a week. Making the decision for nursing home placement is not an easy one, but one must look at the care needed and safety for your loved one. I imagine it is difficult for your mom and I'm sure she will visit more once he adjusts. Family can attend activities and special events, ask the facility for an activity calendar. If you dad doesn't socialize a lot, he may decide to attend for the special events such as parties or musical events. There is no set rule for visitation and it can be different for different people. You have to do what is right for you and your mom will do the same.

This is a painful decision that has to be made on a personal level. My parents would have felt abandoned if I hadn't visited daily, especially my dad who did have dementia but he didn’t have Alzheimer’s and he remembered people.

I kept it up for years since I had several loved ones in the same nursing home. Yes, I spoiled them, for good or bad.

There are some people that do adjust better when the family visits less. I just don't think a blanket policy is a good idea. However it's done, family members should go often enough to get to know the staff and be a visible part of the routine. Also, as was mentioned, short meaningful visits may be better than long drawn out ones.

People with Alzheimer's may not remember you were there the day before, but they do remember faces and repetition helps. My mother-in-law couldn't have told anyone I was coming or who I was, but she'd sit by the elevator and by her face the staff knew she understood I was there for her. So, again, this is an individual matter. Don't expect that your family will get it down perfectly because there's no such thing. Communicate and each person can do what seems best. Good luck. We're with you.
Carol

Thank you all for your input. It's wonderful to hear ideas from others, as we have never been down this road before. Unfortunately my dad is not a social person, and never has been.
The whole issue is beginning to create dissention in the family. My two sisters have the feeling that they need to be there every day. I don't know if dad thinks he can play on their feelings in hopes of coming back home. With his many problems (falling, incontinence, etc) he cannot be cared for at home any longer. The last two years nearly killed my mom.
I am hopeful that my mom will slowly begin making more trips there. I am also hopeful that my tow sisters will back off a little. I think that may allow my dad to begin getting more acclimated there. Their efforts have definitely resulted in improvements in how he is cared for, but he needs to be given some chance to develop some relationships there at the home.
Thank you all again.

If either parent has dementia it would be better to allow them to adjust before you visit. Lots of changes and with dementia although it may make you feel more attentive, it can prove too confusing and upsetting to them. The admissions staff should have some advice for you, but I would give them a little time. Even if they are not affected by dementia, it probably won't be a welcomed change, at least at first. They need to know they cannot 'work' you into removing them from the nursing home.

Ask the recreation person for a copy of the activities calendar. Peruse it and talk to the activities director about getting your dad involved in facility life. Let the person know what your dad's hobbies and interests are so they can get him involved in things that really of interest to him. Ask the staff to seat your dad with other guys at meals, guys if similar cognitive ability who he could make friends with. (They might be doing this already anyway.) When my mother moved into a NH, my husband and l would hang out with her and the other residents in the common area and facilitate conversation among the whole group. We broke the ice for her and it helped her make friends. And by the way, she's in the dementia unit. Ppl with Alzheimer's and dementia often remember and absorb more than we think. Good luck!

Perhaps your sisters could schedule their visits so someone from your family has eyes on your dad 1-3 times a week. There may be times when more visits are required due to changes in his condition. The family should focus on "quality" visits and not the "quantity" of the visits.

There is no "best" way. Your mom has it right, visit infrequently until he has time to adjust. He will forget when you visit, so don't think he will be waiting for you and remember when you don't visit.

When my Mom entered a NH, my Dad went every single day. I went almost every day. As time went on it became clear that short frequent visits were best. It is very important at the beginning for you to make sure the staff knows you are on top of things by being there and developing a rapport. It is a good idea to go at different times to meet all staff on different shifts. It must be incredibly overwhelming for our parents to be in a new situation when they are frail and scared. Bringing some familiarity to them is comforting and important. Best wishes.