Entering an aged care home

Moving into aged care — emotions

For many people, the unfortunate reality of moving into an aged care facility is that they've already faced many challenges and upheavals beforehand. Usually, a significant decline has occurred in their physical or cognitive health, and living independently has become a struggle — perhaps family or a partner can no longer adequately support them, or they've come directly from hospital to aged care following a bad fall or accident, reinforcing their inability to remain independent at home.

When an older person or friend needs to move to an aged care home, there may be considerable emotional upheaval. It's helpful for the carer to be aware of both the positive and negative aspects of such a move.

Positive issues. There can be many upsides. In a quality home, staff are caring and compassionate to new faces and their families, offering support and reassurance that loved ones will be in good hands. Residents come to rest and relax, with no more hard work — their working days are done, and they can rest easy in the assurance of 24-hour care from trained staff. Entry to an aged care home can lift a heavy burden because:

• The difficulty of maintaining a tidy home, and depending on others for shopping and chores, is gone;
• There's no obligation to feel bad about charity, since they now pay for services;
• Lonely hours of boredom are gone, replaced by company;
• The routine of home is now varied;
• If previously living with a relative, instructions about the relative's absence ("use the hot water in the thermos, don't boil the jug") are no longer necessary;
• They no longer risk forgetting medicine and suffering for it, as they might have living alone; and
• They no longer need to worry about dying in their sleep unnoticed, since the aged care home takes care of them.

Negative issues. The first weeks after moving in can be quite overwhelming and exhausting — every element of life is discussed and documented so they're well supported: nutrition requirements, medication, mobility assessment, life story, emotional well-being, and religious practices are all scrutinised, in the nicest possible way, of course. Not everything runs smoothly when the resident's wishes differ from their family's choices, and expectations don't always match reality. Entry to an aged care home may lead to loss because:

• The move means abandoning home, its independence and memories, and perhaps a pet;
• There may be anger at being unable to look after themselves as they once did;
• There may be despondency, seeing the aged care home as the last place before the grave, and fear of dementia or disability;
• Social contacts may not be the same as the family and friends they used to have;
• Some fears can be justified — not all homes give absolute individual attention, and staff may sometimes talk down to residents ("Have we taken our medicine today?");
• Personal privacy once taken for granted at home may be lacking, with staff or visitors not always knocking, or private conversations overheard by other residents; and
• The food may not be "as I used to cook it."

But, ultimately… daily routine can help residents feel more in control of everything, make room for what's important, aid mental health, help them cope with change, form healthy habits, and reduce stress levels.