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12th February 2019

Dementia: I’m Not Going in a Home!

As a community Occupational Therapist, the main reason for clients reluctance to see me was their fear that I would be suggesting they needed to go into residential care. I would tactfully (I thought) try to assess daily living activities, only to be met with suspicion and a very definite “I’m not going in a home!”. The media is full of scare stories of poor care in care homes and does nothing to promote the good care that is provided or relieve the anxieties of those contemplating the transition to residential care. Some clients reluctantly agree to appease their family as they don’t want to become a burden, but I rarely meet anyone who embraces the idea of going into residential care. It is the unknown that is frightening for everyone concerned.

If the transfer to a care facility is planned, then getting family and/or friends on board early can help to make the transition a bit smoother for everyone. Arranging a time when their loved one is at their best and the care home is less busy gives you the best chance to get to know them and help them settle in. Relatives can perhaps fill in paperwork beforehand, although the paperwork can also be quite daunting for some and they may value some help with this. Getting family to think about starting a life story book can be quite therapeutic for them and provides a great resource for the care home.  It also helps to prepare the family for the day that they hand over their loved one to your care. They will be experiencing a range of emotions from sadness, fear and guilt to relief and a sense of loss. Make sure families know you are available for queries and that they don’t have to provide all the information in one go, at a time when they are feeling particularly anxious and may forget things. Information gathering and sharing is an ongoing process and part of building a healthy relationship between staff and family and friends.

However, sometimes the move to a care home happens at short notice and there is little time to prepare. You are faced with a frightened, anxious and bewildered person who struggles to communicate their needs. Their family are just as anxious and rather defensive, and you have a mountain of paperwork to fill in.  Suddenly your new resident says he’s had enough of all this palaver and wants to go home. Sound familiar? At times like these the risk assessments and care plans will just have to wait. Your skills and expertise are needed to reassure your new resident before his unsettled behaviour escalates into something more challenging. Time spent having a chat about old times with a cup of tea or a walk in the garden will go a long way to making sure the move to residential care is a positive experience.

Happily, despite our clients initial reluctance and anxiety, a move to full time residential care can be a positive experience. They feel less lonely as they build friendships with other residents and staff and enjoy the increase in social interaction. Their anxieties reduce and in turn families are less stressed and can spend quality time with their loved ones. The Care Home becomes “home” and they are our “family” and with this comes tremendous responsibility but also great rewards.

*All information is correct at the time of publishing. Use of this material is subject to your acceptance of our terms and conditions.

Katie Farrar

Occupational Therapist

Katie qualified as an Occupational Therapist in the year 2000. For most of her professional career she has worked in the field of older people’s mental health services within community mental health teams. As part of this she has had extensive involvement with people with dementia and their carers, both in the community and in care home settings. Katie is currently working with the Dementia Pathway Team supporting people with dementia in the care home setting and particularly with advanced care planning for end of life care. She has also recently completed the Mental Health Act Best Interest Assessor Course at Leeds Beckett University. Katie has developed and delivered training to care homes on dementia awareness, managing delirium and managing challenging behaviour. As well, she has supported carers to offer meaningful activities and experiences and provided guidance to care homes on improving environments to become dementia friendly. Read more

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