Transitioning into residential aged care

Moving into residential aged care can be very challenging and it is important to recognise and acknowledge the multiple changes the resident and their family/ carer are experiencing. Often the resident will have experienced a significant decline in their physical health with associated loss of independence. The move to communal living and a change to every day routines can be very confronting¹. Similarly the loss or dispersal of significant objects and belongings, change in the person’s sense of control and loss of place can result in relocation distress syndrome².

 

However, it has been found that the older person’s resilience influences their ability to employ effective strategies to assist in adjusting to residential aged care³.  Resilience is a psychological construct referring to the capacity to positively adapt despite experiences that are traumatic, stressful or negative⁴. Thus gaining an awareness of the persons past life experiences can be helpful in understanding the resident’s response and supporting their entry into residential aged care.

 

A number of strategies have been found to support people in their adjustment and transition to residential aged care, including:

• Effective communication that allows you an opportunity to get to know the resident^{5, 6}
• Establishing friendships with other residents and encouraging engagement in recreational and social activities⁷
• Demonstrating respect and ensuring dignity of the resident^8,9
• Maintaining autonomy by discussing options with the resident and allowing choice^{10, 11}
• Empowering residents by ensuring they are provided with choice over as many things as is feasible¹².

It is important to remember that our behaviour and attitude towards older people can have a positive or negative impact on their sense of dignity, self-worth and place in society¹³. Understanding how best to use the above strategies will help you have a positive impact if/when working in aged care.

 

 

 

 

References

1. Lee D T F, Woo J, Mackenzie A E. The cultural context of adjusting to nursing home life. The Gerontologist. 2002; 42(5):667-675.
2. Walker C A, Curry L C, Hogstel M O. Relocation stress syndrome in older adults transitioning from home to long term care facility. Myth or reality? Journal of Psychological Nursing and Mental Health Services. 2007; 45(1):38-45.
3. Brandburg G L, Symes L, Mastel-Smith B, Hersch G, Walsh T. Resident strategies for making life in a nursing home: a qualitative study. Journal of Advanced Nursing. 2012; 69(4):862-874.
4. Bonanno G A. Loss, trauma and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist. 2004; 59(1):20-28.
5. De Haes H, Teunissen S. Communication in palliative care. A review of recent literature. Current Opinion in Oncology.  2005; 17(4):345.
6. Fraher A, Coffey A. Older people’s experiences of relocation to long-term care. Nursing Older People. 2011; 23(10):23-27.
7. Fessman N, Lester D. Loneliness and depression among elderly nursing home patients. International Jouranl of Aging and Human Development. 2000; 51(2):137-41.
8. Williams K, Kemper S, Hummert M L. Improving nursing home communication: An intervention to reduce elderspeak. The Gerontologist.  2003; 43(2):242-247.
9. Chochinov H M, Cann B, Cullihall K, Kristjanson L, Harlos M, McClement S E, et al. Dignity therapy: A feasibility study of elders in long term care. Palliative and Supportive Care. 2012; 10(1):3-15.
10. Phillipe F, Vallerand R. Actual environments do affect motivation and psychological adjustment: A test of self-determination theory in a natural setting. Motivation and Emotion. 2008; 32(2):81-89.
11. Hollman C. Living bereavement: An exploration of healthcare workers responses to loss and grief in an NHS continuing care ward for older people. International Journal of Older People Nursing. 2008; 3(4):278-281.
12. Tu Y C, Wang R H, Yeh S H. Relationship between perceived empowerment care and quality of life among elderly resident within nursing homes in Taiwan: A questionnaire survey. International Journal of Nursing Studies. 2006; 43(6):673-680.
13. Oosterveld-Vlug M G, Pasman H R W, van Gennip I E, Muller M T, Willems D L. Dignity and factors that influence it according to nursing home residents: a qualitative study. Journal of Advanced Nursing. 2013: 70(1):97-106.