Transforming A Life One Room At A Time

smooth ALF transitioning

by Karen Keller Capuciati

After one of the meetings I have every month with a group of geriatric care professionals, Kathryn, a gerontologist, was telling me what she had done for a client named “Rosie,” who had recently transitioned from post-operative rehab, where she was recovering from a femoral fracture, into an assisted-living facility.

Kathryn described how she had transformed an empty room at an ALF into a home for her client. I was touched by the lengths that Kathryn had gone to — in my opinion, she went above and beyond the normal bounds of her profession in making sure that Rosie’s new home was as nice and comfortable as it could possibly be.

“Rosie loves the outdoors,” Kathryn told me, smiling at the recollection. “So I loaded the big picture window with flowering plants, and colorful vases that I filled with flowers. Then I bought a brightly colored flowered quilt, a high-back chair and ottoman that is really cozy — in blue, Rosie’s favorite color. I also brought over some of Rosie’s artifacts and knickknacks to have in her new space.” Kathryn smiled again. “It’s a real joyful room.”

Kathryn couldn’t bring too much from Rosie’s home, but she took what she thought was important, such as the antique secretary desk. Rosie had worked her whole life as an administrative assistant, so Kathryn figured that having her desk in the new home, with lots of shelves and compartments and stacked drawers, would be a point of familiarity and comfort for Rosie. Kathryn knew intuitively that Rosie would enjoy sitting at her desk, reading the newspaper, writing cards and letters to friends. It would give the room a point of warmth and familiarity.

Kathryn was detailing the Rosie situation because of an earlier group discussion about how long it often takes new residents to get acclimated to an unknown facility. It’s no surprise really — imagine being moved into a building full of strangers, sometimes against your wishes, sleeping in an unfamiliar bed, eating in a dining room while surrounded by faces you’ve never seen, being given a routine that’s wholly different from the one you’ve been living for years. It feels like the comfort of home has been ripped away from you.

There is no getting around the inherent difficulty of this process, even for healthy people, much less for someone who’s impaired, either physically or cognitively. But Kathryn showed me there are things we can do to bring some joy to this otherwise stressful situation. This inspired me to email my geriatric-care group for their tips on how to make the transition as smooth as humanly possible.

Here are some of the ideas they offered:

Kathryn J. Freda, MA, CDP:

  • Family members should make an effort to connect with the staff at the new facility and visit as often as possible to ensure that your loved one’s needs are being met. If family lives at a distance, be sure there’s a surrogate who can visit the facility on a regular basis to represent the family and advocate for the loved one. Making friends with staff is key. Even if you don’t love the staff people, find a way to build a rapport. I bring cupcakes, flowers, etc. for the staff so that they don’t dread seeing me when I keep showing up and asking them questions.
  • Bring personal items, scents, photos, etc. that are warming and familiar to your loved one. With some communities, you can bring your family member’s furniture from home. But be selective and bring only favorite things, including favorite articles of clothing.
  • Gradually encourage your loved one to participate in group events (if in an assisted-living community), but be careful not to set expectations too high. This is an enormous step in an elder’s life, and it might take a while before he or she feels ready to participate. It’s best not to overwhelm them with constant urgings to socialize.
  • Send letters and cards to your loved one; ask family and friends to do the same. Connections with people are vitally important.

Donna B. Fedus, MA:

  • In addition to connecting with staff, it is important to share detailed information about your loved one’s preferences and history: details about their family, the kind of music that inspires them, what they did for a profession, places they lived or visited, skills and hobbies they enjoy (do they play an instrument, speak other languages, paint, etc.?), whether they’re religious or spiritual or agnostic, etc. This will likely be covered during the intake process, but reinforcement with staff personnel on all shifts increases the likelihood of person-centered care. This information transforms a “resident” into a “person.”

Joan Blumenfeld, MS, LPC:

  • If the elder has dementia, don’t tell them about the move too far in advance. It only causes agitation and worry. If they have a serious memory loss, a day or two in advance may be enough.
  • Be sure to take along favorite belongings to make the new surroundings as personal as possible. Bringing art, photos and keepsakes that are meaningful to the resident gives the staff a head start in personal relations.
  • If there has been a trusted aide in the house for some time, let that aide stay with the elder for a transition period in their new home.
  • By making frequent short visits in the first week, you can help the elder feel comfortable in their new surroundings. But not so often, or for so long, that the acclimation of the new resident is unnecessarily delayed.
  • Do not take the person with dementia out of the facility (trips to the store, etc.) until they are fully established at the facility. It is too confusing.

Laura Kaplan, LCSW, MPH, OTR:

  • I would just add that it can be useful to prepare the elder’s family for the possibility that moving may trigger a temporary cognitive decline, though the elder may very well return to their baseline once they acclimate to the new facility. It can be unnerving for the family to see their loved one’s mental acuities worsen after the move, and if they are unaware of the potential for short-lived decline, they may start regretting their decision to place their loved one in the facility, which can be upsetting for all involved.

Rosie moved into the ALF in December of 2014. Kathryn said that it took several months for her to acclimate to her new home. But she enjoys taking care of her plants (Kathryn bought her a pretty watering can that Rosie uses all the time). She now enjoys the comfort of her own new space, and she has made friends that she sits with for every meal. Rosie’s doctor noticed how good she looks now that she is recovered from her femur operation and settled in to her new home.

 

Karen Keller Capuciati is the Co-Founder of In Care of Dad.



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