Monday, August 22, 2016

Transition to Nursing Home Care--Exhausting!

Today marks the beginning of Mom's fourth week in nursing home care. I am surprised by how difficult this transition has been; I thought the grief of parting would be balanced by the vast relief of liberation from being constantly on call. However, my time commitment to Mom's needs hasn't lessened during this transition time. The time I spend at the nursing home is balanced by a new freedom from the physical demands of caregiving, but another unwelcome surprise has been a sense of grief. Ministering to someone as I have ministered to my mother engenders a special kind of love.  We might say that it is impossible to give so much without caring deeply: thus the term "caregiver."  In my desperation to be freed of the burdens of caregiving, I underestimated how I would miss the blessings of giving so much. 

I was surprised by the steep learning curve of acclimating myself to Mom's new environment. As the person who knows my mother best, it has been my responsibility to learn how to communicate clearly with nursing home staff in an inoffensive way (though being inoffensive can't be my primary goal). I didn't know this would be so difficult. The hierarchy of authority among nursing home administration and staff wasn't immediately apparent to me (why didn't I just ask?). The administrators in the front offices were apparent, but there were bewildering numbers of aides, nurses, laundry workers, and kitchen attendants. And this is such a small nursing home; I can't imagine how much more challenging it would be to learn my way around a larger facility.

This morning's devotion time yielded a clear message for me: Rest! As I sank to the welcoming cushions of my old office couch awhile ago, I was reminded of how my mother--who in her prime moved quickly and worked hard--used to say, "Whew! I didn't know I was so tired until I sat down!"  Until I quieted myself before the Lord and sought His directive today, I had no idea how depleted I felt.

When we stay busy in order to distract attention from grief, we rob ourselves of the solace of silence and rest. The awareness of God's healing presence in His ordained gift of rest can be masked by too much noise and busy-ness.

  For God alone my soul waits in silence; from him comes my salvation.
Psalm 62:1 ESV

Truly my soul finds rest in God;
    my salvation comes from him.
Psalm 62:1 NIV

Here is a summary of today's recommendations for caregivers who are transitioning their loved ones to nursing home care: 

1)  Your time commitment to your loved one may temporarily increase during the first weeks of nursing home care.  Plan for this.  
2)  Your focus needs to be your loved one's well-being rather than an attempt to be inoffensive to nursing home staff--but try to be inoffensive just the same!  Maintaining a balance between being a good advocate for your loved one and not becoming a pain to his/her new caregivers requires much prayer.
3)  Don't run away from the grief this transition will bring, or fill your days with tasks that bury the Lord's offer of solace with a weight of busy-ness. Find your healing in His arms as you quiet yourself before Him.   
4) At the nursing home, ask this simple question, "Which person should I talk with when I have questions or input about caregiving issues?" I try to visit with the attendant who is charge of Mom's care before I take my concern to the nurse, and I visit with the nurse before I look for an administrator. This provides the opportunity for a problem to be corrected without triggering a correction or reprimand from a superior.
5) Larger nursing homes may have photos and names of staff on a website. This would facilitate learning names, which is important. You need to be able to greet these hard-working folks by name, it's just good manners, and respectful t'boot.  It also sends a clear message that you are committed to partnering in your loved one's care, and makes them feel pleased (that you remember them), but also aware that you know exactly who they are should you need to visit with them about a caregiving issue.  This is an important part of advocacy for your loved one. 
    6)  Be kind to these underpaid, compassionate people who perform the most difficult of tasks for so many people each day.  Nursing home workers face burnout as they form emotional connections with terminal patients. They will cry with you when your loved one passes away, and they will cry with the next patient's family, and the one after that.  Pray for them.


  1. What a loving and practical list, Linda. You are so good with organization and specifics.

    I was questioning why you have been so much busier in these recent weeks when I finally remembered that I was so depleted and done in that I became sick and bedridden myself for nearly three weeks after my grandmother was placed. My husband took on those first weeks of care for Nan until I was back on my feet. Thank God for that. And to think that I had already forgotten!

    May it all become more manageable as time goes on. How does your mother seem to be adjusting? Has she her favorites who just seem to click with her? Is there a Bible study or song time there that you all can participate in?

    1. A part of the perception of extra time spent is the necessity of a 40 mile round trip commute on country highways, and so I'm spending an hour a day driving. The change of schedule, combined with grief issues and the challenges of advocating for Mom with a whole host of new people--these things have me on "overwhelm!"

    2. All that and a commute, too! Yikes! Hope that the driving time becomes "you and Him" time. My commute was about 45 minutes round trip and I liked listening to talk radio. I wish that I had instead listened to worship music or just talked with The Lord. =D

  2. This is beautifully written, Linda, with your love for your mom shining thru in each sentence. You are both in my prayers.

  3. I would have never imagined that a caregiver would go through grief while their loved one is still on this earth. Guilt... yes! But, not grief! What a beautiful testimony to the Lord's deep love He continues to live out through you towards your dear mama.