Updated: Jul 26, 2021
If you’re looking after a relative who is considering a move from home to a long-term care facility, how will the move change life for your loved one? Elder Care Coordinator Janice Fitchhorn talks about the six most important things you need to know about how life in a facility will differ from life at home.
Moving from a home environment to a facility environment is a big step. What do you need to know about how life will be different? Here’s my take:
There’s More Structure
At first glance, it may seem that an older adult living at home has more freedom. Eat when you want, sleep when you want, do whatever you want whenever you want. However, that freedom is often facilitated by the unseen labor of a family caregiver who is working behind the scenes to make sure that the older adult has regular home-cooked meals, takes medication at the right time, gets to doctor’s appointments, and more. This freedom for the older adult often comes at the price of freedom for the family members who are providing care.
Life in a facility will always be more structured. The older adult will eat, sleep, take medications, and socialize according to the facility’s schedule. Food and water intake are tracked to make sure residents are well fed and hydrated. Some older adults chafe at this structure—at first—and then settle in when they see how it allows family members the freedom to spend quality time with them.
The Food is Different
Living at home usually means home-cooked meals. Living in a facility usually means institutional food served cafeteria style. One isn’t better than the other. It’s just different. On the plus side, there’s almost always a professional dietician on staff, which means that your loved one will be served healthy meals.
One of the biggest differences related to food involves expectations. Some families expect facility life to be like a stay at a full-service hotel, complete with room service. It won’t be. Meals are served in a cafeteria. One facility manager told me, “This isn't a hotel. When residents who are perfectly able to eat in the cafeteria request meals in their room, we charge them extra.”
There’s Less Privacy
When your loved one is alone at home, he or she will have plenty of privacy. In a facility, there’s less privacy, especially if staff members need to enter the room to provide care. Most assisted living facilities offer private rooms, but that's not always the case for nursing homes. Keep in mind that if your loved one wants a private room in a nursing home, it will always cost more.
The Care is Different
Facility living means the older adult will receive care 24/7, which increases his or her safety and security, and boosts family peace of mind. There’s no need for family members to manage, schedule, or hire caregivers, and the level of care can usually be adjusted easily. On the downside, staff turnover is common at long-term care facilities, which means that your loved one may be cared for by many different people. The quality of care can also vary greatly.
There’s Less Isolation
While living in the home has its benefits, it can also lead to social isolation which can contribute to an array of health problems, including depression and cognitive decline. In a facility, social opportunities are built in. Residents can choose which activities to participate in.
Expect Less Personal Attention
Long-term care facilities are notoriously short-staffed. This means that your loved one may not get the attention he expects as quickly as he expects it. Just as some families expect food service to be like a hotel, some expect the facility to function like a five-star hotel, when you ring the buzzer and somebody shows up. The personal attention the older adult may have received from a family caregiver at home usually won’t be matched at a facility. Instead of the one-on-one attention, there's a six to one ratio—or more.
Though there will be differences, life in a facility can be every bit as rich and rewarding as life at home. The key is to make sure that your expectations are aligned with reality.
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