Most elderly people who have a clear and compelling need to be in a long-term care facility desperately want to remain in their own homes.
The decision to place a loved one can be agonizing, but caregivers need to consider the following:
- 1. Long-term care placement can be the most loving choice when absolutely needed to ensure the person receives all the necessary care, is around others for social stimulation, and is in a safe environment.
- 2. Caring for a loved one is probably seriously affecting their own physical and mental health and wellbeing. No one can be a good caregiver if they are exhausted and burned out all the time.
Many people flat out refuse to go. In such cases you can try to convince them that it’s best for their own health and wellbeing. If that doesn’t work you may enlist the help of another family member or even the person’s physician to talk with them. People will sometimes pay more attention to the advice of someone other than the primary caregiver. However, if the person is mentally competent and continues refusing, there may be very little you can do about it unless their health is in imminent danger.
If your loved one has dementia and is resisting placement it can be more complicated, but there are several strategies you can use. First of all try those listed above for loved ones who don’t have dementia. You may also obtain the services of a geriatric care manager, who can often guide you through the process.
Another approach is to use what is referred to as “compassionate deception.” You can convince the person to go for a limited period of time, such as a week. Then you stretch it out to two weeks, then three, and eventually they will probably adjust to being there full time. If a loved one is significantly impaired he or she may even forget they were supposed to go back home. Or they may not be aware they aren’t at home.
You may also make arrangements for a facility to allow you to take the person there, saying you’re going to visit someone there or you have dinner reservations there (or some other reason for visiting). Then when you leave don’t take them with you. You will probably feel terribly guilty, but the person will almost certainly adjust. This may take a few days or, in rare cases, a few weeks, but your loved one will probably come to know the facility as ‘home,’ and they are not likely to remain angry with you.
If none of the above suggestions work and you have power of attorney, you may have to enlist the help of law enforcement. According to Hammond, “You should do this only as a last resort. It’s only for the most severely impaired people and the most dire circumstances – such as if the person becomes a danger to him or herself or others.” Law enforcement typically takes the person to a hospital geriatric psychiatry unit for evaluation and treatment, from where they may be released to a nursing home.
Do any of you have any other suggestions for solving this problem?