I spent five and half years working on a memory care unit. I have worked with many families through the adjustment phase of moving a loved one into a skilled nursing facility as well as helping them find grace as they continue to try to communicate with their loved one as they progress through the dementia process.
Making the decision that it is time to move your loved one to assisted care is often the hardest decision. Though, try to remember that memory care units are in existence for a reason, to provide a safe and engaging environment where health needs can be met as one progresses through their journey with memory loss. Visiting a loved one in a nursing home can also be difficult as often they are an uncomfortable place for families and friends to come and visit. Let’s look at some reasons why we have a difficult time, as well as ways to make the visits go better.
It is sometimes hard for families to accept that their loved one needs to be in a skilled facility. It can also be quite difficult to accept and understand that their relationship may change. It is important for families to enjoy the moments they are with their loved ones and accept them for who they are today.
When trying to engage with the individual with memory loss, don’t forget who they were before admission into their new home. They are still the same person, despite any changes to their memory or physical abilities. Try to engage with them just as you would if they were living at home. Here is a list of things that they may enjoy depending on their ability and interest:
- Visit and catch up
- Have something to eat or drink together
- Watch TV/movie
- Listen to music
- Share photos
- Go outside
- Play cards/game
- Participate in their hobbies/interests
Sometimes families over complicate their visit and are at a loss for conversation. Try talking about family and friends. Talk about their favorite sports team or something that they are passionate about. If your loved one has memory issues, it is best not to ask memory questions unless you are asking about things from their more distant past. Often, long-term memory is still the best bet for conversations as dementia progresses. If any of the conversations seem to be frustrating for them or not engaging, switch the topic or switch to a different activity to engage in.
Remember that they’re still a person and just because they live in a long term care facility does not mean they have lost their feelings. They are going to have good days and bad days, just like anyone else. Try to help make their mood better. This can be through a visit, by helping them adjust, through introducing them to other residents, or simply by just listening. We all need to vent sometimes.
One of the most important tips is to be mindful of your non-verbal language as well as your tone of voice. 93% of communication is tone of voice and body language; only 7% is words! So even if they have trouble communicating with words or understanding your words, they still understand plenty. They are reading your face, your body language, your tone. What is your body language saying?
- I am uncomfortable
- I feel sorry for you
- I am angry/sad
- I am rushed
- I am happy to see you
- Hello my friend
- I really want to be here
The first couple of minutes of your visit can set the stage for how the visit will go. Be mindful of your body language as you approach them and your tone of voice when you greet them. If you are trying to have meaningful conversation, try to limit noise in the environment. There should be family spaces to gather, a quiet nook, or maybe their room. If your loved one becomes upset, don’t take it personally. And always try to keep a sense of humor.
Don’t forget the importance of human touch. Give a hug, hold a hand and always remember to flash a warm smile. People need personal touch, and not just the kind from daily care such as help dressing, bathing or going to the bathroom.
Communication is very important to all relationships. But remember where you are when talking and who you are talking with. Don’t talk about your loved one to staff as if they aren’t sitting there. Try to include them in the conversation even if they are not sure what is going on. If you must, take the conversation another location where they cannot hear you talking about them.
Often, families wonder how often they should visit. This is a personal choice and it differs for every person and situation. Don’t wear yourself out trying to be there every day, every minute. You must take care of yourself first. It is about quality moments, not quantity. Give your loved one time to adjust to their new living situation. This takes a different amount of time for everyone. Staff may ask you not to come for a week or two to allow for adjustment.
Saying goodbye following your visit can often be difficult. Make up a routine that you always do before you leave, such as a prayer, a snack or singing a favorite song. Leave on a positive note by letting the person know they are loved and they are safe. Say you will be back to visit soon. Sometimes it is best to say something that you have to do and blame your leaving on a task such as picking up the kids or going grocery shopping. For some families it is best to say you have to go talk to the nurse and then you slip out the door. This can be hard for some families and is often only used for those who are still trying to go home with their loved one at each visit. It may take some time to find the exit strategy that works best for you and your loved one.
When visiting your loved one, remember “Ichi-go ichi-e.” I recently learned about this Japanese saying which comes from their traditional tea ceremonies. It is a cultural concept about treasuring the moment that you are in, with the people you are with. It is important to focus on the present, not the future nor the past, and just simply treasure this moment as it will never happen again. I find this statement and its symbolism to be beautiful and translatable to spending time with our loved ones with memory loss. Enjoy the moment and be with your loved one wherever they may be on their journey.
For more information on family life-related topics and programs, visit our local University of Illinois Extension website at http://web.extension.illinois.edu/cfiv/ or contact Chelsey Byers Gerstenecker at 217-333-7672 or firstname.lastname@example.org.