Many times elderly spouses become a caregiver and the task becomes overwhelming and it is time to look at alternate living situations. Spouses then have to make the difficult decision to move one spouse into a facility.
Katherine Cocks 0:02
Hi, my name is Kathy. I've been a geriatric nurse for over 10 years. Many times when I would meet with family members of aged loved ones, they didn't always know what to do. I started this podcast knowledge for caregivers, to assist them with practical suggestions as they assist their own loved ones age with dignity and grace.
I want to welcome you back to this episode. And today I want to talk a little bit about moving into facility. I know that back in episode 67, I talked a lot about different kinds of facility, and what the process was like moving my dad into a facility. But today, what I want to do is zero in on facility care, especially when we are talking about married couples, or partners who live together. And they have different levels of care needs. Many times when I go into the home, to assess clients, it's an older spouse in their 80s and 90s, with also some health problems taking care of another older person. So the healthier spouse has to do a lot of work. And it's very tiring. Imagine doing this kind of work when you're in your 80s and 90s, around the clock care. And many of them are doing a great job taking care of their loved ones. But the levels of care are definitely different for both of them. Unfortunately, there may come a time when the spouse who is healthier can no longer take care of the other spouse without harming their health, their emotional health, their physical health, their mental health, then decisions have to be made. And these are probably some of the hardest decisions that have to be made. When we moved my dad, he's already widowed, he was happy to move, he's meeting a lot of people. And it was an easier decision. He didn't have to be separated from his spouse. What I have seen is people really struggle with this. So I've seen some spouses, they will work and work and work. And I have seen personally, in my own practice that some of the spouses have died before the people that they are taking care of. The reason is, it's an a big emotional strain. In my family, I have several different scenarios that have gone on. In one scenario, the husband needed to go to an assisted living, his brain was okay, the spouse, she could walk around and do stuff, but she needed to go to a memory care. And one of the reasons they didn't put them in the same room was that the spouse that was having more physical problems, was still trying to take care of her and wear himself down like he had been doing in the house. They were able, though to get them in the same facility so they can still see each other. I know it's different, not being in the same room or building. And the person who is in memory care is in a locked unit. But at least they can have some connection with each other. And many times that might be a solution. When spouses have different levels of care. I one time took care of a gentleman that lived with his spouse, they had moved to independent living, the wife knew that she could not both take care of her husband and manage the house, the cooking, the yard work, the cleaning and all of that. So she moved into a nice apartment in independent living. So she could still take care of her husband. But she didn't have to mess with all that other stuff. But eventually even that became too much for her. But she was in a facility where her husband could go to assisted living or memory care. So she was still close enough by to see him every day to go visit with him. And sometimes that's a solution that people will do is they will look for a facility that has maybe independent living and assisted living. So they are in different parts of the building, but they can still see each other. Some people have chosen to actually move into the same apartment in assisted living. They're given a different rate. They still manage their own medications and affairs. They can still leave and drive. But they are staying in the same apartment, but the care is being provided for by the facility staff. Other times there are people that definitely can't afford to do that. In America. If you cannot afford to live in a facility, but you need to be in a facility, then that is covered by Medicaid, people get Medicare Medicaid mixed up. But Medicaid is basically services that are provided for people in poverty. Those people may go to a facility, but they're not going to pay for the spouse to go. If they don't require, you know, any assistance. And sometimes spouses still have their home, they may have a lot of social life still going on. And they can't take care of their loved ones anyone. So sometimes they will put them in a facility, and they will still stay home. These are some of the most difficult decisions that people make, as I've said before, one time I got called by a gentleman, and he said, I'm in a facility, I want to go back home, and I hear you help people at home. And I could kind of tell his memory, maybe wasn't as sharp, I was asking him some questions. And so I told him, I said, you know, what I need you to do is to call your wife, give her our number, and have your wife called me, because the last thing I wanted to do was put any more stress on the wife, when she had already had to make a difficult decision. And she did call me she said, I appreciate you being really kind to my husband. She states, I made the hardest decision I could ever make. And that was to put him in a facility. It's been very difficult. He wants to come home, she goes, but I just cannot handle it anymore. I did the best that I could. And I told her I said, I totally understand. And no way do I want to encourage your husband, to think that he could go home with our services, if that's not what's best for you. Like I said, this has happened in my family recently, the wife has been taking care of her husband done a great job, but it's just become too much. She's beginning to have her own health problems. And those are getting neglected or exacerbated by the care that needs to be provided, we've had to move the other partner into an assisted living. Unfortunately, they had to kind of find one that was a little further out, that's going to make it a little bit harder to visit. There are some strategies when one person moves or when the partners have to be separated. And first of all, just recognize that there is going to be some grief with this. I mean, most of these people have been married for 50 or 60 years. And it's hard even though there's a relief that the caregiving is not going to be so much on that spouse. But there's also the grief of not being in the same house. And we need to let them be honest about this, and talk about it and acknowledge this is hard. I remember watching a show. And it's about the military, the SEAL teams, and the partner was saying to the guy, like, I'm just worried you're gonna come home in a body bag, and he started making big jokes about it. And one of the things she said was, look, I understand, but I just need you to take my feelings seriously, and not belittle the fact that I'm afraid of what's happening. And we need to do that. With our older people who have made the decision to basically put one of their partners into a facility while they stay home. We need to acknowledge and support their emotions through this, we need to make sure that the person who's being put in the facility, depending on if it's dementia or physical, to let them visit and have as much decision options as possible. There may be many factors, you know, something that's close to the spouse, something that's maybe close to one of the children, it all just depends. Remember that as they're making these adjustments, especially as a married couple, it's not just that, you know, they're going to go through a phase and then they're going to be okay. And then they're never going to go through another phase of dynamic this art decision did I grieve? A good thing to do when you put one partner in a facility and if there's other family members or friends is to set up a visiting schedule so that the person who's in a facility doesn't feel isolated? So this is a time when you could say, okay, the spouse says, you know, Tuesday and Friday are going to be my visit days, and maybe the daughter can go on Saturday, maybe a friend can go on Friday. So anyway, you want to set it up so that this person is getting visitors. But the one thing you don't want to do is visit so often that the person who's moved to a facility isn't getting used to there New routine. These facilities have trained people that are offering all kinds of programs and interactions, exercise, things that build their mental, emotional and physical capabilities to the best extent possible.
Also, don't be afraid to learn new technology. These facilities have gotten used to that with the pandemic, in order to stay connected with your loved ones, with the person that we're going to do, my husband and I live too far away. But we've already been thinking about getting some cards, maybe having some more pictures made, and things like that, to let them know that we are thinking about them. Also help the family deal with grief, especially the spouse, they guilt, I said grief earlier, but I meant guilt help them deal with guilt, because it's going to come up, they're going to have some time to rest, they're going to recuperate in a couple more weeks. And then they're going to feel really guilt and go, maybe I shouldn't have done that I probably could have done still taking care of them. So just continue to encourage them that, hey, we've made the best decision we can. And we need to let this adjustment time happen. The spouse who stayed home, if they're unable to drive, there are services that can provide transportation that will help people get to the facility to visit their loved one. And so one more thing that I want to go over is if you have parents, and they're like, We don't know, I don't know when to send one of my you know, my partner to the assisted living or to the memory care. Some of the things that you can look for are things like burnout, they feel isolated, they're angry, they're neglecting their own health, and they'll tell you they're not getting any rest or not getting any sleep. Those types of things, you know, really raise red flags that maybe it is time to look at. Sending a person to a facility especially if you've already kind of used homecare and the care that they need is still more than what you can provide for home care. So thank you for listening. I appreciate you going on this caregiving journey with me. And if you have any questions, feel free to send me an email. I hope you have enjoyed this podcast. If you have found it helpful, then share it. If you wish to contact me for consulting services, you can reach me at www.kathysconsulting.com. Remember, all content is meant for informational purposes only, and not to replace the advice of healthcare professionals.