Is the health and well-being of your loved one making you think about housing options? L'Appui recently met with Genevieve Gladu, Family Caregiver Counsellor at the Caregiver Support Service to explore the implications.
Genevieve Gladu: It’s important to mention that there is no right or wrong moment to address the subject. Everything depends on your situation and how the opportunity presents itself. Ideally, you should talk about housing options as soon as possible to take sound decisions while the concerned parties are capable to do so and are not faced with an imminent choice. You can open the discussion with your loved if they are starting to exhibit loss of autonomy or if they received a new diagnostic.
While some seniors may never move into a residence, it is still important to open the discussion to talk about your limits as a caregiver and know the limits of your loved one as well. We may sometimes take for granted the fact that our loved may wish to stay at home, but this might not be what they want. This is why it is important to discuss the wishes of everyone concerned and define the expectations of your loved one in regard to the family caregiver.
In cases where the discussion is closed, you can come back to the topic later, particularly if you are anticipating changes in your loved one's health status; you can then establish a plan and discuss the direction to take.
GG: Family caregivers can experience several conflicting emotions. When thinking about housing options, they might feel a sense of guilt and abandonment, but later feel relieved when their loved one is taken care of in their new living environment.
By choosing a housing accommodation, some family caregivers will feel guilty of breaking a promise they had made to their loved ones. Therefore, care must be exercised, and promises must be reassessed to ensure that the caregiver’s capabilities remain realistic. When the loved one is relocated, some people may experience a feeling of loss of control. Normally, the caregiver is the expert; seeing other people take care of their loved one by using a different approach may trigger a sense of loss of control.
To prepare for this, caregivers can participate in information sessions on accommodations. They may also participate in the intervention plan of their loved one. It is important to mention that housing a loved one does not remove the caregiver’s title. They are still their loved one’s caregiver. This is not the loss of a role, but a redefinition of it.
GG: In the case of bi-generational houses, the difference is that each of the parties have their own living environment. However, before choosing a type of accommodation, it will be important to sit down with your loved one and define cohabitation boundaries.
To do this, you can hold a family meeting with your spouse, children and the important people in the life of your loved one to discuss ground rules. Since the whole family is involved and will live under the same roof, decisions should not be unilateral. You will need to determine common spaces and how to orchestrate them. You will then need to discuss the expectations and involvement of every family member.
GG: With everything that has been made public in the media lately, family caregivers have a lot of fears and concerns. Many are willing to continue living exhaustion instead of considering relocating their loved one. The fear of institutional abuse is a topic which raises a lot of concerns among family caregivers, even if things generally go as best as possible. There are also fears regarding the quality of the care and services provided in the residence. Some people also fear that their loved one may not adapt to their new environment, or that their health will deteriorate.
After the relocation, some family caregivers are afraid that their loved ones will be bitter that they broke their promise. This is why it is important to discuss about accommodation options and your personal capacities as soon as possible. Needs and options should be reassessed with time, taking care to explain your positions.
GG: The first thing to do is to visit the premises to familiarize yourself before the relocation. You can also try to develop relationships with the residents or the nursing staff. It will be important to realize that this is a new universe and that the person who will reside in it will not be alone. The simple fact of acclimating to the residence will be an important step. For the caregiver, it might be useful to participate in the intervention plan of their loved one to be informed of what is going to happen in their new residence. Knowing that they will be taken care of is reassuring!
To help the caregiver keep their bearings, it will be important to install a new routine, for example, spending time with their loved one at the residence. This helps reduce the feeling of guilt and justifies a form of involvement.
To better manage the transition, the caregiver can participate in activities in the residence or even go to dinner with their loved one. Observing how people are served and how they mix, may reassure the caregiver. They can also ask for help within their network to share tasks and ensure constant visits to the residence.
Customizing the person’s living space is also a good way to better deal with the transition. Providing personal objects or decorating the room will help the loved one with reduced autonomy feel at home and thereby reassure the caregiver.
GG: We have addressed this in several points but asking for support from your network is key. Whether the health network or your social network, getting support is an important part of being a family caregiver. Community organizations also provide external services. Delegating tasks is also important. These are all methods that can help a caregiver reduce their exhaustion and feel well surrounded. Set limits, attempt to respect them and create a routine. If you love reading, take a few moments to enjoy a book. Enjoying life’s simple pleasures is important to recharge your batteries.
Managing the feeling of guilt is also key in preventing exhaustion. Go back on past promises and redefine them when needed. You can also participate in psychosocial or individual support, meet other caregivers or an intervener who will standardize, and not trivialize your situation. It is also important to listen to your body. Recognize the signs of exhaustion and understand what your body is telling you. A good medical follow-up is also important. Know that you are in good heath and not jeopardizing it to take care of your loved one.
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