For some seniors, short-term rehab can end up becoming a transition stage to long-term care. For all its collected wisdom, medical science can't always predict how the human body will heal. There are times when a person just doesn't respond as expected to treatment, or when there is simply more deterioration than the body can overcome. Sometimes a return home isn't possible. As a result, many family members and caregivers find themselves suddenly facing something for which they are unprepared. It can be stressful — for you and for your senior loved one.
So what do you need to know when your aging parent's short-term rehab stay doesn't go as well as expected? How do you go about the process of moving him or her into long-term care?
Let's take a look at what you should expect and at steps you should take.
There will be many emotional issues to address.
First, if your loved one is lucid and understands what is going on, he or she will need a lot of emotional support. He or she may resist making a decision about long-term residential care and cling to unrealistic hopes. That senior is used to being independent and being in control of his or her own future; losing that control is naturally going to be unsettling. You need to be patient and gentle.
You might talk with your parent's primary doctor or nursing case manager about recommendations for a transitional living counselor, or you could contact your local Agency on Aging. Many senior services and faith-based programs exist to help your loved one work through the emotional challenges associated with losing independence.
You might find that you feel a certain sense of guilt when going through the long-term placement process. It is important to remember that no one is at fault and that you are not abandoning your parent; this is a step along the path of life that the majority of us must take.
The most important goal must be to get your parent the care that he or she needs, so that he or she can live as vibrantly as possible going forward.
Plan for your parent's financial future.
What happens to your aging parent's house and possessions? Are his or her finances in order, and is there a living will or power of attorney document? How will you pay for long-term care, and is any of it covered by Medicare or Medicaid?
If your parent is able and ready to discuss these matters, you should address them calmly and patiently. Take one step at a time — remember, you and your loved one are essentially dealing with a grieving process (for the loss of independence) and you shouldn't rush through each decision. Give yourselves as much time as possible to adjust to each new decision.
You might find that your parent refuses to discuss finances or care. If that is the case, and you are the power of attorney, you should work closely with your parent's care team to make the best, most well-informed decisions on his or her behalf.
Schedule a care planning meeting.
Sitting down and discussing the situation with your loved one, with family members, with the care team and with a case manager helps everyone to be on the same page. In it, your loved one's condition, treatment progress to date, care plan and revised recovery goals should be thoroughly discussed.
You will undoubtedly have questions and concerns before such a meeting. Write them down and bring them with you, so that you remember to ask them.
And it doesn't hurt to take notes in the care planning meeting, either — especially if your loved one is confused about the situation or unable to participate due to his or her condition. You'll want to be able to review with your loved one what was said later on, when his or her physical or mental status allows.
Don't forget to take time to care for yourself.
Many caregivers become over-stressed. Some struggle with anxiety, sleeplessness, or depression. Remember, you are important, too; in fact, you're probably going to need to serve as the "family backbone" going forward. Don't lose yourself.
When your family member must transition to long-term care, he or she will rely on you for emotional support. Even if he or she is initially angry at losing independence, reality will eventually set in.
Stay patient, be kind and find ways to relax, so that you'll be emotionally available to your loved one when he or she needs a shoulder to lean on.
An unexpected transition from short-term rehab to long-term care is never easy. But if you take your time, stay focused on what's best for your loved one's health and safety, and keep yourself balanced, the process doesn't have to be nerve-wracking.