In our last article, we discussed how to choose a facility. This article focuses on how to prepare for a move into a facility and how, once moved, to acclimate to a facility. Focusing on these topics may make the transition smoother for the resident and his/her family.
During the selection process, meeting with the facility’s admissions coordinator is key. An admissions coordinator can provide valuable advice to the resident and/or a family member about the transition process and can also assist in gathering and organizing documents to include in the resident’s file to ensure that the resident is provided the best care possible. For example, the facility may request an Advance Directive for Health Care, also known as a living will, which may contain a health care proxy. A medical power of attorney is another way to designate a medical decision-maker. Either option allows the resident to make known his/her wishes about medical care or other care if the resident is too ill or unable to speak. A copy of the document should also be provided to the resident’s primary care provider (if other than a facility physician) and to the person(s) named in the document who are authorized to make decisions if the resident is unable to speak. Another document to consider including is a Do Not Resuscitate order, which is signed by a physician. Discussing the transition process and the necessary documentation for the resident’s file with the admissions coordinator can assist in making the transition more seamless.
As in the selection process, another important consideration is a resident’s finances and paying the monthly costs of the facility. Notifying a resident’s financial planner, attorney, and any other professional who can provide guidance in making decisions about the resident’s budget and assist in estate planning is essential.
Before moving into a facility, the resident may need to provide the facility with the results of a recent physical examination by his/her primary care physician and any other specialists, as well as a chest x-ray. Notifying the resident’s medical care providers about the move will also allow the resident’s physician to assist in the transition and to provide information for treatments, prescriptions that need to be transferred to the facility’s pharmacy, and documentation of any necessary immunizations or shots, such as a flu shot.
The physical move into the facility requires planning. Typically, this transition requires a resident to downsize. Factors to consider include the size of the resident’s room and the items permitted by the facility. Questions to ask the facility include: Who provides the bed? If the bed is provided by the facility, what is the bed size, and who will provide the bedding? Is a refrigerator provided, allowed, or needed? What is needed for television viewing? Can the resident’s special chair be moved into the room, and framed photos and art can be hung on the walls? After learning what the facility provides and allows, the resident and/or a loved one can determine how to furnish the room. Moving as many of the resident’s personal items creates a familiar environment and eases the transition. Additionally, planning to furnish seasonal decorations and wear seasonal clothing helps make the new home feel cozy, warm, and familiar. All personal items, including personal cell phones, wheelchairs, walkers, and especially clothing and bedding that the facility’s laundry will launder, need to be clearly and permanently labeled so they are not misplaced.
Another important consideration is how the resident communicates with his/her family and friends. Does the resident’s room have a telephone, or will the resident need a personal cell phone? If the resident cannot place a call independently, ask the facility to schedule weekly Facetime calls on their iPad and or iPhone, regardless of the means of communication. Be sure to practice with the resident how to make and answer telephone calls.
After a resident moves into a facility, the involvement of family and friends during the first few weeks and months is essential to help the resident acclimate and develop a new routine. A family member/friend needs to attend care plan meetings to advocate for the resident. It is essential to keep the lines of communication open between family members/friends, the resident, and the staff. Learn the staff’s names and help the residents learn them. Be alert for any discomfort or problems the resident may have with staff or routines and advocate for any necessary adjustments. Encourage the resident to establish a daily routine, make new friends, and form relationships. Visit as often as schedules permit. Accompany the resident in activities; eat a meal with him/her in the dining room; engage with the resident’s neighbors. Ask for a copy of the facility’s activity calendar, and when talking with the resident, remind him or her of upcoming events. If the resident has a calendar in his/ her room, note future visits or call times on the calendar so the resident will know he/she will see or talk with you again.
Change is hard for all ages. Developing a transition plan before moving into a facility, as well as being present and offering encouraging words and positive reinforcement to the resident as he/she settles into new surroundings, creates a more positive experience for all involved.
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