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Thursday, June 14, 2012

Ask the Matriarch - Preparing People for a Retirement Facility

Our question this week regards the challenging issue of helping people make a major life transition, one that can often be accompanied with complex emotions, especially if not everyone in the family is ready for it. Our colleague asks:

How do you help your seniors prepare to move to a retirement facility? How would you advise a couple if one is ready for a retirement home and the other is not?

Crimson Rambler responds:

The question of seniors moving to a retirement facility is a daunting one.  In my own experience, it is complicated (often negatively) by the affectionate concern of family members (whose elders feel some sort of Moral Imperative to resist their suggestions, their arguments, their strategies, because, after all, THEY weren't through the war, what do THEY know???); and (often positively) by the example and the Very Forthright advice of their contemporaries ~~ "and I said to her, Clara, I said, you have a choice: you go into Somerset Manor and have a lovely apartment and all your meals, OR you are facing THIRD FLOOR SHADY PINES.  Now which is it going to be?" 

The minister often is enlisted by the family to "talk sense into Mother" -- but unless the minister is also a contemporary, she can be quickly boxed with the know-nothing non-veteran offspring.  (I'm making light of this because I've been in just exactly this position.)

So how do we help them prepare?  By listening -- listening to their children's frustration, listening to the seniors' apprehensions, grief, anger.  And by recruiting contemporaries to maintain the links that have been built up while the seniors were in their own homes.  And by transportation: I have learned that it is a kinder action, often to collect Mrs. A and take her to visit Mrs. B, than to visit Mrs. A and Mrs. B oneself, solo.  The line here is: "I'm going to leave you girls to get caught up, and I'll be back in about three-quarters of an hour, and then we can have our Communion all together -- how would that be?"  Because they always have much more to say to each other than I (not having been through the war) can possibly have.

You can also encourage your senior to find out whether there are folks among the new neighbours who would enjoy a monthly informal worship service, a hymn sing or Holy Communion.  Some folks will do this spontaneously, phoning to say, "Well, I've found fifteen Anglicans, and I made them promise to come on Sunday if you can come and do a service for us in the afternoon!"

When the situation involves a couple needing different levels of care and assistance, the ministry of transportation becomes even more acutely necessary.

The important thing is to find ways to demonstrate that their church's love and care for them do not cease when they move into a less independent living arrangement.

I'll be most interested to hear what other RevGals' experience has been!

Terri offers:
This can be an easy task, or a more difficult one. I have helped move people into retirement homes where they have a lot of autonomy and I have helped move people into locked units due to cognitive and memory loss issues…and everything in between.

By and large most of my effort has actually gone toward supporting the family members who are facilitating the move. I also visit people in retirement homes all the time and find that I end up being a local contact for long-distant family members who want to know that their loved one is okay. 

In terms of helping the actual person making the decision to move- my role is usually one of information provider – I share what I know and have heard about the local facilities. I let them know which ones people like and why. I let them know, if they don’t already, who lives in the facility and who can offer them more inside information. I try to help them make informed decisions. If the couple is in a stalemate because one wants to move and the other does not I listen as each one discusses their reasoning and then hope they are able to make a good decision. Again, I would probably advise them to make some site visits and talk to people about any facility they were considering, so they can make informed decisions. As I said above, often my role is one of supporting the family – so this would be true as well if one member of a couple needed make the decision to separate as a couple because the other member of the couple needed to live in an assisted living facility for memory loss issues.

What I can’t do is make the decision for them, I can only offer a listening ear and some support, perhaps a little inside information from my visits to the local facilities.

Generally I have found that when people are ready to move they do, and they end up really liking it. In a retirement community they find people like themselves and plenty of activities to keep them busy. Occasionally people make the move and then shut down and enter a slow decline, but that is rare, usually people thrive and find new life. I let people know this as part of their decision making process.

And Kathrynzj writes:
This is a timely question. With all of the family, financial, physical and emotional issues wrapped up in a move away from a home to a community it is pastoral care that is filled with land mines. We live in an area heavy with a variety of senior living options so there are a wide variety represented in our congregation. Encouraging conversations between those who are already there and the ones thinking about moving there can be helpful. Some of them have restaurants open to the public as well. 

--
Thank you, matriarchs, for your really wonderful and thoughtful answers. Are there others of you out there who have insight or experience to share? Please join our conversation in the comments section. And, as always, we welcome your questions at askthematriarch[at]gmail[dot]com.



5 comments:

  1. I spent a year as an assistant chaplain in a long-term care facility. When I help families make this decision/transition I feel compelled to downplay the reasoning that the new resident will make new friends. What typically happens is the newest residents make friends with each other. Longer term residents do not. Sadly, as these new friends pass away, the trauma of losing friends begind to dampen enthusiasm for forming new friendships.

    Therefore, I appreciate the offering of the ministry of transportation. Keeping old friends together is more satisfying than encouraging making new friends. Thanks for your vision in this matter.

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  2. Terri's comment really grabbed me: "By and large most of my effort has actually gone toward supporting the family members who are facilitating the move. I also visit people in retirement homes all the time and find that I end up being a local contact for long-distant family members who want to know that their loved one is okay."

    I want to thank and encourage those of you who do this work.

    As a non-pastor, middle-aged child of elderly parents who live 5 hrs. away...I am in the population you describe. And I remember, vividly, calling their (new at the time) church, crying, and saying to the secretary, "I need some pastoral care...and it's really as much for me as it is for my parents."

    God bless her, she talked to me until I calmed down, got me the rector, and he did the same.

    That's been 7 years ago, and now we are facing the move you describe, in some format. Listen to us kids? Not so much.

    If we did not have the clergy and church community to rely on as my parents look to the future, I cannot imagine how we would cope.

    You as clergy bridge a gap that HIPAA won't allow medical professionals to approach. I am profoundly grateful. I thank you for this ministry.

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  3. I just discovered that one of our matriarchs, Ruth (who blogs at Thinking About Preaching ) had submitted a response to this question that I missed:

    The hardest thing about the transition to retirement/sheltered/cared for accommodation is admitting that it’s time. I see people leave it too late – until the move is forced upon them & they don’t have time or energy to settle in the new situation. I try to encourage people to be realistic about the grief for what they’re leaving behind, but also the relief that putting aside some of the worries about the present situation can bring.

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  4. One of the ways I have been able to help is by providing a referral to a geriatric care manager, an invaluable professional who can help families in a myriad of ways. If any of you haven't yet discovered this specialty, it is worth exploring and getting to know someone you can trust. I am not sure about smaller or more isolated communities having this resource, but many other areas do. This is someone who can come in as an advocate for the older person, with a tool kit of resources for looking at options but without all the emotional baggage that comes with being a family member. The needs can be for short term issues--Mom broke a hip and has to figure out what to do until she is fully recovered--or for specific problems like malnutrition, or for evaluating if the time has come for a higher level of care and what that might look like. S/he can also help with communicating with relatives at a distance. Most families don't know this sort of person exists, but I sure have seen a lot of relief when they discover that there is someone who can help them.

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  5. Here's another perspective! As a full time pastor in a CCRC, I deal with these issues all the time. The best way to encourage folks to consider such a move is by spending time with the residents who are already there. They overwhelmingly report wishing that they had moved sooner - they treasure the time to develop important friendships and local contacts. We have a Protestant congregation of about 140 active members, a choir of 40, 5 organists who share responsibilities - and a vibrant, active group. The services are all on a dedicated chapel channel - and are repeated several times during the week. There are other faith groups as well, all involved in a strong interfaith community. If you have a member who's facing the decision - be sure to contact the pastor in the community - a natural way to begin establishing an interface- and meet members of a faith community. Once the door closes on the old familiar home - a window opens that truly can become life giving and spiritually powerful. Especially when you remind them that God is already there!

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