Help for Senior Caregivers: Transitioning to Facility Care

According to Mark Reese, MA, LPC, LAMFT at the Center on Aging, part of the School of Public Health at the University of Minnesota, the following are the most common factors for family members to eventually place their loved one in a nursing or assisted living facility:

Changes in medical condition     81   %   Affordable Home Care, At Home Caregivers, Companion Home Care, Elder Care in Minnesota, Home Care Companies, Home Help for the Elderly, In Home Care Minneapolis, In Home Care St. Paul, Private Pay Home Care

Caregiver exhaustion                     30.4%

Wandering                                        24.6%

Incontinence                                    18.8%

Inability to be left alone                  17.4%

Aggression                                       14.5%

Illness of another family member or

conflicting family needs                  11.6%

Caregiver illness                              10.1%


Any one of these is a good reason for family members taking care of elderly parents to want some relief from the role of primary caregiver.  I would venture to say that in all actuality, caregivers are likely dealing with several of the reasons simultaneously.  Keep in mind that caring for a loved one is 24 hours a day, 7 days a week.  You can’t call in sick or take a break (also called respite) without having someone to take your place.


Caregiver Burnout

Caregivers sometimes get stuck in the thinking that no one will ever be able to care for their loved ones the way they have been.  I have seen many times in my career when caregivers are exhausted and suffering their own health issues but still cannot give up the caregiving role because they feel that no one will be able to take their place.  More often than not, the caregiver ends up in the hospital before the care receiver, which puts the whole family into crisis mode.

In my experience, caregivers are mostly uneducated about the toll caregiving takes on their own health.  Therefore, they don’t plan ahead for a transition and often end up in crisis.  To help people think about planning for the future, it helps to ask caregivers, “If something happens to you, if you end up in the hospital, then who will take care of your loved one?”  Usually, they have not given much thought to the question.


Facility Placement

Placing a loved one in a facility is never an easy decision.  Just making the decision is very stressful in and of itself.  It’s not uncommon for caregivers to feel inadequate or like they have failed when they can no longer care for their loved one at home or choose not to.

Along with the agony and relief of finally deciding comes the depression, sadness, loneliness, and guilt when the loved one is actually out of the house.  The caregiver gives up the role they have been filling as the primary caregiver (i.e. their purpose).  Many times, it’s not easy for caregivers to find something new to fill all of the hours they previously spent on caregiving.

It’s better to be proactive and plan ahead for a move out of the home rather than wait for a crisis to happen.  During a crisis, your choices are limited, and you are apt to make decisions that are emotion-based rather than rational.  If your family will accept in-home help for the elderly, such as respite care, or assistance with non-medical tasks such as laundry, housekeeping, meal preparation, and the like, caregivers can often get the relief they need in order to continue caring for the loved one at home for a longer period of time, which is generally the goal for most families.

Julie Ellingson, LSW

January 22, 2012


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