#53: Supporting Families in Residential Care

Show notes: Special edition

CASE STUDIES

Supporting families in residential care

The focus this special six-episode series of the Voice of Aged Care podcast is case studies – real-life stories focused on the topics that impact those of us working within the aged care sector.

These topics have all been requested by listeners, and the first that we will discuss is supporting families whose loved ones are living in residential aged care.

In this episode we will cover:

• The importance of respecting families and their unique journeys
• How to provide a safe space for listening, rather than fixing problems
• Where and how to seek additional support when it is needed.

The case study we will focus on here involves a family of three daughters and a mother who needed to move into residential care. Her husband had died some years before and she was living alone. She was experiencing memory changes and was suspected of having dementia but was refusing the thought of moving into care for additional support, as she had no concept that she needed help. Her daughters were taking turns assisting her at home and she also had some home care support visiting too. Her three daughters were working full time, and took turns in visiting their mum who spent time knitting and watching TV. It had gotten to a point where cooking meals was beyond her and her daughters were concerned (as was the home care provider) about falls and her safety.

When they came to the decision of residential care, it evoked a lot of emotions in the daughters as they came to terms with the reality of the situation. Changes in memory can happen fast or slow, and in this case it was slow, which made it hard for their mother to understand what was happening.

In Australia two thirds of people who access home care transition into residential care and over half are people living with dementia.

The journey towards acceptance for families can be quite different. Families have different challenges and pressures. Initially there can be a sense of relief, but guilt, stress and grief can follow. They may feel like they haven’t done enough.

So what can we do if the family is struggling? In this moment, we need to be able to respect their journey. It is not about us, or about the resident – it is about the family’s experience.

‘We need to be good at supporting families as they support the elders in our care. Supporting families does not mean handholding, counselling or doing tasks outside the scope of our roles. It may include listening, collaborating and working together towards shared goals.’

This really highlights that your role is not to fix everything – but to recognise and listen to what their concerns are, and notice when additional support is needed.

Flagging the need for additional support can be tricky. It can be difficult for families who feel like they are advocating for their loved one. The easiest way is to suggest they talk to their GP, to have a chat about how they are feeling about the family member’s move, as the GP may be better equipped to direct them to the right support.

In our case study, the mum didn’t want to move, and the three daughters all had different expectations. When their mum moved into residential care, they took turns staying overnight with her. They also told her she was staying in a hotel as they didn’t know how to say she was moving into aged care. This was really confusing for their mum. The daughters were basically doing what they had done in her home and were there the whole time, not allowing staff to care for her. They were visibly upset and this was also distressing for their mum who just wanted to go home.

What did help was when they started backing off, and their mum was able to start making connections with staff and other residents. Once they allowed her to start mixing with others, she started to adjust better. And that made them feel good too.

At about the two-month mark of admission, you could finally see they were all doing better. Over the course of the next 12 months, their mum started to flourish. She would be interacting with others, gardening, knitting, having really positive interactions with staff and residents.

This was so different to the beginning when she would actually lash out at staff. Once her daughters saw the change, they became more accepting of the situation themselves.

Everyone has different relationships with their loved one before they move into aged care. Everyone has different personalities and histories. So when it comes to families, I think it is just meeting them where they are in their journey and supporting them through that. We can’t have expectations as everyone’s experience is different. We need to meet them at the level where they are, listen without judgement, respect them and their journey and also notice when they might need additional help or support to assist them as they navigate their role as a caregiver of someone in a residential care setting. It’s not always easy.

For the family in the case study, we went from a complete mess in the beginning to seeing Mum flourish, and also the emotions of the daughters moving from stress, overwhelm and guilt, to relief and enjoyment. All it took was time, and skill from the workers, understanding where to meet the elder and the family where they were at.

In this episode you will learn:

• Strategies to help you effectively support families whose loved ones moved into residential care
• Skills in how support may vary and could include activities such as providing a safe space, seeking additional support and helping loved ones process grief and loss
• An understanding that family involvement can provide seniors with emotional support, help them maintain their autonomy, and enhance the quality of care they receive.