Support for people starting a new life in a care home
Intended for healthcare professionals
Opinion Previous     Next

Support for people starting a new life in a care home

Mary Maclean Adult nurse lecturer, University of Huddersfield

When older people pack their belongings to move into permanent care, nurses can offer emotional support

While many nurses involved in hospital discharges are well trained to support patients’ physical and practical needs, the intense emotional needs of someone transitioning into a permanent care setting are often not identified and supported.

Nursing Older People. 34, 3, 10-10. doi: 10.7748/nop.34.3.10.s3

Published: 31 May 2022

A few years ago, while working as a community nurse, I witnessed the distress of an older female stroke survivor, who was in a temporary care setting and awaiting transfer to permanent 24-hour bed-based care.

She sobbed loudly about the prospect of this move, and the distress she felt about her brief return home with a family member to select the few belongings that she was allowed to take to her new residence. She likened the experience to ‘packing her life away’.

Even as an experienced nurse I had never witnessed this level of distress in a patient before discharge to a 24-hour care setting. I felt guilty as I thought back to other patients I had supported during this incredibly difficult transition.

As nurses we often explain to an individual that leaving their home and moving into 24-hour care is in their best interests – it offers a safe and supportive environment.

nop_v34_n3_3_0002.jpg

Picture credit: iStock

While this response is well-intentioned, I realised that I had never provided these patients with the opportunity to discuss and explore what it meant to them to be saying goodbye to their own home, where they had experienced significant life events such as raising their children.

I had not appreciated the full extent of the effect this move could have on someone’s psychological well-being.

Happy memories

The Stroke Association points out that for many people the thought of moving into a care home is frightening. With this in mind I sat with my distressed patient allowing her to explore her feelings, and listening with minimal interruption. She explained what her home had meant to her and all the happy memories she had created there.

I acknowledged her grief and continued to sit quietly, holding her hand as she cried. Afterwards, I suggested that she might benefit from further support and she consented to me contacting her GP with my concerns about her psychological distress. I also informed the care manager of her care setting so they could hand over this information to the new residential home.

The charity Age UK suggests that people transferring into a care home bring some favourite possessions such as photos, cushions or favourite pieces of furniture, and that relatives should be encouraged to attend meetings.

As healthcare professionals, many of us will care for people faced with the prospect of leaving their homes and moving into 24-hour care. We need to ensure that we provide a more empathetic and holistic approach when it is time for the people we care for to pack their lives away.

How nurses can support patients

According to Healthwatch, a statutory body that champions users of health and social care services, many patients do not receive visits or assessments of their continued health and care needs after discharge. It says nurses should:

  • » Help patients to discuss what it means to give up their homes and move into 24-hour care settings

  • » Document discussions and concerns in the patient’s notes, and share them with the multidisciplinary team to ensure any necessary referrals are made to support the individual post-discharge

  • » Alert the patient’s GP and care home manager to any psychological issues through the discharge summary

(Source: Healthwatch 2020)

Find out more

Age UK (2022) Support Moving into a Care Home. tinyurl.com/AUK-moving-to-care-home

Healthwatch. www.healthwatch.co.uk

Healthwatch (2020) 590 People’s Stories of Leaving Hospital During COVID-19. tinyurl.com/HW-peoples-stories

National Institute for Health and Care Excellence (2022) Mental Well-being of Older People in Care Homes. tinyurl.com/NICE-wellbeing-care-homes

Stroke Association (2021) Moving to a Care Home After Stroke. tinyurl.com/SA-care-home-stroke

This is an abridged version of an article at rcni.com/care-home-support

Share this page