Relocation can have negative physical and psychological effects on people. “People who have to leave their homes and families, and move into a nursing home experience lots of grief and loss. ” (Harker, 1997) In this essay I will discuss how moving from one place to another for different periods of time might affect a persons well being. Using relevant materials I will focus on the reasons why elderly people are relocated into nursing homes. I will look at the feelings and emotions which the elderly experience and suggest ways in which they can be supported during these changes.
A few people decide to go into care themselves as seen in the case study of Mr and Mrs Smith (unit 7, p99) A couple in their 80s who decided to go into residential care because of Mr Smith needing some care himself thus putting strain on Mrs Smith. Some people may see that a member of their family needs a break and opt to go into respite care for a short period of time, or possibly a day care centre where a break on a daily basis is required. But more often than not people go into nursing homes involuntary due to illness or may be they are unable to cope on their own.
There are a number of reasons why a move is necessary. Firstly the elderly person is cared for by a member of their family and they are finding the caring role to be a burden. Secondly a person may need to be hospitalised due to illness or possibly a fall, then due to lack of personal care in hospital, the ability to cope independently is retained. Norman suggests that ‘the longer the period in hospital, the more likely it is that the social space at home will have closed up. (Reader, p78) This could also be the case for a person in rented accommodation and being hospitalised for a long period of time, the landlord may want to repossess his house thus creating a barrier stopping the person entering their previous life and resulting in being relocated into a nursing home. One of the greatest feelings associated with relocation is loss.
Loss of independence is experienced when in institutionalised care, resulting in the person feeling that they are not themselves anymore, Harker agrees that having independence is something that everyone has worked to accomplish in a lifetime. Harker, 1997) So when this is taken away people are bound to feel worthless. A person losing their home can simulate the same kind of grieving as someone would experience if they were to lose a loved one. ‘feelings of painful loss, the continued longing as expressed by Maris (Reader, p75) are feelings of grief. All people go through the same emotional transitions in response to change. Hopson and Adams (Unit 7, p101) have developed a transition model based on Elizabeth Kubler-Ross’ change curve (Kubler-Ross, 1969).
The first stage of emotions experienced by change as illustrated in the transition model is Shock, going to a strange place and not knowing or recognising anyone. Shock occurs following a change in environment or location. There could be an increase in anxiety “many people feel disorientated and anxious in unfamiliar settings”, (Unit 7, p95) loneliness and confusion. If a person is confused, a sudden move to a strange place would trigger even more confusion. The second stage is Denial, trying to prove ways that it isn’t happening.
The psychological problem that some people experience when they are moved to a home is known as Relocation Stress Syndrome (RSS). Admission to a long term care facility, considering the loss of choice involved, is a stressful event, which may well result in a relocation stress syndrome. (The New South Wales College of Nursing, 1998) This recognised psychological disorder is evident on the transition model as the lowest curve where depression takes place. Prior to that is frustration and this is where anger can take place.
Anger is something that psychologists call a cover feeling, allowing someone to hide all their other feelings behind it. Whilst a person is angry they are not thinking about how poorly they are or about the other things in their lives. A person may withdraw themselves from social activities and choose to be isolated from others. With Mrs Smith’s scenario (unit 7, p99) when Mr Smith’s health took a turn for the worst their circumstances changed and Mr Smith was placed into a nursing home away from his wife. This bought on a whole myriad of emotions from both Mr and Mrs Smith.
Although Mrs Smith showed no anger toward the choices made to put her husband into a nursing home, she accepted the decision, she still feels very sad when she thinks of her husband. ‘Mrs Smith recounted the story, sometimes breaking into tears when she thought of her husband. ‘ (Unit 7, p99) it suggests that she accepts the changes made, but perhaps the reason why she is saying things such as “Well, you have to go where is suitable, haven’t you” (Unit 7, p99) could be her way of covering up her true emotions.
Negative physical effects occur because some people, after being transferred to a nursing home, they feel like they want to give up on life, they think that it is the end and therefore they refuse to walk, eat or socialise with other residents. Some people however do find that relocation or change can be a ‘stimulating experience’ (Unit 7, p96) these people may have been lonely and living by themselves, and a move to a more populated place can give them the company that they need. This is more widely experienced in day care centres where a person only visits on a short term basis.
It is always a good idea to plan a move well in advance although this is not always possible in some cases where a sudden change of circumstances arise. Planning a move can lessen the emotional stresses attached to relocation. When a person experiences relocation it is essential to remind them that they are still an important person, and continue to do this through out their stay. ‘adjusting to life in a care home is a complex process, requiring a range of social skills,’ (unit 7, p100). Goffman? Patience and continuity is important as is reassurance toward the person who has been moved.
Family members need to be supportive as do carers. “Regular visits by family and friends are important. They can be reassuring and comforting. ” (Best care giver info, 2000) Communication is extremely important when a person is moving to a nursing home. If an elderly person doesn’t understand the reasons why they are going this makes the situation worse. The person can feel rejected and can perhaps begrudge the member of the family who has suggested they go into nursing care. It is very important for the person moving, whether long term or short, to be able to trust their family.
If a person is in a care home they can sometimes become withdrawn. Talk groups such as reminiscence therapy can be beneficial, by talking to people about where they use to live and where they use to work for example can help people to become less confused. It may also be helpful for the person moving to talk to a therapist or someone of that nature to discuss their feelings about the move. By talking about the positive things which will come out of the move people will feel less unhappy. Helping a person to get through the transition model is also a very good way to support people.
I have explored some of the reasons why people are relocated to nursing homes and have identified some of the emotions related to this. I found a very close resemblance toward the transition model and Relocation stress syndrome which may need more research. I have found that communication is very important to reduce the effects of moving. The support which we can give to people moving has also been explored and I have identified that if a person is moved into care then talking to them and exploring there needs is extremely beneficial to them.