It is a very daunting task when you need to make major life decisions and choose one option from a number of competing alternatives. In old age, these choices and decisions are most likely to be around health, finances, and living arrangements. If you don’t make these choices yourself, you are choosing that someone else will make them for you.
Moving to residential care is a huge adjustment for anyone. In my experience, those who have chosen where, and when to move, adapt and enjoy this life stage better than those who have not chosen.
I am motivated to write this, my first blog, because over the past 20 years of working with older people I have seen time and time again the end result of older people not taking control of their future. They frequently end up depressed and miserable in a residential care setting not of their choosing. With this, they suffer a sudden loss of autonomy; losing their independence, home, social roles and networks, belongings, sometimes pets, and all things held dear for many, many years. Whereas those that choose when and where to move, are in a better position to cope with the accompanying grief and loss issues, as they maintain some degree of control in the situation.
Why does this happen? My sense is that a number of factors will influence our choices:-
- Individual values are the most important driving force behind our choice of action. Let’s take the example of deciding when to move from home into a residential care facility. If we value our ‘independence’ we might choose to stay living at home for as long as possible. However, if we value ‘control’, we might prefer to make the active choice of where and when we go into residential care rather than allow others to make that choice if we are not able, which is so often the case if we leave it “as long as possible”. So, in this example, we need to weigh up and balance the values of independence and control. This is not easy, but old age equips us well for this challenge. With ageing, comes wisdom, a collection of life experiences and knowledge gained through those experiences, which help us negotiate a course through such dilemmas.
- Flexibility is also key in such cases of value adjustment. Values that serve us well in one stage of life, may not serve us as well in a different stage, and may need some adjusting. For example, if we clung to our willful independence of teenage years, it would be difficult to form long term relationships where there is a need for some degree of mutual dependence.
- Old age changes our perception of loss. Recent research found that older adults are more prepared to take risks with loss than younger adults.We become more familiar with loss, over a lifetime of experiencing different types of loss, and therefore are prepared to take more risks in relation to loss. This research relates to our choices when it comes to moving to residential care. We are more prepared to sit tight in our current situation and accept the unknown future risk, rather than take the inevitable and known loss of moving now, while we can still make choices.
What can we do about this dilemma, and ensure that you have the best possible quality of life in your later years?
Design a Residential Care Moving Action Plan
- Start a conversation with your family or support person/people about the criteria that you and they might think need to be met for you to seriously consider moving to residential care. See https://www.myagedcare.gov.au/getting-started/starting-the-conversation-about-aged-care
- To establish the criteria ask yourself questions such as:- How’s my health, and what are my medical needs (medications, dressings etc)? How’s my mobility (do I need walking aids or wheelchair access); Am I still able to get around town eg. drive or take buses/trains? Am I still in control of my bowels and bladder? How’s my short term memory? Am I at risk of falls? What’s my current support at home? Is the possibility of more support available? After you’ve asked these questions of yourself, you may wish to ask them of your family member, with whom you are discussing the issue. They may well have a different perception of the situation. Attempt to be open-minded and flexible as you discuss any differences in perception.
- After establishing some agreed upon criteria for when you think it will be the best time to move, weigh up the pros and cons of moving versus staying at home. Write them down, and discuss them with your family or support person/people.
- When you make the decision that you might want to trial a period in residential care, you will need an ACAT assessment (Aged Care Assessment Team) to classify you as high or low care. Call 1800200422 or visit the website at :-http://www.myagedcare.gov.au/eligibility-and-assessment/acat-assessments
- Phone and book an appointment to go visit some places that you would consider appropriate for when you are ready.
- Consider a period of respite in a residential care facility to try it out, and put your name on a waiting list. The government allows you 63 days of respite per year.
If you would like to book an appointment to discuss any of the above with us at Amazing Ageing Psychology, please call 02 98445403, or send us an email via our website.