We’ve all been through the chaos of packing, the sorrow of leaving behind friends and familiar faces, and the anxiety about what lies ahead. Moving into a new home and community can be stressful for anyone. But if you live with a form of dementia like Alzheimer’s, it can be especially distressing. The shock of moving may appear to cause a degeneration of the disease, though abilities usually recover somewhat as the person becomes more comfortable in their new environment.
Fortunately, caregivers and loved ones can minimize the trauma and make moving a more pleasant experience for everyone by relating to the elder from an understanding of his special psychological needs. People living with dementia need love, comfort, attachment, identity, inclusion, and occupation, according to dementia researcher, the late Tom Kitwood.
Keep in mind these six practical means of satisfying those needs as you prepare to help the elder move or to welcome her into her new home.
- Appeal to emotion: We all need love, but persons with dementia, especially, respond to warm emotion and empathy rather than to cool rationale. A loved one helping an elder overcome his fear of moving might sympathize with him while highlighting the positive, “Yes, it’s hard and a bit scary, but it’s also fun to think about setting up your new home, making new friends, and maybe doing new things.”
- Reassure the elder: They may feel more vulnerable, less able to remember, and unable to control their emotions and behavior, perhaps lashing out in anger. “I’ll be there to help you” is reassuring and comforting. If you’re a staff member, you might tell him or her, “If you feel lonely, I can sit with you and we can have a cup of tea.” Family members about to leave the elder alone in her new home should reassure her that they will see her again, “We’re leaving, but we’ll be back soon.”
- Be genuine: Mean what you say and keep your promises to the elder. People living with dementia can sense when you’re not honest with them. It may be tempting, for example, to try to avoid upsetting the elder by hiding the fact that you’re moving him into a memory care community, “We’re just going out for lunch.” But he or she can tell something important is happening, and not knowing exactly what creates an even greater feeling of vulnerability, anger, and ultimately, betrayal.
- Involve the elder: Include him or her in planning, moving, and setting up her new home even if she is unable to respond. This helps satisfy the needs for occupation and inclusion and is consistent with the dignity we should afford everyone. In preparing for the move, walk around the house and ask what things the elder wants to take. If she or he is unable to reply in a helpful manner, you could say, “We’ll make a list together” and offer suggestions.
This is the same when helping unpack and settle into a new home. “I think we’ll put your pants in the drawer, what do you think about that? Should we hang these up or should we fold them? Shall we put this plant on the table by the window?” If they’re unable to assist, give them something to do— even if only to drink a cup of coffee while you finish unpacking. The important thing is to include everyone in the process of both the decision making and the doing of the task.
- Know the individual: As you compile the moving list, observe the elder and take note of things that are especially important to him or her and help define who they are as a person. Perhaps it’s an easy chair, pictures, books, or a houseplant that are part of their life. Also learn his or her daily rituals and favorite foods. Give the information to staff so they can have these items on hand and the means for the elder to continue their routines in the new home. The more details, the better: e.g., is it a Hershey’s bar, Rice Krispies or the newspaper with morning coffee that gives the elder comfort and reinforces his identity in his new surroundings.
If possible, bring along descriptive photo albums that staff can peruse with the elder to learn the important events and people in her life, “She’s a mother and she liked to go camping with her children. See how happy they are.”
Such specifics can help staff comfort the resident when she is lonely or confused. Plan how to keep the elder connected to special people in their life through visits, the telephone or internet, or simply by talking about the loved one with the elder, “Tell me about your daughter, Mary. She seems like a lovely person; what was she like while growing up?”
With advance information about the new resident’s favorite activities and interests, staff can design a “buddy system” of caregivers and residents best suited to engage with and help him feel at home. The idea is not simply to issue an invitation or advisory, “Hey, we’re having a discussion about gardening at 11; you’re welcome to join us.” Better still to be in companionship with the elder, like the staff person who stops by his room and says, “I’m about to have lunch … it’s a big piece of lasagna, which I know you like; can I sit down and share it with you?”
- Enable relationships: Keeping old friends and making new ones addresses the need for attachment. Can we involve the elder’s friends in helping her move? Can we invite them to lunch or other activities of daily life with the elder in her new home? Staff should endeavor to make the elder’s family members and friends feel comfortable, and to encourage them to visit as often as possible. As appropriate, communicate both the positive and concerning details with them about how well the elder is settling into her new home. Again, it is important for staff to know which people are especially important in the elder’s life so we can help them connect.
Caregivers should engage other residents already living in the home in welcoming the new one, though slowly and in a low-key fashion to avoid overwhelming the person living with dementia. Invite the elder and her loved ones to visit the long-term care home and hang out with other residents a few times before she moves in—this will help create memories and familiarity with the new environment.
After move-in and unpacking, counter feelings of vulnerability and loneliness with gentle reminders of opportunities to make friends and explore new possibilities, e.g., have breakfast with friends, join the exercise class, participate in the kitchen.
There are countless everyday activities like this that people living with dementia can do that helps them establish a normal life within the long-term care home. Matching each individual with the appropriate activity is key, as everyone is unique.
Megan Hannan, MS, is an Executive Leader at Action Pact and has provided leadership in long-term care for over 25 years. Megan developed Action Pact’s signature train the trainer program, PersonFirst®. She is the former President of the Board of the Pioneer Network, and now sits on their Education Committee.