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When should my loved one move into aged care?
Episode 33 • 3rd December 2024 • Your Aged Care Compass • Coral Wilkinson & Michelle Brown
00:00:00 00:39:16

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Supporting an older loved one to move from their own home into residential accommodation is a task that often takes an emotional toll on all family members involved.

Sometimes the move can be planned, when the older person acknowledges it’s time to make the move. But more often this significant life change happens during a crisis, when there’s been a massive decline in the older person’s health, often after a hospital admission.

In a perfect world, we’d all be having these conversations with our older loved ones, well in advance of this situation arising, but it doesn’t happen like that for many families. Today’s guest, registered psychologist Dr Julie Bajic-Smith, helps us understand the impact on everyone when the time comes for a loved on to move into residential aged care. She discusses how to approach these conversations and how frame the move more positively.

 In this episode:

  • Only a small percentage of older people move into aged care
  • Independence vs risk
  • When might a person need to move into aged care?
  • How much informal support is provided?
  • How to start a conversation about a move to residential care
  • The significance of losing independence
  • Moving a loved one into care doesn’t always reduce stress
  • Moving an older person into care can enhance family relationships
  • Frame things positively
  • Loss of insight in the older person and how to deal with this
  • Have gentle and compassionate conversations earlier and regularly
  • Improving mental health for older people in residential care

Resources mentioned:

Connect with Dr Julie Bajic-Smith:


Connect with Coral Wilkinson: 

Follow See Me Aged Care Navigators:

  

More about Your Aged Care Compass podcast: 

Do you support an older loved one at home and you're ready to give up because it’s just too hard? Your Aged Care Compass is for you.

We're Coral and Michelle, the sisters behind our business, See Me Aged Care Navigators.

Coral is a registered nurse with over 30 years’ experience in both health and aged care. A former assessor with the aged care assessment team, an advocate and author, there’s not much Coral doesn’t know about Australia’s aged care system.

Michelle is a former pharmacist with over 30 years in the public health and private sectors of pharmacy. Michelle is the client care manager for our business. 

Our story started as one of supporting our parents to remain in their own home, to be as independent as possible and remain connected to their community. When we eventually needed extra support, we achieved this because we know Australia’s aged care system so well. We knew what programs could assist us and our parents.

Your Aged Care Compass podcast brings together not only our personal experience in supporting our parents but also our vast professional experience in supporting other families to keep their loved ones at home. 

We'll help you makes sense of Australia’s aged care system and bring you topics related to ageing as well. Legal, financial, health, forward planning and more.

 Your Aged Care Compass will guide you clearly and compassionately to the right support at the right time for your ageing parents and loved ones. 

Like what you hear? Please leave us a rating and review. We’d love you to share this podcast with any friends or family who have older loved ones.

Transcripts

Coral:

Welcome back listeners.

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How to initiate that difficult

conversation about moving an older

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loved one into residential care.

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It's a question we're

asked from time to time.

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It's not my area of expertise.

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So I reached out to our guest speaker, Dr.

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Julie Badgick Smith to join us

on the podcast today to guide us

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on how to approach this topic.

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Julie is a registered psychologist

and has 15 years plus years in aged

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care as a clinician and researcher.

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Her work focuses on the well

being of home care workers and

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decision making in dementia.

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Julie's book, Beyond the

Reluctant Move, enhances

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emotional well being in aged care.

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As a board approved supervisor,

she guides intern psychologists

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and mental health professionals.

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Julie's award winning programs

significantly impact older adults

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and their carers, providing crucial

support and practical solutions.

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Julie, my mum still lives in her own

home, and we're doing everything we

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can to support her to remain in her

own home for as long as possible.

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But she's had a few significant health

issues over the past three years,

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and I wondered each time if her care

would be too high to remain at home.

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She was able to return home each time

after those hospital admissions and

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is doing well now, but I realize her

care may one day become too high for

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us to continue to support her at home.

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I'd feel sad and guilty that I wasn't able

to keep her at home if it came to this.

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Is this a situation you find

many families grappling with?

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Julie: Hi Carol, thank you so much

for having me on your podcast.

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This is a very common issue and dilemma

that a lot of people encounter as they,

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as their loved one gets older and starts

to experience challenges in late life.

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So the situation that you're finding

yourself in with your mum is not uncommon.

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Coral: Yeah, that's right.

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And, that's what we consistently hear as

well from our followers and listeners.

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Julie: We must keep in mind that

most people actually remain living

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in their homes, that it's only a

very small population of adults who.

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move into care, we're talking

about six, 6 percent or so.

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So vast majority of people do

remain living independently.

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I think sometimes a lot of people

tend to have this fear that

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they'll end up in nursing homes.

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And the people who end up in care,

the ones whose health declines

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significantly and whose risk of

being or remaining independent in

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the community is just too high.

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So the challenge for families.

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And loved ones is determining what

level of risk they are prepared to

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maintain independence at what risk.

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Coral: That's a really

interesting comment from you.

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you know, the, in the media, the

stories that we often hear are those

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crisis kind of, situations where

people have to make this really big

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decision and it's very traumatic and

it's about moving mum into aged care.

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So that you said, it's actually

quite a small, or a smaller number

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of people compared to the people

who are still living at home that

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really got my interest there because.

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From where I'm sitting, and I

deal in the home care space, not

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in residential accommodation.

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To me, I would have assumed that that

number would have been, much larger.

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Julie: Yeah.

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See, that's assumption often.

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And having been to a number of nursing

homes here in New South Wales over

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the years, many people who move into

care, the ones that don't have the

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family support, the ones that don't

have no one to support them, in their

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own homes, or maybe they've had a fall.

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and they used to live on the

second, story unit block.

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There's no lift.

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They can't navigate the stairs anymore.

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And it's not just about the stairs.

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It's also then, well, actually,

even if I lived on the ground floor,

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no one would be able to assist me.

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So we don't hear often stories

from people whose voices are, not

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represented in our population because

maybe they don't have family members.

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Maybe they've, never

married, never had spouses.

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Maybe there's only a niece or nephew who

have their own aging parents to deal with.

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So we don't hear the true representation.

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And I believe that a lot of your

listeners who are so committed and

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dedicated towards supporting their.

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And all the people themselves have

this fear, but also, that they're

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so blessed to be surrounded by

people who are supporting them.

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Coral: Absolutely.

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Yeah, look, the other thing you

just touched on was about risk.

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So the question I wanted to ask you

now is, in your experience, what are

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the indicators that make family members

supporting an older loved one at home

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consider that it's time for mum and dad?

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To move into more supported accommodation.

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Julie: So it comes down to the activities

of daily living, their physical health,

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but also their emotional wellbeing.

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Some people might have the physical health

in, reasonably good, but perhaps they are.

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not motivated to attempt to

activities of daily living.

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So maybe they are not showering and

just making sure the floor is wet so

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that family will think that they've had

a shower, perhaps they're not eating

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properly and feeding themselves properly.

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And look, Coral, there could

be a whole range of reasons

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as to why that might happen.

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So it could be because they might

be having mild cognitive changes.

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Maybe they are, experiencing Some

neurological changes, or it could

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be because of their mental health.

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And it's really hard to jump to

conclusions as to what is going on.

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We know that with older population

and older generations, we don't, talk

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about mental health so comfortably.

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And a lot of older people might

be in denial that they might

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have a mental health condition.

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So what would be happening

is like, no, no, no, I'm not

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depressed, I'm not anxious.

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Not recognize that actually

that, is what might be going on.

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So.

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A very important note is that

Although we know that, we can't

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reverse the impact of dementia, we

know that, we can slow it down, but

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we can't cure people from dementia.

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We can cure people from

mental health conditions.

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We can cure people who might

have experienced grief and loss

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because they've experienced

significant loss of their loved one.

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And, and, maybe that manifested

into depression, but we know that

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regardless of a person's age,

that they can actually improve.

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So when, when the family thinks about,

what risk and what, factors they would

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need to see where their loved one, might

be, requiring additional help and support

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is obviously, making sure that everyone's

on the same page, but also making sure

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that, are they eligible for service?

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No good talking to mom and dad about

additional support and service if they're

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not eligible for residential care.

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and so what, tends to happen is that

sometimes people do become eligible.

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They do not want to move.

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I can understand.

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That's why my book is called

Beyond the Reluctant Move, because

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people don't want to move there.

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In, in, in many cases, I, I've met a

handful of people who are keen and willing

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to do that, to stay out of trouble.

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family's way and not impact their

family's, activities and lifestyles

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and feel like they're a burden.

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I think that the main challenge, Coral,

is in people who might have additional

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needs, support needs, or they may have

a diagnosis of a degenerative disease.

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And if it's impacting them

neurologically and cognitively, what

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tends to happen is that these people

lose the insight into their ability.

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And so they are under the impression

that they can do things independently.

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Yes, my daughter will come and top up the

fridge and cook, but they can downplay the

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level of support that they are getting.

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And so what happens is that,

offspring, goes on holidays or

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becomes unavailable suddenly.

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And then it comes to light, wow, actually

there's a lot of help That they're

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giving me, and it becomes unsustainable

at one stage where it's like, well,

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no, if, if they're not helping me do

this, I can't stay living independently.

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I'm not going to feed myself properly.

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I'm not going to chuck food

that's off, that's been sitting

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in the fridge for weeks and weeks.

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I'm not going to go and get, new supply

and no, it's not okay for Meals on Wheels

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meal to last you for three meals in a day.

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It's supposed to be one meal,

it's not to be split up.

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So it is about.

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Really determining what risk there is.

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And for some people who have cognitive

changes, who have very little insight

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into what is going on for them, they

might be like, Oh yes, I can do lots of

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things independently, but it's like you

leave the stove on and your house goes

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on fire, your front door is unlocked,

you, go wandering on the streets.

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So it's about mitigating that risk.

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And it's really hard because

it can be quite subjective.

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And some families can be prepared to deal

with a higher level of risk than others.

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So I think that a lot of that comes into

play and it really depends on individual

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circumstance and their support unit

and their own insight and, willingness

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to explore additional support needs.

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Coral: Really, really interesting

that you just spoke about insight

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and the level of care because this is

something I often speak about as well.

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And when I'm presenting to a group, I

say it's a really difficult conversation.

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And sometimes, like you said,

that lack of insight, the older

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person will say, I'm okay.

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I don't need any help and I'll

say, okay, let's talk about that.

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And then I'll say, well, my daughter

prepares all my meals for me.

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So I just have to reheat them

and I pay a private cleaner.

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And when I go to my bridge club on Monday,

Marge, the neighbor takes me because

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I'm and, There isn't that insight, that

recognition that they are actually getting

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a significant amount of support already.

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and I always suggest to them, all

right, we need to remove, just let's,

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let's just take all that support away.

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How, would you cope at home?

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And that's when it can be, it can

reveal itself to the person that in

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fact they are getting quite a lot of

support already, but that it's informal

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doesn't seem like support to them.

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Julie: absolutely.

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And then when you peel the layers of

onion, when you realize, wow, it's amazing

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that this person has been able to keep

doing for what they've been doing for

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so long and just the level of support

that they might downplay and think, oh,

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it's no big deal, but really it is a big

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Coral: Yes, absolutely.

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Yeah.

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So look on that point, Julie, how would

a family member approach that perhaps

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initial conversation with an older

loved one about, Hey, mom or dad, you're

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needing quite a little bit of support.

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And, I, as the son or the daughter,

it's really hard for me, mom,

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I'm working, I'm exhausted.

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Perhaps it's time to consider

moving into residential care.

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That's a really difficult conversation for

people to have with their older loved ones

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or and certainly what, in our experience,

that's what people always report to us.

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So how would someone initiate

that kind of conversation, Julie?

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Julie: I think that you're spot on Coral.

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I think it's really, it is

a hard conversation to have.

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It is very difficult for family

members to, accept that their

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loved one needs additional support.

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And it's hard to get that message across,

without, touching on many emotions.

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it's not a brief conversation to have.

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I think that it's something that,

It's likely to get people upset.

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We can't, just assume, look, it's going

to be a happy brief chat, but I think

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it's something that probably evolves over

time and being clear in the communication,

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even when, you are able to do things.

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To highlight that you are doing those

things, I think it's really helpful for

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the person to realize just about the level

of support that goes into helping out.

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Not, not to say, look, I'm so burdened

by what I'm doing for you, but just

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to say, look, mum, at the moment

where things are like, I'm probably

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helping, five to 10 hours a week.

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To maintain living at home.

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And yes, I can do this, but can we

reevaluate this in six months time and

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see how that's going, with my availability

and my commitments and also for you.

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And, if mom also has home care packages

or, supports in place just to Track

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along and see how that's going, as

opposed to what I find choral happens

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sometimes is that it's the, it's the non

spoken, word for so long that goes on

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and then the family gets to a breaking

point and they're like, I can't keep

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doing this and then, the family member

like, it was like, Oh wow, I had no

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idea what impact this was having on

you, or we didn't really talk about it.

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And then it's like, well, no,

you need to move into care.

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and so sometimes, there's

really, I'll take a step back.

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There's, two types of

people that move into care.

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There's one, Where they've had significant

change, like they've sort of had

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overnight events that have happened.

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And they may have had a stroke,

they may have had a fall, they ended

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up in hospital or they, they had

some sort of event that from being

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completely independent to, requiring

a lot of support happened overnight.

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And usually for those people, it's

really hard because they haven't had

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any time to adjust to that transition.

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But you know, if they end up in a

hospital setting and it's like, the

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doctors say, look, you can't go home,

you can't mobilize or they've had

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something happen quite traumatic.

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So those people don't really have

a lot of say as to what they want.

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And they end up in an aged care facility

because, they, can't have a hoist at home.

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They can't, return to

that environment at all.

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The other type of people

is the ones that have.

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They're called slow growers or the

changes happen slowly over prolonged a

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period of time, and it's really hard,

because technically it doesn't matter

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if mom moves into home today or next

week or a month ago, and that can be

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really harder to know where do you

reach that point when you go, yes.

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yes, this is where we're getting and

that's really hard because then that

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older person is hanging on to the

independence the family member is

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like, well, what are you waiting for?

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There's room in this facility for you now.

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Why don't you go in?

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And I think that because

that move signifies so much.

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It signifies so much for the older person,

it signifies so much for the loved one.

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And we know that research shows

that even when an older person moves

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into care, the immediate caregiver,

their level of stress remains the

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same until the person passes away.

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So putting a loved one into care doesn't

necessarily mean that, your life is over.

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It's all going to be easier

because then you'll just have

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different concerns and worries.

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But I think it needs to be a collaborative

approach and collaborative discussion

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and looking at different, facilities, if

time allows it, if there is vacancies,

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and having all parties on board.

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So I think, having medical

team on board, speaking to the

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GP about the support needs.

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Talking to facilities and families makes

it more of a team effort as opposed to

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a daughter wanting to have mom moved

into care and also communicating about

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the rights and responsibilities of

all the people in care as well, that

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it will become their home, that they

can personalize their rooms and how.

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The care delivery will look like,

and it doesn't mean the end of that

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relationship between a child and

the parent, but they can focus on

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more fun stuff because someone else

is going to be providing the care.

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And so that moving to care can

actually enhance their relationship and

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their time together because of that.

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They now have this additional time

that's available, that's free because

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mom doesn't need to cook anymore and

mom doesn't need to clean and you

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don't need to clean all this, you can

really have nice fun outings and enjoy

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this later stage of your mom's life.

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Coral: Yeah.

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Yeah.

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Fantastic way that you've reframed

approaching this situation.

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And in fact I was listening to some

of your own podcast episodes and

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noted, noticed how you talked about

reframing this kind of discussion

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suggesting a more positive approach.

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you know, The guilt associated with moving

mom or dad into care could be reframed

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to be supportive, rather than reactive.

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you've touched on some of those points.

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Are there more, are there other ways

or things that people should be perhaps

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considering that they could introduce

into that kind of conversation that

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would be, more positive and supportive

rather than reactive and reactive.

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Negative.

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Julie: Yeah, Look, I think that

it's really important to look

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at the positive side of things.

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And I think that often families can feel

quite overwhelmed about that process.

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And so, I have a really handy tool,

which I actually started off with

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just like a blank piece of paper.

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And when I just started working in

aged care, one of my, Mentors, Dr.

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Nancy Bahano was saying about

this, just write down, just get

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family to write down what's very

positive about their loved one.

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And so I actually designed this resource

that I'm sure you can link to your

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listeners from my website, Five Facts

About Me, and actually writing down

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what are the five things about mum

or dad that the facility should know?

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and putting it in a positive

way, like mum, is a modest lady.

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She loves to have her cardigan over

her shoulders, or it's really important

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that, she has her cup of tea from

her cup and you'll find it here.

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Or mum loves to talk about horses,

just putting it on positive things and,

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your mum or your dad, they're not just

their diagnosis, they are a person.

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So when we think about more

like a systematic approach.

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to care and support needs framing

what, you know, you might feel really

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overwhelmed at that point of time going,

Oh my God, there's so much I can say.

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But if you think about what's the five

most important things that we need

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to know about, your loved one, it can

really help and you can update it, you

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can update it, monthly, quarterly, six

monthly, whatever might be relevant,

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but just focusing on those positive

aspects initially can really help

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the older person adjust them finding

things that are, in common with other

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residents and making those connections

based on all the people's strengths and

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abilities rather than their weaknesses.

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Coral: Fantastic.

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So, if a family member or spouse or an

adult child is, is You know, pursuing this

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kind of conversation, with mum or dad, and

yet they're still very resistant if they

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are completely lacking that insight that

we've touched on, what does a person do?

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What does this, what does the spouse,

typically from our experience,

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what, can the adult child do?

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What can they sort of say to,

perhaps they can say nothing.

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I'm not really sure, but

what is your experience?

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And what would you suggest if, Mom

or dad, or perhaps both of them are

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completely resistant to going into

supported care residential accommodation

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and you can actually see that that

big crisis is about to happen.

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Julie: yeah, absolutely.

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Look, I think that, it reminds me

of this case, like years ago, I

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met this lady who was in retirement

village and she absolutely refused

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to go into residential care.

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Interestingly, the facility

was actually on site.

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She lived in a retirement village.

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The facility was on site.

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On site where she lived and her two

daughters were beside themselves

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and they were like, mom needs

to go up the road to a hostel.

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She doesn't want to go.

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And this lady presented beautifully

and she was very kind, generous.

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I'd come over.

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She's like, I'll make you a cup of tea.

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On surface, it all looked amazing,

but Coral, like, then I realized

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:

she was making a cup of tea and

the milk expired two weeks ago and

331

:

the, the mugs were dirty and, like

I allowed her to make a cup of tea.

332

:

I didn't drink it, but she wanted to

show me how hospital she was and I could

333

:

really see that there was problems.

334

:

And in hindsight, actually, her

dementia was quite advanced.

335

:

So that insight was really impaired

because she couldn't actually.

336

:

see how how much she deteriorated.

337

:

So then I realized that her

conversations were actually all the same.

338

:

And she couldn't tell me that,

she couldn't tell me what she

339

:

had for dinner last night.

340

:

She couldn't tell me when

she last saw the doctor.

341

:

She couldn't tell me what

she was doing next week.

342

:

And I actually think that That

if those daughters spoke with mum

343

:

six months prior, her admission

would have gone a lot better.

344

:

So what happened was this lady was

moved into hostel without her agreeance

345

:

to it the daughters were power of

attorney, they could do all that and

346

:

mum would, run out of the facility

because it was not locked facility.

347

:

And so she was putting herself in

more risks because she was trying to

348

:

go back into her hostel and she was

like, not packing her bags, leaving.

349

:

It was really stressful.

350

:

And the daughters would

be beside themselves.

351

:

Mom was really upset.

352

:

And so, Unfortunately, in that

case, this person missed out on an

353

:

opportunity to live in a hostel and

assimilate with other residents and

354

:

ended up moving into a secure unit.

355

:

So I think that sometimes when things

get too far and too complicated, it's

356

:

more stressful for all parties and not

having everyone on the same page can

357

:

result and look, I'm not trying to get

your listeners upset but it can result

358

:

in the older person then deciding that.

359

:

The only way they can, assert themselves

is by refusing to eat, refusing

360

:

to shower, feeling that that's the

only thing that they can control.

361

:

And this is why I think it's great that

we're doing this episode and I'm hoping

362

:

that your listeners, that they're not

quite at that stage, whether it's early

363

:

or on, and that they can communicate

with their loved one about, no, these

364

:

are the risks, with you being at home.

365

:

Involving the medical team, as

I said, like talking to GPs,

366

:

making appointments, getting more.

367

:

team approach to this.

368

:

So it's not just about, Hey,

I'm the daughter who wants to

369

:

move my mom into care, that the

concerns are across the board.

370

:

And so that the older person can

see that the safest option for them

371

:

and their health at that point of

time is supported accommodation.

372

:

And I think that more we can preempt

those discussions and involvement.

373

:

The better outcome it can be for,

for all parties, but it's so hard if

374

:

we just ignore it for so long ago.

375

:

Oh, we're not going to talk about it.

376

:

And the older person's health declines,

then, they don't want to go, they

377

:

don't realize, and they can't see

that actually that there are any

378

:

benefits for them moving into care.

379

:

Coral: it's so interesting.

380

:

What you've just said is kind of

like what I say when I'm talking to

381

:

people about accepting in home care.

382

:

And I always say preparation is key, and

don't leave it until the crisis happens.

383

:

So, uh, what I'm hearing

loud and clear is.

384

:

have those conversations earlier

and it's not just one conversation.

385

:

It's a number of, gentle and

compassionate kind of conversations

386

:

that, that will lead you.

387

:

And when that point, when that

situation makes itself clear, it's

388

:

not a surprise, to the older person.

389

:

And it's like, Hey mom, I think we

might, might've reached this point.

390

:

We've talked about this for the last

six months for the last year, not

391

:

dissimilar to advanced care planning

or, having an AHD and advanced health

392

:

directive is, talking about it and,

understanding what the person wants.

393

:

And then when you reach that point, it's,

I think it's probably an easier step.

394

:

But look, even if you, like looking

upon my own situation with my mum,

395

:

and we kept dad at home, with his

dementia and, he died at home.

396

:

And for me, I would love to keep mum

at home, but I still acknowledge that,

397

:

my mum's getting a lot of support

right now and, my sisters and I are

398

:

at the point where we actually can't.

399

:

give any more support.

400

:

We have a private carer coming on top of

her home care package, support workers.

401

:

And I know that at that point where, and

again, I'm, I'm very positive and I, I

402

:

look at the positive aspects of whatever.

403

:

That, I would feel some guilt and some

sadness about helping mum make that

404

:

transition into residential accommodation.

405

:

So is there, people ask,

ask us this as well.

406

:

Is there, and I know you work

in this space and certainly your

407

:

website titled Wise Care will be,

in the show notes of this episode.

408

:

But is there support out there for.

409

:

Family spouses, adult children to debrief

to talk about this to help them, kind of

410

:

come to terms or accept that it's okay

that, mom or dad have reached this point

411

:

need to go into residential accommodation.

412

:

Julie: there is a lot

of support out there.

413

:

And I think that sometimes it's

hard for people to know where to go

414

:

and where to find help and support.

415

:

And.

416

:

Sometimes people might think that

they don't have time for support,

417

:

they don't have money for support,

they don't have energy for support,

418

:

that they don't want to unpack it.

419

:

Sometimes there could be issues, from

earlier on in their life and that

420

:

they feel maybe mum or dad helped

them so much earlier on and that,

421

:

that, they just can't process that

emotionally at that point of time.

422

:

There are associations.

423

:

Relevant to different diseases like

Parkinson's Association, Alzheimer's

424

:

Australia, or Dementia Australia, or

there's, Dementia Support Services.

425

:

There's different agencies, but I

think, Coral, what's really important

426

:

is for the family member to take

a step back and just to think what

427

:

is their gut feeling telling them.

428

:

at that point of time that

would help them the most.

429

:

I think that, and I've been talking

about this so much this year, just

430

:

to go, what would help me right now?

431

:

And sometimes it might not be

connecting with other people who

432

:

have a loved one, who has dementia.

433

:

Sometimes it might not be

necessarily about talking to

434

:

others, who moved into aged care.

435

:

Sometimes it's just, I just want to

be seen and heard and understood.

436

:

And it could be about, reaching out

to a counsellor and, and having some

437

:

counselling sessions to debrief.

438

:

Sometimes it could be like,

you know what, I, I really,

439

:

just need to look after myself.

440

:

I'm going to pick up swimming

again and I'll start doing my 10,

441

:

000 steps a day, but just seeing

what actually works for you.

442

:

Cause not everyone needs to

necessarily reach out for help.

443

:

for psychological support.

444

:

Some family members might be experiencing

burnout and maybe they're not

445

:

sleeping well, they've got insomnia.

446

:

And so once we fix those issues,

they can actually feel better.

447

:

So there's different supports available.

448

:

I know that Flinders

University offers free support.

449

:

I know that also there's support through

I will put Swinburne University down

450

:

in Victoria, they offer telehealth

for residents of aged care, but

451

:

also for families and for workers.

452

:

So that's free confidential counseling.

453

:

A lot of families can also just go to

the GP, get a mental health care plan

454

:

and connect with a local psychologist.

455

:

Doesn't mean that you have to

have anxiety or depression.

456

:

Carer burnout is real.

457

:

And if you want to talk to

someone, you can do it that way.

458

:

There's lots of Facebook

groups that you can join.

459

:

If you want to connect with

another, it's not going to.

460

:

Fix your personal problem.

461

:

So I think it really depends on

what is the person struggling with

462

:

most at that point of time and

approaching it from that point of

463

:

view, like what would help you most?

464

:

What outcome would you love most?

465

:

Is it about, Connecting with others,

is it about finding time for yourself?

466

:

Is it about, treating, if you have

sleep disorder, if you have you know,

467

:

if you're feeling really stressed

and overwhelmed, how can you create a

468

:

healthy pathway for your own wellbeing?

469

:

It's just, teasing apart what's going on.

470

:

I don't want everyone to think,

Oh, I need to see a psychologist

471

:

or I need to speak to someone.

472

:

It really is so individualized.

473

:

Couple of nursing homes that I've

visited in Sydney, they did have monthly

474

:

meetings for the families as well.

475

:

And they found that quite

beneficial and useful.

476

:

It might work in some cases,

but in some, it might not.

477

:

So it really depends on what's

going on for the individual.

478

:

Yeah.

479

:

Sorry.

480

:

I hope that's helpful.

481

:

I guess it really depends.

482

:

Coral: Yeah, it does.

483

:

Look, it's, it's obviously individual

and case by case and what works for

484

:

one person or what one person is

seeking is not going to be what the

485

:

next person needs or wants as well.

486

:

So certainly a tough situation, but

I think, I agree with you there, I

487

:

guess you have to reflect on what

it is you're seeking and, source

488

:

what's going to be most appropriate

to your personal situation.

489

:

Julie: Yes,

490

:

Coral: what about thee?

491

:

older person themselves?

492

:

Like, that's, a huge life change.

493

:

Well, for some people, if, they've

been talking it through and the

494

:

older person acknowledges its time

and makes the move, that's probably

495

:

going to be positive experience.

496

:

but, people who have been resistant

to that, perhaps they've been in that

497

:

crisis and they've gone from hospital

to residential care is very traumatic.

498

:

Uh, and you know, It's a space I've

mentioned this that we don't work in,

499

:

but what we hear from people is, anxiety

and then mood disorders, depression,

500

:

what could be available to an older

person to help them, adjust or accept.

501

:

That big situation because I just

can't think of anything more, kind of

502

:

traumatic, I use that word, but you

know, from, having an event, perhaps

503

:

it's been a significant fall and going

to hospital and then going from hospital

504

:

into residential care, like, so big.

505

:

What, could support the older

person in that situation?

506

:

Julie: Look, we know that people in

residential care are at higher risk

507

:

of developing poor mental health.

508

:

And research indicates that up to 50

percent or one in two would experience,

509

:

symptoms of depression and anxiety.

510

:

Anxiety is a lot more

common than depression.

511

:

And we know that physical health can

definitely impact how a person is feeling.

512

:

So, What can help all the people when

they move into care is really connecting

513

:

with others, not isolating themselves in

rooms, organizing, for family when they

514

:

come to see their loved one, to take

them out of the room, do the visit on

515

:

the balcony, go out in nature, look for,

what's on the program for the day, can

516

:

family help and facilitate that so that

the older person is not spending prolonged

517

:

times in isolation, By themselves.

518

:

What we know is that the more

the person is isolated, the worse

519

:

their mental health will be.

520

:

Antidepressants alone are not

going to fix, how a person

521

:

feels if they remain isolated.

522

:

We've learned through

COVID just how deadly.

523

:

The impact of isolation and with is

an older people and all age groups,

524

:

how much we all struggled being

physically removed from others.

525

:

So I think that just looking for

opportunities, what would help an older

526

:

person have meals out of their room,

connect with others, join activities.

527

:

Go on outings would definitely

improve their well being.

528

:

And I know even last week when I

was in an aged care facility, an

529

:

elder said to me, Oh, but you know,

like I'm so comfortable in my room.

530

:

And I said, I know, but I want you

to be a little bit uncomfortable.

531

:

I want you to feel something a

bit different because, you know,

532

:

her son visits her every every

week and they always sit in that

533

:

room and, they just chat away.

534

:

And it's like, well, yes, I know

that, you're really comfortable with

535

:

it, but you know, there's horses in

a paddock next door to the facility.

536

:

Go and look at that.

537

:

It's spring.

538

:

So many trees are flowering right now.

539

:

Come and experience that.

540

:

There's not so much you can do

in air conditioned room, and I

541

:

think that physically moving to,

Uh, looking at nature is good for

542

:

her health because she's moving.

543

:

She, blood is flowing through her body.

544

:

She's got something new to talk about.

545

:

She's got, come across staff and

other residents to say hello to.

546

:

and I think that the more we help.

547

:

Older person assimilating that

environment, the better outcome

548

:

that will be for them as well.

549

:

Coral: They're fantastic tips.

550

:

So simple, hey,

551

:

Julie: Yeah.

552

:

Coral: and achievable.

553

:

Julie: Over, we overthink them and we

think we don't have time, we don't have

554

:

money, but I think that, yeah, like

the more we come to attention of stuff

555

:

and go, Oh yeah, this is what we like.

556

:

Yes.

557

:

I'd love to do it.

558

:

Do bingo, do exercise or

something like, that we can do it.

559

:

And the family knows their loved

ones so much and they know what,

560

:

their worries and anxieties are,

maybe there'll be like, Oh, initially

561

:

I don't want to join dining room.

562

:

It's too noisy.

563

:

There's too many people.

564

:

But if they form friendships with

people at their table next time,

565

:

they'll invite them, come on,

time to come to the dining room.

566

:

So just looking for little things like

that and having family support and

567

:

guide that process can help so much.

568

:

Coral: Julie, I'm a person that,

has a very positive and encouraging

569

:

kind of approach to aging and aging.

570

:

Well, and I'd love to

conclude this episode.

571

:

On that positive note, can you recall

perhaps a family, a situation where

572

:

there was some resistance and it was

difficult for the family supporting mum

573

:

to move into residential accommodation

and then actually, it turned out okay

574

:

and it became a positive experience

for the older person in the family.

575

:

Julie: Oh, I have so many

positive stories, Coral, and

576

:

not just moving, in dad as well.

577

:

There's been.

578

:

I can think of several cases.

579

:

I can, one specific one where, this lady

was a little bit hesitant about coming in

580

:

and if, she would be okay with food and

if she'd be comfortable with her room.

581

:

And I really encouraged the daughters

to come in and look at the, program

582

:

of what was going on in facility, help

mom, join those activities, even though

583

:

there was a little bit of resistance.

584

:

And that lady just.

585

:

adjusted so well because it was

done so well and collaboratively.

586

:

She was reassured by staff.

587

:

And so she took great pride in how

she dressed and what she did each day

588

:

and she made really great friendships.

589

:

And I know that when I was writing

my, first book, I referenced her a

590

:

lot in the book because it was really

helpful to see just, from someone who

591

:

was getting so upset and disappointed

about the move to actually making

592

:

some amazing friendships in that.

593

:

Facility connecting with others because

the reality for this lady was when she

594

:

was living at home, she was becoming more

and more isolated and she didn't have any,

595

:

friends that she could see and talk to.

596

:

And she just got a completely new

lease on life and she started making

597

:

beautiful cards and then she actually

became part of the welcoming committee.

598

:

So when other residents moved

into care, she was the one who was

599

:

actually helping them adjust as well.

600

:

And I think that that's really,

a great example of how that

601

:

collaboration and working together.

602

:

Not only help that family,

but help so many families, as

603

:

Coral: That's a fantastic story.

604

:

I love that.

605

:

Julie: There you go.

606

:

Maybe your mom could, become

part of the welcoming committee

607

:

if she ends up in care.

608

:

Coral: know, you've all, you've already

made me feel a little lighter, actually,

609

:

about, should this time come for my mum

and should, we all realize we're at that

610

:

point just in, in that case that you

said, I do actually feel, better about it.

611

:

So thank you.

612

:

So supporting an older loved one

move from their own home into

613

:

residential accommodation is a task

that often takes an emotional toll

614

:

on all family members involved.

615

:

Sometimes the move can be planned when

the older person themselves acknowledges

616

:

it's time to make the move, but more

often this significant life change is

617

:

done during a crisis when there's been a

big change in the older person's health.

618

:

Such as a series of falls

resulting in a hospital admission.

619

:

In a perfect world, we'd all be

having these conversations with

620

:

our older loved ones well in

advance of the situation arising.

621

:

But it doesn't happen like

that for many families.

622

:

Mum and Dad can be very resistant

to leaving the family home and

623

:

moving into supported accommodation.

624

:

Julie, you've given our listeners

some fantastic advice about how to

625

:

approach this kind of conversation.

626

:

If anyone wants to follow

up with you, is this okay?

627

:

Julie: Absolutely.

628

:

No problem.

629

:

More than happy to be

connected with your listeners.

630

:

Coral: Wonderful.

631

:

Well, look, we will have, your

contact details in the show notes.

632

:

and certainly, I imagine, I think

your book is on your website as well,

633

:

Julie: Yes.

634

:

So I'm just finishing with the

editor is my second book beyond

635

:

unexpected changes in late life.

636

:

So that covers residential

and community care.

637

:

My first book about residential

care is on my website.

638

:

So if you just share the link to wisecare.

639

:

com.

640

:

au, that would be much appreciated.

641

:

Coral: Absolutely.

642

:

And congratulations.

643

:

it's such a big task, publishing a book.

644

:

And here you are about to

publish your second one.

645

:

So congratulations on that, Julie.

646

:

Julie: Thank You.

647

:

Coral: thank you for joining us today.

648

:

It's been an absolute pleasure

having you on the show

649

:

Julie: Thank you, Coral, for having me.

650

:

Coral: listeners until next week.

651

:

Take care.

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