Care and support - Housing options - Preparing to move into a long-term care home

It is a good idea to prepare for your move in order to reduce your stress. Preparing early will also help you to have more free time to spend with your family and friends after you move.

One suggestion is to complete a 'life story' or a 'personal care book'. A 'life story' or 'personal care book' is like a biography and can be very simple. You can include:

• Photos
• Your characteristics
• Your likes and dislikes
• Your accomplishments
• Major life events (both happy and sad)
• Memories
• Experiences that have made you the person you are today

This book can be given to the staff in the long term care home so they can get to know you better. This will help your care team to better understand your needs. You can also use the All About Me resource from Alzheimer Society Canada. 

Source: The information above was adapted from Mobile Interprofessional Coaching Team (MICT): Focus on Seniors Mental Health. (2009). Preparing for the move into long-term care; "A Checklist", in Living with Dementia: a Guidebook for Families. Kingston, Ontario, Canada: MICT.

It is helpful to gather all important documents together before making the move. If you find this an overwhelming task, have a family member or friend help you. It is important for you or your care partner to ask the director of care or administrator of the long term care home about government subsidies that may cover the cost of your basic accommodations. Other documents you should bring with you or ensure your family partner in care has before you move are listed below:

• Power of Attorney for Property

  • This legal document appoints a person who can make financial decisions for you now, or in the future, if you are unable to make these decisions yourself.

• Power of Attorney for Personal Care

  • This is a legal document that appoints a person who can make decisions about your personal care (for example, medical treatment or where you live)
• Health card
• Banking information
• Personal identification
• Cheque book
• Insurance benefit information or veterans benefit information that may cover additional services
• Locate Notice of Assessment for Revenue Canada if your family member is applying for basic accommodations. Take this with you on the day of admission to the home.
• Money for the first month's accommodation. Inquire about the cost of extra services (telephone, cable, hair care and assistive devices)
• Prepare change of address notices for the bank, Revenue Canada, your pension, physician, place of worship, friends and family

Source: The information above was adapted from Mobile Interprofessional Coaching Team (MICT): Focus on Seniors Mental Health. (2009). Preparing for the move into long-term care; "A Checklist", in Living with Dementia: a Guidebook for Families. Kingston, Ontario, Canada: MICT.

As a care partner, what can I do to help cope with the transition of my family member into a long term care home? Preparing to move a loved one into a care home is never easy. It is important to surround yourself with people who you can talk to about your fears, feelings and concerns. Talk to family or friends. You can also consider joining a support group through the Alzheimer Society. There are many things you can do to cope with this difficult period including:

• Use a journal to write down questions or concerns that you have about the long term care home. Use this in your discussion with staff.
• Find out whether the long term care home has a buddy system that can connect you to a family member who has already been through the move
• Think about the kind of care your family member would want to receive. You will want to think about it ahead of time if these choices have not already been made by your family member in their Power of Attorney for Personal Care or 'living will'.
• Talk to your family, close friends and the attending physician about care choices
• Make a list of utilities that need to be cancelled after the move. You should also consider making a list of mail that needs to be redirected to the new address.
• Prepare change of address notices for the bank, Revenue Canada, your family member's pension, physician, place of worship, friends and family. Ensure that you also notify Canada Post of your change of address so that mail can be redirected.
• Find out information about involuntary separation for couples who live in separate locations. Involuntary separation is only for people who receive Guaranteed Income Supplement (GIS) benefits or those who receive Candian Pension Plan income. You can get this information from the long term care home or the Local Integrated Health Network.
• Arrange a transportation plan for the day of the move and decide who will help you on the day of the move

Source: The information above was adapted from Mobile Interprofessional Coaching Team (MICT): Focus on Seniors Mental Health. (2009). Preparing for the move into long-term care; "A Checklist", in Living with Dementia: a Guidebook for Families. Kingston, Ontario, Canada: MICT. 

Your experience on the day you move to a long term care home will vary depending where you go. Before you move, you may have been involved in a preadmission meeting where you would have been given information about when to arrive, what to bring with you, policies around labelling clothing and what personal furnishings you will be allowed to bring with you.

When you first arrive, the home will take you through the admissions process that will likely take several hours. During this time the following may happen:

• A staff person will meet you and take you to your room
• You will meet the director of nursing, who'll help you complete your medical and consent forms
• You will meet other residents
• You will meet members of your care team
• You will unpack your personal items and set up your room
• Arrange for phone, cable and Internet service
• You will meet with a dietary supervisor to discuss your dietary needs and be assigned a dining table
• Someone will review with you the safety and security features in the home

It will take time to adjust to your new home. For some new residents it takes six weeks, but for others, it could take several months. Families and friends play an important role in helping new residents settle in.

Source: The information above was adapted from Region of Peel Long Term Care Home. (July 20, 2010). Moving and Settling Into Our Homes 

Here is a list of items that you should bring with you when you move into the long term care home.

• The personal care book
• A list of clothing, belongings and assistive devices
• Copies of all the completed legal and financial documents
• Your calendar of upcoming appointments
• All of your current medication in the original labelled containers (including over the counter vitamins, herbals, or any other "pill" that you take, regardless of whether or not your doctor prescribed it). If the directions on prescription bottles do not match how you are taking a particular medication, be certain to make staff aware of this discrepancy.
• Advance care choices or copies of your wishes for medical interventions if you have put these into writing.

After your move, consider contacting some of your close friends and family. Moving can be emotionally and physically exhausting for you and for your care partner. It is normal to feel a sense of loss. Having friends and family around you will help with this transition.

Source: The information above was adapted from Mobile Interprofessional Coaching Team (MICT): Focus on Seniors Mental Health. (2009). Preparing for the move into long-term care; "A Checklist", in Living with Dementia: a Guidebook for Families. Kingston, Ontario, Canada: MICT.  

It is helpful for you, or your care partner, to have some questions prepared for your meeting with the care team. Below are some items to think about.

Physical health

What is my medical history and current health issues (e.g., walking, eyesight, hearing and sleep)? What do I need to support my physical well-being?

Intellectual ability

What is the skill I have regarding date and time? What are my abilities in terms of memory, speech, problem solving and decision making? What do I need to support my continued intellectual abilities and cognitive well-being?

Emotional well-being

Do I have strong feelings about certain life events or losses? Are some of my memories triggered by music, photographs or personal care? What do I need to support my emotional well-being?

Capabilities

How much help do I need with daily living skills (e.g., bathing, dressing, grooming)? What do I need to support my independence in these areas?

Social

The Personal Care book or life story will describe your likes, dislikes, happy and sad memories and life accomplishments. How can the home support your social needs? What activities or experiences are most meaningful to you now? What aspirations do you have?

Environment

What would make my new surroundings more comfortable for me? Is there anything in the home that will upset me (e.g., noises, lighting levels, temperature)? What do I need to feel safe and comfortable in my new environment?

Source: The information above was adapted from Mobile Interprofessional Coaching Team (MICT): Focus on Seniors Mental Health. (2009). Preparing for the move into long-term care; "A Checklist", in Living with Dementia: a Guidebook for Families. Kingston, Ontario, Canada: MICT.  

In about six weeks following your move, a care conference will help to bring you together with your family and the staff to share valuable information. Write down your questions and bring them with you to the care conference. This is a good opportunity to talk about your adjustment to the move with your family and the staff.

Other things to consider include:

• Is there anything that hasn't been done yet? For example, any items that were not moved to the home?
• Sending out change of address cards to family and friends to let them know you have moved and they are welcome to visit.
• Think about getting involved in the home's resident council.
• Take time to speak with a family member or friend about your transition to your new home

Source: The information above was adapted from Mobile Interprofessional Coaching Team (MICT): Focus on Seniors Mental Health. (2009). Preparing for the move into long-term care; "A Checklist", in Living with Dementia: a Guidebook for Families. Kingston, Ontario, Canada: MICT.

Visits from family and friends in the early days after a move, even if only for a short time, can provide valuable reassurance and support to the new resident. Also, visiting is essential to staying connected, now that you are no longer providing care on a daily basis. Visits can be as simple as sitting holding hands, listening to quiet music, or looking at pictures. Encourage your family member to meet other residents; maybe join your family member for a meal, or attend a group activity together. Make visits meaningful; give your family member an update on other people in your family. Even better, encourage other family members to join you for a visit.

Source: The information above was compiled from:

Alzheimer Society of Canada. (March 2010). Visiting someone with dementia

Region of Peel Long Term Care Home. (July 20, 2010). Moving and Settling Into Our Homes