The Emotions Involved in Choosing Long-Term Care Dr. Patrick O'Shea

Last year Living Longer, Living Better A walk through the health care system

This year How to know when the time is right to accept Long-Term Care Emotions you will experience when making that decision

"Long-Term Care" Nursing Home, Assisted Living, Personal Care Home Anywhere outside your home

My own experiences plus a book: "Living Well in a Nursing Home" by Lynn Nickerson and Xenia Rosen

WHY DO WE DREAD THE THOUGHT? old memories of "poor houses" poor people, ones with no families most people looked after at home by family

"Good" sons and daughters wouldn't put their parents away

Nursing Homes are institutions easy to criticize not all equal

Why greater need for Long-Term Care? societal changes

People Live Longer In 1900 the life expectancy was 47 Now it is late 80's

Less Deaths from Pneumonia, Fractured Hips, Heart Disease

Families more mobile, not all relatives in same village not as many children

Women's roles have changed not as available for caregiver role

Expectations are that our children will most likely NOT look after us in our own homes

If you live long enough, almost all of us will need Long-Term Care

TWO OVERALL ASSUMPTIONS 1) You are responsible for your OWN level of happiness You are not responsible for the happiness of your spouse, parents or children and they are not responsible for your happiness

2) In your relationships with your loved ones, you would prefer to be a "Love-Giver" and not just a "Care-Giver"

"Care-Giver" - attends to a person's physical and comfort needs "Love-Giver" - attends to emotional and relationship needs

Roles are not mutually exclusive - it can be an act of love to be a care-giver

Danger in exhausting oneself being a "care-giver" and have nothing left for the important task of "love-giving"

Sometimes better to delegate care-giver tasks and use your energy for the love-giver role

DECISION TO ACCEPT LONG-TERM CARE not a lot of planning - sudden change prefer not to think of need we plan for the other significant changes - wedding, buying a house, changing jobs

Change can be stressful How much stress depends on: expect or surprise viewed as "good" or "bad" how much control we have over change how much support we have from others

Shakespeare: "There is no thing either good or bad, but thinking makes it so"

A lot of stress from change is in our minds Positive outlook can help Is the glass half-empty or half-full?

Long-Term Care is big business expansion in last 40 years many new models, more choices

For many, accepting long-term care may be the BEST choice

CAN YOU STAY AT HOME? Depends on: medical condition strain on people at home need for community economics

Medical Condition Diagnosis? Around the clock care? Equipment needed?

Strain on people spouse, children - what support do you have? energy level of people at home

Need for Community Amount of social support each person needs is variable Participation in community gives sense of belonging, importance, meaning No one person can fulfill all social needs of another Many situations at home are akin to solitary confinement

Economics services not covered by MCP or insurance home care workers around the clock? - $16/hr = $384 a day or $2,688 per week nursing home = $3,500 a month

EMOTIONS feelings can be difficult to understand

CONFUSION about what to do - many conflicting options and opinion

DESPAIR if no matter what you do, someone will be unhappy no obvious "best" choice many need to get counseling with someone outside the situation to avoid depression

HELPLESSNESS if offer of help is rejected; common in dementia issues

HURT from rejection of help, lack of appreciation

WORRY can make you depressed, diminish your energy many need counseling, exercise, meditation

ANGER is common - at God, at doctors, at patient, at family needs to be handled carefully - can be destructive

LONELINESS

RELIEF perfectly normal and natural reaction to resolution of a stressful situation

GUILT combination of shame and regret many of us feel guilty even if we haven't done anything wrong we aren't responsible for the happiness of others - it's up to themselves

SADNESS inevitable acknowledge your sadness, cry, feel the pain it will pass

RESENTMENT from patient, from family members frequently suppressed - can lead to anger and depression needs to be expressed in controlled manner

Sorting out emotions can be difficult Usually a combination of several contradictory feelings Everyone's emotional soup is unique

Summary It is difficult to make the decision to accept Long-Term Care Planning can make it easier Be a love-giver, not just a care-giver If emotions are overwhelming, get help