Still Caring: Supporting Older People in Residential Aged Care

By Lyndis Flynn and Margaret Shelton

Still Caring shows the many ways in which families or friends can provide continuing support to elderly people in residential aged care facilities, and how important this is. Such ongoing involvement in an elderly person's life in care can help to make it as comfortable, happy and fulfilling as possible.
Self-care is also discussed, along with practical ideas about how Carers can look after their own well-being as they continnue to provide support to others.
This book was completed while Australia's Royal Commission into Aged Care Quality and Safety was investigating widespread concerns about the industry. At the same time, the COVID-19 pandemic also highlighted the vulnerability of elderly people in residential aged care.
Like many others, the authors had a strong desire to enhance the lives of aged care residents and were driven to record their thoughts and offer suggestions for possible improvements.
Written by two retired social workers with relevant personal and professional experience, Still Caring is an informative and insightful read for anyone, anywhere who is supporting an elderly person in residental aged care.

• Language: English
• Publisher: Brolga Publishing
• Release date: Mar 1, 2023
• ISBN: 9780645586480

Book preview

CHAPTER 1

EARLY DAYS IN RESIDENTIAL CARE

The Relative’s Move Into Care. Visiting. Giving Information to Staff. Learning How Things Work. Coping With Strong Emotions. Carers’ Self-Care.

THE RELATIVE’S MOVE INTO CARE

Many relatives will approach entry into residential aged care with some sadness, fear and anxiety, knowing they are entering the final stages of their lives.

While moving into a residential aged care facility is a major life event for the person moving, it is also a major life event for those who are close to them, such as a daughter, son, partner, wife or husband.

It is generally understood that moving from one place of residence to another involves much preparation and work. A relative’s move into residential care is not only stressful for them, but is also a particularly stressful and busy time for their Carer, who has usually been involved in much of what precedes it.

Some relatives enter permanent residential aged care following a short period of respite in a facility, often used as a trial to see how it works for them. For many others, their move happens after an often very lengthy and difficult decision-making period. Either way an admission into care involves considerable time spent in information gathering, completing detailed application forms, having financial consultations and assessments and application interviews. This preparation for admission to care is often physically, mentally and emotionally exhausting for all those personally involved and can sometimes cause family conflict over decisions made, which adds to any stress already being experienced. The whole process can be drawn out or rushed, depending on circumstances.

When the move is completed, the relative and the Carer start a different phase in their lives, where there is much that is changed.

Like other beginnings there is a sense of loss and of having to face a future with new challenges. For example, a Carer is still a husband or wife after their partner moves into care, but other aspects of their former role change immediately. Both the Carer and the relative are likely to be unsettled and experience similar strong feelings or emotions such as anxiety, grief and sadness.

Despite having completed the many practical tasks involved in the moving process as well as all the caring that preceded the admission, after the move has taken place Carers might see themselves as not doing much for their relative that is meaningful. Apart from visiting and helping the relative to settle in, they might feel somewhat redundant and think that the most valued aspects of their Carer identity have been relinquished to the aged care facility. They might also feel less confident and somewhat unsure about what their changed role is going to be. This is not at all surprising, considering that it is early days for them as well as for the relative.

However, when a relative enters aged care there are many opportunities for Carers to continue with their support, which can make such a positive contribution to their relative’s quality of life in the new setting.

It will become apparent that right from the ‘early days’ Carers are often doing many caring tasks, including some new and different ones, and by so doing are forging a new Carer identity for themselves.

VISITING

From the beginning of the relative’s life in residential aged care, Carers usually willingly commit to being an ongoing visitor. Many Carers instinctively know the benefits that both they and their relative will gain from this. Their visits are very important and meaningful for both the relative and themselves, as both adjust in their own ways and at their own pace to the changes in their lives.

Carers may initially feel unsure and anxious about when and for how long they should visit and it can be difficult to gauge what visiting schedule is best for the relative as they settle in. Carers can try to establish a visiting pattern that suits both their relative and themselves, as well as the facility. They have a lot of freedom to choose the frequency and length of their visits and don’t have to stick to one visiting routine.

Even if Carers’ visits are lengthy and frequent, the time they spend with their relative may still not seem significant when compared to the time they may have spent with them previously. However, extra travel may now be involved and visits may sometimes be very emotionally and physically draining, especially for the Carer.

Such factors and others specifically related to the Carer’s situation, need to be taken into account when Carers make decisions about their visiting in the early period of their relative’s residential care.

GIVING INFORMATION TO STAFF

Understandably Carers want to pass on their wealth of knowledge about their relative to staff whenever they are given the opportunity, particularly during this early stage. Carers are usually keen to ensure that all relevant information has been given to all the necessary staff and is linked right from the beginning to good and personalised care practices. Some Carers might become impatient and irritated when this does not appear to have happened as they would have expected or liked. Their response of annoyance could be driven by their strong desire to ‘protect’ their relative and demonstrate their own past Carer competency to the staff. However, the way matters such as this are handled by Carers can influence their future relationship with staff.

If Carers are respectful and show a willingness to see themselves as becoming part of a caring team with the staff – a team aiming for quality care and a smooth transition from the relative’s former home to their new home – it can be very helpful to all concerned. This concept of being a team and the need for time to develop a sense of belonging to the team, can be a shift in perspective for Carers, but it is encouraged as it can reap many benefits for everyone.

LEARNING HOW THINGS WORK

While a Carer has a wealth of information about their relative, they usually have limited information about the residential facility and the staff. It takes time and effort to learn about the facility’s layout, parking, day to day routines, practices, activities, policies, staff names and responsibilities and so on.

Much can be learnt from direct observation and simple enquiry, enabling Carers to build on their existing facility knowledge.

This Carer orientation and learning, which is often self-initiated, is not necessarily as fast, or as straightforward, as might be expected. Aged care facilities share similarities as well as some differences with other health organisations such as hospitals, and each facility is uniquely different.

The assistance given by staff to Carers as they learn will vary in different facilities. Facility staff can come from a wide range of backgrounds and cultures. Generally they are aware of the importance of the Carer to the relative and know building good relationships with Carers as well as the relative is valuable to them. Staff usually respond positively, when they see that a Carer is trying to learn about the facility, its staff and their individual jobs. Most staff are helpful to Carers who are patient, respectful and courteous to them. However, there could well be times when this is not the Carer’s experience. As stated above, Carers may find at times that staff do not communicate or interact with them in a way they would like and were expecting. This can be disappointing and frustrating, especially in the settling-in period, when Carers may often feel extra-sensitive and unsure about staff expectations of them. Responding to staff with patience, understanding and a belief that things will improve, can be one way to cope with this, given it is a time of loss and adjustment.

In any aged care facility staff will usually have had some good as well as some poor experiences with Carers and their relatives. Some Carers and relatives can be rude, demanding of staff, critical and quick to complain without always understanding the context and facts of whatever the problem is. Some request or want to give information at times that are inconvenient for staff. Some require lots of information and others little. Some like to be helpful and friendly to staff, while others prefer to keep their relationship with them more distant and formal. In these early days the staff are also learning about the relative and the Carer, with their main focus being on the former. If Carers are aware of this as well as the time and resource pressures on staff, it may help to manage their own anxiety and frustrations, which can surface as they try to absorb and adapt to all the new information and