To Visit or Not to Visit…

 “When should I visit my loved one in a Memory Care Community? 

Senior providers often ask “What is the best way to ease the transition?” Generally, there are two schools of thought when it comes to the initial visit to Memory Care. 

The first practice is to have no visitation for a period of time, 3-5 days or more. This allows the person to adjust to the community, bond with the staff, and get used to the routine. This will prevent the family from seeing their loved one distressed and wanting to go home. It also gives them a much-needed break without the guilt. 

The second practice is to begin building a relationship with the individual prior to the move and letting the family and loved one set the visiting schedule. This allows both the person and the family decide what feels comfortable and gives the resident a sense of security and trust. It removes the feeling of abandonment and reduces anxiety.

Let’s look at these practices in the following case studies. 

Case Study 1

Sam has been living alone with a private duty caregiver for two years. His daughters have decided that Sam now needs Assisted Living. They know their father is going to be angry. They did all the homework and found a place that they believe will be the best community for him. He has short-term memory loss and will not remember if they tell him he is moving. So they wait until they get to the community and have the professionals tell him he is staying. They are following the first practice of not visiting for a week. 

The staff does well introducing Sam to other residents, and he has a good day… until the sun goes down and he wants to leave. The staff attempt to redirect him but he does not know who they are and is getting anxious. 

They explain he is here to see the doctor and that the doctor will be here in the morning. He immediately says, “Ok, I will be back in the morning. Let me call my daughter, I want to go home”.

Either the staff do not let him call his daughter, his daughter doesn’t answer the phone, or worse, the daughter says “Dad I will see you in the morning.”  

The staff redirect him with a beverage, and he sits down seeming ok. This occurs until the daughter visits. 

How is Sam feeling?  If the staff didn’t let him call his daughter, they are violating his rights and he will feel trapped. If the daughter doesn’t answer the phone, then he feels abandoned. If the daughter says she will be there in the morning, whether he remembers or not, he is being lied to. How does that provide a caring, trusting bond with the person? How does that establish a routine?  What will come next? 

Case Study 2

Barbara moved to an Assisted Living community. After two weeks, the community was requiring a private duty nurse because Barbara would not sleep and was uncomfortable in the community. She eventually moved back in with her son.  

Another community was recommended and they contacted the director who came out to meet with Barbara. They had a joyful visit. They talked about gardening, and Barabra’s travels, and enjoyed drinking an iced tea. At the end of the visit, the director invited Barbara to visit her and have lunch. 

The following week, the director selected two ladies to join her for a luncheon where they had a lovely time. Afterward, they had a music event and sat together. The director introduced her to several of her friends. They decided this would be a great fit for Barbara and began to make a move-in plan. 

The director and the son decided they’ll have the doctor tell Barbara that he thinks she should make a move. The son will then tell her she can try out the new community for a trial stay. They set a move-in date and had an agreement that the son will visit late afternoon the following day. 

During the evening of the move-in, the staff helped Barbara call her son. He provided reassurance that she is going to be ok and he would see her the next day. The staff wrote a reminder for Barabra that her son would be visiting tomorrow afternoon. 

Barbara most likely won’t remember the visit from the director, the luncheon, or the doctor's recommendation. She will, however, feel comfortable because her surroundings feel comfortable and safe. The staff allowed her to call her son, the son was truthful about his visit, and the doctor recommended she come to stay there for a while. All of these steps together helped to build a trusting relationship. Barbara still wanted to go home, however, her anxiety was reduced by conversations with the staff and an established routine that reflects her preferences. She also had a connection to her son through the phone and his visits to alleviate feelings of abandonment. 

Two scenarios, two different results. 

Think about if you were the person who had to move into Memory Care. You don’t know anyone. You're scared because you can’t remember why you are there and the community feels strange to you. Would you want to see your family or be able to call them?

Final Thoughts 

No one ever wants to move into Memory Care or Assisted Living. It should be expected that there are going to be feelings of distress and wanting to go home. There will be a lot of redirecting and repeating. Therapeutic fibs are a good way to redirect if it’s appropriate for the cognition level. The goal is to respond to the emotion, support the person, and recognize their feelings.

Remember it isn’t about what is easier for the family members or the staff, but what is best for the resident who is making the change.