Transforming Palliative Care in Nursing Homes by Mercedes Bern-Klug

Author:Mercedes Bern-Klug [Bern-Klug, Mercedes]
Language: eng
Format: epub
ISBN: 9780231132251
Barnesnoble:
Publisher: Columbia University Press
Published: 2010-02-12T00:00:00+00:00

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Identifying and Addressing Family Members’ Psychosocial, Spiritual, and Existential Issues Related to Having a Loved One Living and Dying in a Nursing Home

PATRICIA J. KOLB

For many families, it is extremely difficult to place a relative in a nursing home, and family members and residents experience many challenges. Stereotypes abound regarding families heartlessly sending older relatives to nursing homes and abandoning them, but reality repeatedly discredits these stereotypes. Nursing home placement is frequently a decision of last resort that is made only when family and community resources are inadequate for an older relative to remain at home safely (Kolb 2003). Other responsibilities and demands on time, money, and energy of informal caregivers, as well as gaps in formal care systems in the community, often combine to make community-based support systems inadequate to sustain an older relative safely outside of a nursing home in spite of relatives’ best efforts.

The resulting nursing home placement is often distressing for residents and relatives. Relatives may experience many psychological and emotional reactions, including grief, depression, guilt, and regret, during the admission and adjustment processes. Family members’ cultural expectations about multigenerational roles and responsibilities when a relative becomes chronically ill and older influence their reactions to placement. Reactions become more complex when relatives learn that the nursing home resident is terminally ill. Social workers must recognize that the involvement of relatives and close friends can bring important strengths to difficult situations because of the support that they can provide to the resident. Individuals who have long-term relationships with the resident can also provide information about earlier family experiences with health problems and decision making, as well as coping skills that have been developed by the resident and relatives.

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