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Caring for Parents in a Long-Term Care Facility
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Ruth Goodman, MSW, Baycrest Centre

When your parents are Survivors, and if their frailty and dependencies increase, you may be profoundly affected by the ongoing struggles and determination they exhibit. As a child of Survivors, you may be dealing with an entanglement of losses, witnessing the gradual loss of physical and cognitive capacity of your parents. Diminished cognitive capacity is a profound loss, as shared memories, stories, and anecdotes are an integral part of all relationships. If these become fragmented, new ways of being together are needed.

The loss of independence that usually precedes and follows admission to long-term care can be a devastating blow. The decision to place a parent is difficult for any family, but for children of Survivors these difficulties are especially profound and complex. Often adult children make commitments to themselves and/or their parents which, when faced by the realities of aging and illness, they find themselves unable to keep.

Admission to a long-term care facility should not be seen as a failure. When it is the only option, you should know you are supporting your parent(s) to the best of your ability. That is all any child can do.

Dealing with a parent's frailty and incapacity may trigger adult children to recall their parents' experiences during War years. Their resilience, fortitude, ingenuity, anguish and their losses are all remembered. Layered on top of this are the struggles, achievements, and losses of the post-War years. As a child of Survivors, you may be dealing with multiple layers of loss, and depending on the nature of your adult relationship with your parent, you may be able to find ways of understanding and responding that support the integration of all these realities.
Providing intimate physical care to one's parent offers opportunities for healing and closeness that can be deeply felt by both. As the losses of aging increase, emotional processes are altered. One's sense of one's body changes, and Survivors are often not able to express those feelings. Physical closeness with your parent can be a healing experience. There is comfort and satisfaction that you are needed and loved, that you are involved in the daily fabric of life. Mixed with the emotional pain of seeing our parents' abilities fade is the comfort of knowing that you have shared those moments, that you were there for them, and that you have provided assistance.

Children understand their parents' need for and reaction to care different ways. For some, instances of resisting care may remind the children of the degradation and pain of the concentration camps. For others, issues around food and intake hold great symbolic weight. Rational thought is often insufficient in trying to problem-solve these situations. The spectre of starvation, malnutrition, withholding and deprivation are some of the strong emotional reactions you may be faced with as your parents' capacities diminish.

With admission to long-term care, you may feel overwhelmed by more recent losses, as the losses of the past recede and others are felt more acutely. After all that your parents have already endured, these current losses seem unfair. Because your parents are dependent and vulnerable, it is understandable that you want them to receive the respect, gentleness and support that they deserve.

To help staff provide the most sensitive care, you can share your parents' family history and stories. Try to capture, validate and remember the core of their personhood, their life-long struggles and their accomplishments. As much as possible, become part of the care team. Work closely with staff, advocate for your parents, and provide as much physical and emotional support as you are able. Remember the importance of caring for yourself during this potentially draining time.
Suggestions for Visiting Parents in Long-term Care Facilities

It is never easy to visit a relative in a hospital or long-term care facility, where you are inevitably reminded of better and healthier times. In many cases, families can enjoy reminiscing during such visits. But such healing conversations may not be possible among many Survivors and their families. This is especially true when dementia is a factor. Visits may be even more painful, as past and present get confused and the resultant guilt and pain become exacerbated.

Here are some suggestions that might make visiting more pleasurable for all family members.

Some Activities to Enhance Your Visits
  • Go for a walk of the floor - visit the gift shop, or go outdoors if possible.
  • Do some gentle stretching or range of motion exercises. Consult with the physiotherapist/occupational therapist for instruction.
  • Attend recreation programs together.
  • Listen to tape-recorded music brought from home. Add a variation by playing "Name that Tune".
  • Sing songs together, even if they are a little off-key.
  • Bring in a pet to visit, in accordance with the facility's policy.
  • Children add joy to a visit. Ask them to bring some of their favourite toys to share with your relative.
  • Read a book, magazine, short story out loud. Talking books (books recorded on audio tapes) are also an option.
  • Bring in a joke book and have a laugh.
  • Bring in books of photographs, which show various countries, familiar personalities or outdoor scenes.
  • Bring in family photo albums and reminisce.
  • Read "Dear Abby" newspaper columns and discuss what advice you might give.
  • Explore the day's newspaper.
  • A new manicure is easy to do; for mothers or grandmothers, a fresh coat of nail polish might be appreciated.
  • Test out new perfumes and aftershaves.
  • Pamper your relative's hands by massaging them.
  • Try a new hairstyle with hair spray, curlers and other accessories brought from home.
  • Try doing an arts and craft project together - knitting, crocheting, painting etc.
  • Bring in fresh flowers and make a floral arrangement.
  • Care for plants, or plant an indoor bulb and some seeds and watch them grow.
  • Sand wood blocks and paint them.
  • Play a board game or a game of cards.
  • Attend an outing together - either one planned by the facility or just with your relative. Discuss plans with the staff - for example, a trip to a restaurant for lunch, a few hours at the mall or an outing to the park during warm weather.