Nurses deal with geriatric patients in a wide variety of settings. As common as in acute care hospitals, the care is usually extended to other institutional healthcare services, such as nursing homes, assisted living facilities, retirement communities and day care centres.

The transition to the new environment can be very challenging for the elderly, especially for older adults with dementia or Alzheimer’s. However, family members often choose nursing home placements rather than in-home care as the majority of cases involving serious patient conditions requires more intensive care from the staffs – often more than what family members and relatives can provide. Hence, as a nurse who cares for dementia patients, it is part of your responsibilities to help them with this transition phase.

Let patients be involved in decision making

Dementia patients, who are in a state of poor cognitive impairment, could be emotionally unprepared for their new transition. When communicating with them, be alert for signs of emotional disturbance such as the lack of eye contact, irritability and expressions of anxiety.

The nurse’s role is to provide information about the selection of a good nursing home based on the care needs of the dementia patient and support from family members. Though the decision to enter a nursing home is never a final choice, many elderly consider living in nursing homes as their final residence.

Find a nursing home that meets their care needs

In any form of dementia, the nursing management always considers the needs of older adults. Hence, finding a nursing home that best suits the needs of the patients are important.

Based on the assessment that is done during the patient’s hospitalisation, you would be able to list some of the nursing homes available that are tailored to the patient’s needs. However, dementia leads to increased cognitive deterioration, which entails that the patient’s needs could change over time, making it crucial that you are frequently updated on his condition.

While you search for a nursing home, consider the physical, safety and psychosocial needs of the older adults. When you do a survey, focus on the main services provided such as facility cleanliness, staff availability and security, safety precautions, providence of meals, social activities and medical appointments.

Advices and support for family members

For most nursing care centres, staffs will advise family members to visit less frequently during the first week, and more frequently for short intervals in the following weeks. This is considered ideal for the family to be updated on the patient’s health progression.

Choose a few familiar items and pictures to bring

The nursing home should not feel like a hospital. It is a home; a place where people live. Therefore, residents should be encouraged to personalise their rooms. You may suggest that the family brings a few items that are familiar to the patient, such as pictures and books. Bringing personal items creates a more in-home environment for the dementia patient.

Encourage participation in social activities

The functional assessment of residents is the cornerstone of clinical practice within the nursing homes. Based on the comprehensive assessment of each resident, staffs can distinguish and decide the care planning decisions within a certain period.

During this assessment phase, a resident’s functional ability, cognitive function and psychosocial are the main focus. Basically, nurses have to complete the Resident Assessment Instrument (RAI) on every resident to evaluate their physical and mental health status. Once the assessment is completed, you can develop the care planning along with social activities.

For an advanced dementia patient, multisensory activities such as getting him to be familiarised with brightly coloured items, interesting sounds and tactile objects are helpful in capturing their attention rather than chatting with them or engaging in reading activities.

The transition to a nursing home for dementia patients is undeniably challenging. With proper help from nurses, the family members will be sufficiently guided on making the right choice of nursing home and have a deeper understanding of what the patient would experience during his time there. MIMS

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Sources:
Potter, P.A., & Perry, A.G. (2009). Fundamentals of Nursing: Care of Surgical Nursing. 8th ed. ELSEVIER.
http://www.healthcentral.com/slideshow/chosing-a-nursing-home-10-considerations
https://www.verywell.com/help-a-loved-one-with-dementia-adjust-to-a-nursing-home- 97697
http://www.nhs.uk/Conditions/dementia-guide/Pages/dementia-activities.aspx