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As an Occupational Therapist in an Assisted Living Facility, I frequently witness the transitional process as a family visits, selects, and moves their loved one into their new single or shared room or apartment.

I often hear the voice of the new resident, filled with uncertainty and anxiety, met with the encouragement and reassurance of the family member. Some moves are unexpected or unwelcome, triggering anguish, despair, and anger. Others may be viewed as a welcome transition – a move to an easier, safer place where needs are met and socialization is available and encouraged.

No matter what the situation, a few things can make a big difference in making the adjustment easier, especially for those residents who may have physical or cognitive needs that will warrant therapy.

Here are the top 5 things I wish all families knew during this time:

  1. As therapists, we don’t get a lot of initial information. It’s true that during the interviews, visitations, and moving process that there may be a lot of conversation and discussion about your loved one’s history, likes, dislikes, and what led you to your decision to seek an ALF. Therapy is not always privy to those discussions, and they DO make a difference in how we approach a new resident, the treatment techniques we choose, and ultimately the goals we establish. If you know that your family member will be evaluated for therapy, a phone call, email, or (best) scheduled time to visit during the evaluation will give us a great headstart on formulating an individualized program to maximize your loved one’s time and progress in therapy.
  2. Mom or Dad doesn’t need 4 (or 3) seasons of clothing, or that 10 piece dining set. Most ALF apartments are rather small. Many are shared. And many residents use a walker, rollator, or other device that may take up floor space. Clutter is the enemy, especially for a resident that may have some memory issues or be at a higher risk for falls. It is difficult enough to adjust to a new environment and new routine without needing to sort through multiple drawers and dig past the snow jackets and holiday decorations to find a clean outfit. Most likely, family will visit at least a few times a year, so plan to rotate seasonal items and clothing during those visits. When moving into an ALF, keep it simple. Clear floors, easy to locate everyday items, and a few precious mementoes are best.
  3. Labels work magic. Speaking of mementos, label those photos and objects. Many ALF residents demonstrate some level of memory impairment. Many families say they notice a significant decline in their loved one’s memory after a move. And while stress can be detrimental, much of what is seen is a person’s pre-existing impairment, struggling to adapt to a new environment or situation. Those effects are more a factor in short term memory or situations, but can translate into difficulty with long term recall. Place a small sticker on photos or items, indicating who is in the photo, for example, and the date it was taken. Believe me, those items are wonderful talking points in building rapport, and taking away the anxiety in recalling the details does wonders. Do it for the staff; we’ll thank you.
  4. A few pieces of well-chosen equipment can make a world of difference. Please don’t rush out to buy a ton of equipment that you think may be helpful (refer to #2 above). But please do talk to the Occupational and Physical Therapists in the ALF and see what might be helpful for your loved one. It’s true that many ALF’s have “accessible” bedrooms and bathrooms, but so much of the time, it’s just not quite right for a person with a physical or cognitive impairment. For example: a commode over the toilet may provide just the right height and ability to push with both hands (rather than a grab bar), a bed cane may give just a bit of needed help to sit up at night, and a tub transfer bench may be much safer for a person with a balance impairment rather than a built in shower seat. A non-skid shower mat, command hook to hang a long shower hose, and a sink caddy to keep items in easy reach may make a world of difference. A lower closet rod and loosened hydraulic mechanism on the door may make reaching items and entering and exiting the room much easier and safer. Talk to the therapists to see what is right for your family member. Fortunately, Amazon and on-line retailers have made purchases much more convenient and inexpensive than in the past.
  5. Communication is key: Please, check in with the therapists to see how your loved one is doing. But…please try to make it during therapy time if at all possible. Therapists are often in a time crunch, and a phone call or unexpected visit can often be difficult to manage if it isn’t planned or occurs during another resident’s treatment time. We want to help in every way that we can, so plan on spending 30 minutes or a half hour not only during the evaluation, but after a week or two of therapy treatment, when we have gotten to know your family member and can make some appropriate recommendations. A follow up before discharge is welcome, too, to be sure everyone is on board with suggestions, tips, and techniques to keep your loved ones functioning at their peak performance so they can settle in and enjoy this new period of life.
  6. We all struggle with life changes, in different degrees. Selling a home and moving to Assisted
    Living can be a difficult time, but I’ve seen firsthand how incorporating those tips above can
    make a new living situation easier, more familiar, and more satisfying for everyone involved.
    Good luck!

This article is written by ~ Cherylynn Horn, OTR/L

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About the author 

Dr Michael Chua PT, DPT

Dr Michael Chua is a physical therapist practising in Home Health, Skilled Nursing Facilities and Acute Care Hospital. His clinical interest involves pain management, geriatrics and dementia management. He enjoys treating patients and bringing out the best in them using positive treatment approaches, his dynamic work setting in a rural area provides an opportunity to treat a wide range from geriatrics to orthopaedics.

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