By Jennifer Trowbridge, Indiana State Director on Feb 13, 2018, 2:15:28 PM
As your loved one’s memory declines, or as the effects of dementia or Alzheimer’s disease become too much for the family or caregivers to handle, you will have to make the decision to place her in memory, dementia, or Alzheimer’s care. After you have consulted your family and her healthcare professionals, made financial arrangements, and chosen your loved one’s new home, you have to prepare for transitioning her to a new level of care. You understand the need for the move, but it still is difficult for you to accept the decision, and your emotions run even higher when you think about telling your loved one and anticipate moving day.
To help ease the transition for your loved one (and for you), we have rounded up 50 tips from caregivers, memory care facility administrators, dementia and Alzheimer’s experts, and others who have experience in working with seniors who require special care. Keep in mind that everyone handles the transition differently, and you will need to use the tips that best fit your loved one’s personality and needs and your situation. Please note, our 50 tips for easing the transition to memory, dementia, or Alzheimer’s care are not listed in order of importance or value in any way; rather, we have categorized them to help you find the tips that will be most useful to you.
Preparations Before Move-In Day
- Choose the best facility. “Do your research. Talk to your loved one first to understand their needs. Before choosing a memory care facility, research facilities and their amenities to know whether it is the right choice for your loved one. Know the community policies and procedures, the security available, and the features and treatments available.” – The Transition to a Memory Care Facility, American Senior Communities; Twitter: @ASCSeniorCare
- Avoid telling your loved one he needs more help. “If I can, I want to avoid the conversation that says, ‘You need more help.’ Generally, by the time they need 24-hour care, people with dementia are no longer able to identify the fact that they have a problem. So, if you suggest they can’t do something, they can get very angry. People tell me they’re in denial. That’s not denial. They’re not putting this on. They truly believe there’s nothing wrong with them.” – Chris Ebell, as quoted in Advice from an Expert: Dealing with the Transition to a Dementia Care Community by Chris Harper, The Arbor Company; Twitter: @ArborCompany
- Recognize the transition will be challenging. “While long-term care communities provide important round-the-clock care, nutrition, social activities and support services that improve your loved one’s quality of life, it is extremely important to recognize that the transition from home to residential care can be a very challenging one.” – Collin Tierney, as quoted in Easing the Transition to Long-Term Care for Your Loved One, Bryn Mawr Terrace; Twitter: @BrynMawrTerrace
- Don't include your loved one in planning or packing for the move. “Don’t pull your loved one into the details of the planning and packing process. Don’t ask them to decide what to bring and what to leave behind. With memory loss, decision making and any process with multiple steps will present challenges. If you don’t already know which objects or knick-knacks are most important to your loved one, spend time observing what things around their home they use and enjoy on a regular basis.” – 4 DOs and DON’Ts of Moving Your Loved One to Memory Care, Coventry Senior Living
- Align moving time with your loved one's best time of day. “Schedule their moving time to coincide with their best time of the day. For example, if they are at their best in the morning and worst around sundown, plan to arrive at the assisted living early in the day. It will allow you time to get them settled and comfortable while they are at their best.” – Moving a Loved One with Dementia, Elmcroft Senior Living; Twitter: @ElmcroftLiving
- Don't take too many items. “First and foremost, people need less than they think. Most residents bring too much with them. Once here, they realize how few items they actually need. And for those suffering from memory loss, too many items, especially clothing options, can confuse or frustrate the resident.” – What to Take With You When Moving Into an Assisted Living or Memory Care Community, Rambling Oaks Courtyard
- Ensure loved ones are placed in the appropriate setting. “Effort should be made to ensure that individuals are not transferred needlessly, or too swiftly…. It’s key that clients with dementia are placed in settings where people understand dementia care and appreciate the challenges and can help clients navigate in a new environment.” – Kate Jackson, Prevent Elder Transfer Trauma: Tips to Ease Relocation Stress, Social Work Today; Twitter: @SocialWorkToday
- Work with counselors and managers to ease the transition. “Moving your family member into memory care can be uneasy. There are counselors and managers who will be able to work with you and your loved one to help with the transition. Caregivers and family members who have questions or who would like to follow closely along with the memory care program can also benefit in many ways. Everyone is going through this transitional time together, so having the knowledge to face it together will help.” – Alison McCool, 4 Things You Need to Know About Transitioning Your Loved One from Independent Living to Memory Care, Thunderbird Senior Living
- Attend events at the care facility prior to move-in day. “Invite [your loved one] to make a few visits for lunch or to attend other events with you at the one or two places you’re looking at. Making these activities fun and social can increase warm familiarity with the communities.” – Madeline Vann, How to Move a Parent with Dementia to Assisted Living, Caring.com; Twitter: @Caring
- Take advantage of transition programs offered by care facilities. “Not every scenario allows for a gradual introduction to a memory care nursing home. In some cases, a parent needs to be moved in to a nursing home environment much quicker. In these types of cases, talk with the facility’s staff about their transition program. This program is designed to help your loved one adjust to life in the nursing home without your presence.” – Wilmington NC Memory Care: How to Move Your Loved One Into a Memory Care Facility, The Davis Community; Twitter: @julier_davis
- Give the staff information about your loved one ahead of time. “Speak with the staff about your loved one’s background and any special needs. Provide details on your loved one’s medical and mental health history, including a detailed medication list.” – Alzheimer’s: Soothing the Transition on Moving Day, Mayo Clinic; Twitter: @MayoClinic
- Rely on healthcare professionals for help in explaining the situation. “In the best of worlds, your parent can participate in a decision to move to Memory Care. However, dementia often causes impairment in decision-making ability, so family members may have to spearhead a decision in the best interest of a loved one. Often a doctor or other healthcare professional can be an ally in this situation, explaining to your parent in a calm but authoritative manner why a transition to Memory Care is ultimately a positive move.” – Diane Franklin, Moving from Assisted Living to Memory Care, Our Parents; Twitter: @OurParents
- Make several visits before moving day. “Give the Alzheimer’s patient a sense of comfort and familiarity by visiting the Memory Care community as frequently as necessary, for as long as necessary, before the move. Perhaps you can talk to the staff to provide some of the care required in the old apartment while making the transition. Encourage the senior to get involved in activities and meet the other residents in Memory Care.” – Dawn Allcot, Moving to Memory Care Within Your Senior Living Community, SeniorLiving.net; Twitter: @SeniorLivingNet
- Share your loved one's story. “One of the most important things a family member can do is to share their loved one’s story. By sharing their hobbies, likes and dislikes, passions and pastimes, this helps the staff create an environment in which your loved one will thrive. It also helps them match them with residents who have a similar background. When residents have someone to share stories with, this makes the transition much easier.” – Transition to Memory Care: Helping Your Loved One Transition to Memory Care, Tri-County Caregiver Resource Center
Advice for Family Members
- Be prepared to take some time off. “If you work, consider talking with your employer about the possibility that you may need some time off with very little notice. Try to save a few vacation days in case the move comes up suddenly. Remember to have money saved to pay for the home’s first month rent and any other services that the person with dementia may need (e.g., phone, cable television). Also, pre-arrange for a family member or friend to be available on standby to care for children or give a hand, if necessary.” – Long-Term Care: Preparing for a Move, Alzheimer Society of Canada; Twitter: @AlzCanada
- Remember it will get easier. “As hard as this seems right now, it’s important to know that this will not always be so hard. Your parent will get used to their new memory care community and may come to love being there, thanks to the engaging programming, other residents, and personalized care. Just remember that you made the right choice for your particular situation and are helping to give your parent the care and lifestyle they deserve.” – Helping Parents Transition to Memory Care, Travanse Living; Twitter: @tl_wheaton
- Do not announce the move in advance. “Avoid anticipation anxiety by not telling her that she will be moving on next month or so. Wait until it is close to the date to inform her, or even tell her only at the very moment of the move. Moving anticipation anxiety can cause extreme negative feelings that may escalate into extreme behaviors. By not giving her too much advance notice you will promote a calmer state of mind for the transition. Some homes provide opportunities for socialization, such as dinner parties or day center activities, prior to residency. These are great ways of initiating the adaptation process without being too obvious about the move itself.” – Luciana Cramer, Seven Tips for a Successful Move to Dementia Care, Alzheimer’s Association; Twitter: @alzassociation
- Make regular visits to ease the transition. “Keep in mind that throughout the first few weeks the individual will be adjusting to his or her new way of life, and by making regular visits you can help ease the transition. However, there may be a delicate balance to how often you should visit throughout this period; talk to the staff to discern the best days or times.” – What to Expect After Moving to a Memory Care Community, American Senior Communities; Twitter: @ASCSeniorCare
- Be prepared for bad days. “During the transition, your loved one may make negative comments. You may dread these because they seem to be a judgment about the decision. When your loved one expresses dissatisfaction with something, write the comment down. Keep these comments in the proper perspective: they are an opportunity for you to help make the situation better for your loved one.” – Transition to Care, CareConversations.org
- Do not bend or waiver once you make a decision. “The family has the tall task of staying the course. A lot of resolve is required to not bend or waiver in the decision. Families often know the time has come for their loved one to live in a supervised, specialized community. However, staying true to this decision can be challenging.” – Kim Warchol, How to Reduce Transfer Trauma for a Person with Dementia, Crisis Prevention Institute; Twitter: @CPI_Training
- Be prepared to hear complaints. “Be prepared for complaining, no matter what. Try to be patient and point out the advantages of the nursing home, even if a room must be shared. Note the increased medical care, the added attention of CNAs and the immediate attention if someone falls.” – Carol Bradley Bursack, Making the Transition from Assisted Living to a Nursing Home, HealthCentral; Twitter: @healthcentral
- Use the power of music. “Many people living with Alzheimer’s disease or a related dementia benefit from music therapy. It has been shown to decrease stress and anxiety. It might help to bring a small CD player and some of their favorite music on CDs when they move. Talk with the staff to see if they can use it when your loved one is anxious.” – Moving a Senior to a Michigan Memory Care Community, Heritage Senior Communities
- Use compassionate deception. “Hammond says another approach is to use what is referred to as ‘compassionate deception.’ You can convince the person to go for a limited period of time, such as a week. Then you stretch it out to two weeks, then three and eventually they will probably adjust to being there full time. Loved ones who are significantly impaired may even forget they were supposed to go back home. Or they may not be aware they aren’t at home.” – Marie Marley, Convincing a Loved One With Alzheimer’s to Move to a Nursing Home, HuffPost; Twitter: @HuffPost
- Use comfort food. “Arrange for favorite and familiar foods for your loved one’s first few meals in the new community. To do this, you will have to talk to the chef and kitchen staff to find out whether they can accommodate your request. You or other friends and family should join your loved one for at least one meal on the first day, and if you can stay for more, so much the better.” – Casey Kelly-Barton, Managing Moving Day for Dementia Patients: 6 Tips, SeniorAdvisor.com; Twitter: @SeniorAdvisor_
- Reassure your loved one. “How you address the move can help establish a successful transition for your loved one. Again, this is dependent upon your family member’s ability to process the information and cope. Many families keep it very simple making statements about ‘the new residence, new neighborhood and friends.’ They may refer to the quality care the community is known for or the many activities or perhaps it’s hospitality in welcoming new neighbors. The decision for how to address the move is purely dependent on the scenario you feel your loved one would respond to best. The main point is for families to reassure their loved ones that they will be nearby and continue to see them which can limit any associated anxiety.” – In Touch Tips for Moving Your Family Member to Memory Care, SRG Senior Living
- Give your loved one time to adjust without you. “As much as you may want to be there every hour of every day, it’s best to give them some time to adjust on their own. Give them time to get involved in programs and make some friends. Let them get used to their new home at their own pace. If you visit too soon, according to the article, they may ask you to take them back home with you, which can make it harder for them to adapt. Try talking to staff instead to check in with your loved one. After the first week, try visiting a little at a time, and once your loved one is used to their community, you can begin making visits regularly.” – Tips to Ease Parent’s Transition to Memory Care, Travanse Living; Twitter: @tl_wheaton
- Wait until he is adjusted before taking him on outings. “You may feel the urge to take him out for a drive shortly after he's moved in, but it is usually better for your loved one to get into a routine and feel settled before you do that. Give him a little time to adjust to his new home before you take him on an outing.” – Esther Heerema, Help a Loved One With Dementia Adjust to a Nursing Home, Verywell; Twitter: @Verywell
- Minimize Disruptions. “No matter how much you’ve disclosed to your loved one about the upcoming transition, on the day of the move it’s best to try and follow their usual routine as closely as possible. People with dementia often have times of day when they are typically at their best; if you can, schedule the move during this time frame in order to minimize stress.” – Helping Your Loved One Transition to Memory Care, Vista Prairie Communities; Twitter: @VistaPrairie
- Expect setbacks. “Just when you think you are over the hump and your parent is settling in, things will change. They will tell you they are lonely. They will decide they don’t like their new dining hall friends. They will ask to go home. These moments are heart wrenching but knowing that they are normal and that they will pass, can help get you through them.” – Moving a Parent to Assisted Living: 12 Strategies to Ease the Transition, Working Daughter
- Move during mid-morning or mid-afternoon. “Early mornings tend to be a busy, hectic time at communities. A calm entrance will be less alarming to an elder with dementia.” – Deborah McLean, 10 Transition Tips: Advice for Moving Someone Who is Affected by Dementia, Maine Senor Guide
Coping with Emotions
- Remain positive. “Remain positive with an upbeat attitude. Your loved one will likely reflect the same feelings that you do about the move. If you are constantly fretting and seem anxious, they likely will too. Point out all of the positives of their new community and the amenities that this move means they will get to enjoy. Encourage your loved one to be excited about the transition.” – Memory Care: Helpful Tips for Making the Move, Angels Senior Living
- Understand your loved one may be afraid of being lonely. “Yes. Even if your loved one has lived at home alone for years, and even if they will now be surrounded by many people, they may still be afraid of being lonely. Really, they are afraid of isolation from their family members.” – Jayme Kinsey, Moving to Assisted Living / Easing the Transition, Assisted Living Directory; Twitter: @AssistedLivingD
- Reduce the surprise factor as much as possible. “Ideally, your loved one was involved in choosing the community; if they were not able to do so, it’s best that they visit in advance, perhaps enjoying a meal in the dining room or even spending a few nights through respite care. Respite stays are often a very successful way to ease the transition. Even if their memory doesn’t allow them to recall those events, it will still help in developing relationships and a comfort level at the community.” – Juliet Holt Klinger, Six Tips for Transitioning Your Loved One into Dementia Care, Brookdale Senior Living; Twitter: @BrookdaleLiving
- Listen and validate your loved one's feelings. “I’ve been called into countless situations to ‘talk some sense into’ a parent who’s refusing to move, after the family’s had no luck. Here’s where the wheels come off the bus: the family tries to sell it as a trip to Disneyland, then an act of love, then uses reason and logic.
“Reminder #1: Reason and logic don’t work.
“Reminder #2: Feelings just are.
“This is what I do instead: I listen. I listen to every last bit of it. True, it’s easier for me because your dad isn’t pushing my buttons. Still, I listen. And I empathize and validate. Instead of trying to convince your parent how great it’s going to be, I listen and then I tell him I can absolutely see why he’s so upset. I’m certain I’d be upset too! I hate the whole deal for him. I reassure him he never, ever has to like it. The End. No arguing.” – Christy Turner, Moving Your Parent Into Memory Care: Insider Tips from a Former Memory Care Director, CTC Dementia Care Management; Twitter: @DementiaSherpa
- Don't feel ashamed. “Moving your parent from an assisted living facility to a memory care center can be a double-edged sword. Not only your loved one but sometimes even your close friends and family members will criticize your decision. This harsh criticism may force you to wonder whether or not you have made the right decision. However, don’t let a few raised eyebrows spiral you into an abyss of embarrassment and guilt.
“Most people, including your loved one, have no idea what it’s like to take care of someone suffering from Alzheimer’s. You don’t need to reason with every accusation or argument that comes your way. It may take some time, but you need to learn to face facts objectively. The most important thing that your loved one needs is for you to keep fit both mentally and physically. So, instead of feeling guilty, pay attention to your health.” – Evan Thompson, 6 Ways to Ease Your Parent’s Transition from Assisted Living to Memory Care, The Diary of an Alzheimer’s Caregiver; Twitter: @rm29303
- Be understanding in your replies. “Doreassure the person that they will be getting more help. Because of their dementia, they may bring up the same concerns or fears over and over. Let the person voice their concerns, and be understanding in your replies, i.e. ‘I can see why you’re worried about that. We’ll figure it out.’” – Moving Your Loved One into Memory Care? Four Dos and DON’Ts to Make for an Easier Transition, Ebenezer Memory Care; Twitter: @EbenezerMN
- Put your loved one's responses into perspective. “During the transition, complaints or dissatisfaction may be expressed. Your loved one may appear depressed, anxious, hostile, or withdrawn. This may make you feel as if the choice was not in their best interest after all. Try to put their responses into perspective. Oftentimes, these can be ways to express uncertainty or fear. Your loved one may just need you to listen and offer support and comfort. Try to really listen to the emotion behind the words. Never dismiss a negative comment or attempt to reason it away. Provide lots of reassurance. Use facial expressions, gestures, and comments to show you are paying attention.
“Often listening can be the most powerful solution, along with assurance that you are there for them. Sometimes a hug says it all. After your family member has had time to express their feelings, you may be able to refocus attention to another subject or activity. You will both need time to adjust and grieve. Be patient with your loved one. Be patient with the care team. Be patient with yourself. This is new for everyone.” – Tips for Easing the Transition to a Memory Care Facility, Erickson Living; Twitter: @ericksonliving
- Validate your loved one's feelings. “… when parents are resistant, adult children use the opportunity to better understand their concerns. ‘It's always better to listen more than talk,’ Gray said. ‘If a parent says, 'No way, you're trying to push me out,' if they get defensive, that's your cue to really listen and make sure you're hearing what their concerns are.’" Jullie Gray, MSW, LICSW, CPG, CMC, as quoted by Dennis Thompson, Jr. in Easing the Transition to Assisted Living or a Nursing Home, Everyday Health; Twitter: @EverydayHealth
- Don’t feel guilty. “While I always help these caregivers troubleshoot their dementia-related issues and provide advice about care communities or care at home, we always end up talking about guilt. All of these caregivers feel guilty, even the ones who are taking care of their loved ones at home… Choosing to move a loved one into assisted living or skilled nursing should not be a worst-case scenario. Sometimes it’s the best-case scenario for aging adults and their families.” – Rachael Wonderlin, When You are Shamed for Moving a Parent Into a Care Center, Forbes; Twitter: @Forbes
- Avoid being emotional. “Transitioning your loved one to a memory care community can be very emotional time. You may have spent years of your life supporting and caring for each other. When moving your loved one, it is extremely important that you not show your sadness or cry. ‘When a spouse begins to cry, it can ruin it for the resident,’ says Marthe. ‘I know it is hard to do, but you have to put on a facade. You want them to be cheerful.’
“‘I tried to explain to her what was going on and I doubt she understood what I was saying,’ says Garry Wright speaking of the day he transitioned his wife Marcia into Villa at Terracina. ‘But the fact that there were people around her, she sensed the level of comfort and she wasn’t upset. I fell apart, though, when I got to my car.’” – Memory Care: How to Ease the Transition for Your Loved One, The Goodman Group; Twitter: @TGGLLC
- Be positive about the facility. “When you go on tours, point out all the positive aspects of the facility. Be as excited as you would be about renting a new apartment or buying a new home: focus on the possibilities. Would mom’s favorite antique chair look good in the rooms of a particular facility? Does the activity room have a piano so that dad could still play?” – Five Steps to Convince Your Parent to Move to Memory Care, Raya’s Paradise; Twitter: @RayasParadise
Organizing Your Loved One’s Room and Belongings
- Label your loved one's items. “Having worked in long-term dementia community care, I can tell you first-hand that residents’ items go missing constantly. Typically, this is because another resident will go into a room that is not their room and walk out with a couple items. It is important to understand that this is not something malicious that one resident does to another—it is just a part of the disease process. People with dementia typically have trouble understanding their surroundings, and they may not be aware of what belongs to them and what does not.
“Labeling your loved one’s shirts, pants, socks, towels, walkers, canes, and anything and everything else will save you a lot of pain and time. I have had many family members call and complain that a loved one’s sweater is missing, only to hear them describe a very basic sweater that could belong to anyone. It is very challenging for people who work in the community to remember what belongs to whom. A permanent marker can solve a lot of mysteries—and it can ensure that your loved one’s items will be returned to their room.” – Rachael Wonderlin, 5 Tips for People Choosing Long-Term Dementia Care, Alzheimer’s Reading Room; Twitter: @rachaeldawne
- Include copies of family photographs. “Bring in copies of photographs. Just like clothing and other articles, photographs can also wander off. We think it’s absolutely wonderful to bring in lots of photos, both in frames and photo albums, we also recommend that you bring in copies of these pictures so as to not lose something that cannot be replaced.” – Tips for Moving a Loved One into a Memory Care Community, Arbors Memory Care; Twitter: @ArborMemoryCare
- Create an activity box. “Did your loved one really enjoy their career as a teacher or a nurse or other profession? Did they have any lifelong or retirement hobbies and interests such as gardening or music? You can create activity boxes with the supplies they might have used. Creating a teacher’s box, for example, full of pencils, papers to grade, and an old-fashioned grade book might give them meaningful activity to do and can help calm agitation.” – Moving a Northern Michigan Senior Living with Dementia, The Brook Retirement Communities
- Make it feel like home. “Move in the good memories. Schedule a time that you and your family can move in your loved one's favorite belongings. Try to arrange the items in a way that reminds your loved one of their prior home. Seniors with Alzheimer’s or another form of dementia take comfort in what they recognize. Help them decorate a room that will be calming and comfortable.” – Beginning the Transition, Brookdale Senior Living; Twitter: @BrookdaleLiving
- Create a Reminiscence Board. “Create a Reminiscence Board full of photos of the important people and events in your senior loved one’s life. Label each photo. It can provide conversation starters for staff when they are first getting to know your family member.” – Helping Seniors Transition to Memory Care Assisted Living, Five Star Senior Living; Twitter: @5StarSenior
- Decorate your loved one's door. “Decorating the front door to their room with a wreath or other personal item can help your loved one remember which room is theirs. These visual cues will be helpful.” – The Cottages Senior Living, Tips for Helping a Loved One Downsize to Residential Memory Care, Seniors BlueBook; Twitter: @alzcottages, @seniorsbluebook
- Recreate as much of the home environment as possible. “People living with Alzheimer’s disease benefit from familiar surroundings. Before moving day, work with the staff at your senior loved one’s new home to try to recreate as much of their home environment as possible. It can help to decrease their anxiety and agitation. Think about what some of their favorite things from home are and try to have them in place at the assisted living community before they arrive. It might be their favorite rocker or recliner or a television they’ve watched Wheel of Fortune on for many years.” – The Alzheimer’s Caregiver Dilemma: How to Transition a Loved One with Dementia to Assisted Living, Seniors in Transition, LLC
- Give a doll to a woman transitioning to memory care. “To an outsider, giving baby dolls to elderly loved ones might seem a bit strange, but the calming effect can be life changing. To those with dementia, the baby doll is real. The baby dolls provide a deep sense of calm and purpose over an extended period of time. When they show the baby to their other friends in memory care, many will feel similarly. Some memory care units even have baby stations.
“While the baby doll approach isn’t limited to only women, men might respond to tools, stuffed animals, woodworking and other crafts. The theme here is that when facilities figure out what your loved one was interested in as children, they can help recreate aspects of those interests. You might have key insights that can lead to a breakthrough.” – Pam Silverberg, 3 Things That Can Help Your Loved One Transition to Memory Care, Stacy’s Helping Hand, Inc; Twitter: @AsstLivingDEN
- Decorate your loved one's room to display her personality. “Decorate your loved one’s room with items that define who this person is. You want staff to be able to know something about them the minute they walk in the room. An example might be a person whose hobby was making quilts. You could put a beautiful quilt on the bed or on the wall, and bring her sewing box with fabric pieces, yarn, thread (no pins) patterns, measuring tape, etc.).” – Laurie White and Beth Spencer, Ten Tips to Ease Transition into Memory Care, Trails of Orono; Twitter: @EbenezerMN