Post #33
I’ve known many elderly people— family, friends, and acquaintances— who have refused to leave their home even when it seems to their younger relations that it is unsafe for them to continue living there. In my youth, I often felt that these older folks were just being stubborn, unable to accept the obvious because of their age. However, as I’ve aged, I’ve begun to understand how much stronger that tie to “home” grows the longer you reside in one place. Recently I’ve become quite a homebody myself, which has caused me to consider how difficult it would be to move or be moved to another residence.
I remember the struggle my stepfather went through trying to decide whether he should sell his house and move with Mom to a facility where he would have help caring for her. They would still live independently as long as they were able, but he would have the security of knowing she was in a safe place if anything happened to him. As things played out, an emergency occurred before he could make that decision, so Mom had to adjust to the next stage of her life without him.* Because she had Alzheimer’s she couldn’t understand why she was suddenly whisked to Texas to live with us when she wanted to be at home caring for her husband. Sadly, she herself had to be cared for, and my stepbrother wasn’t able to care for both of them so that they could stay together.
Mom struggled with the desire to go home, even while she loved us and enjoyed the fun we had together. At first she wanted to go home to be with her husband, and as she declined the desire changed to wanting to go home to her parents. I was sympathetic, but since they were both deceased, there was nothing I could do except try to distract her. When she was insistent, we went for a drive. When she demanded that I drive her home, I would tell her I didn’t know the way so she would have to tell me where to go. Sometimes she would agree to give me directions, and we drove around the countryside until I convinced her we needed to go back to my house for the night.
It is not only those who must move in an emergency who have difficulty adjusting to new residences. My aunt and uncle had no children so they decided early to invest in a community where they could live independently in an apartment, then when necessary move to assisted living, and later, if needed, memory care. Each step towards lesser independence was very difficult for them. Although it was part of the plan they had initiated, they felt as if their independence had been taken away when they were moved to assisted living and told they could no longer drive. Friends of mine felt this same attack on their independence as their children purchased a smaller home for them, then “forced” them to sell the home they loved.
Loss of independence and missing loved ones are not the only reasons that people don’t want to leave home. Usually the move is to a smaller place, which means that not only do people have to leave their familiar geographical location, but they must also put aside many mementos and possessions that have emotional value. Some items and spaces that have to be left behind may help define who the person is or has been in earlier years. Consider the artist who has no room for easel and paints, or the fisherman or hunter, rancher or gardener who must give up that part of themselves that loves to frequent the outdoors in order to live in a small apartment in a bustling city. There's no denying it--something will be given up and missed in a move motivated by health concerns. No wonder that a couple from our church who recently moved to a senior community described their new residence this way: “It’s just so small!”
When you have a home of your own, especially if you’ve lived there for many years, there is a sense of belonging and security associated with it. This is the place you return to after work, vacations, hospital stays, etc. This is the place where you sleep, watch TV, cook, do your hobbies. You have a routine to follow in your home and a sense of having your own place in the world. Perhaps your purpose in life is also tied up in taking care of the property and the others who live with you on the property. While you go out frequently into the world, you return to this mini-world where you can be yourself. (Or at least this is how many people experience the concept of "home.")
A little over a year ago a distant relation, who was dear to me, passed away. He had insisted on living at home to the end, even when his loved ones felt he was in danger. His self-chosen caregiver seemed to be connected to a group of people who may have been dangerous. Unknown people were coming and going on the property all night long, and tools, etc. often turned up missing. At one point his son felt he needed to be moved—so did his other relations. However, he was still cognizant and insisted that he be allowed to live at home — with the caregiver he had chosen. Eventually we realized that to move him would kill him. So we watched nervously as things went on mostly the same.
Maybe the situation wasn’t as bad as we thought or maybe it was worse. Yet there are times when it is more dangerous to move someone than it is to leave them where they are. Other friends have shared similar situations: a grandmother who might break her leg on the stairs, but would probably die quickly after moving from the home she’s known for the last seventy years . . .
My maternal grandfather lived by himself up until he was almost blind. Eventually his children intervened whenever a car backed over him at the grocery store. (It scratched him up, but no serious injuries because he was miraculously between the wheels.) It would have been wonderful if he could have moved before that accident happened; however, he was still capable of making decisions, and he had decided to live alone—until that accident convinced him and family members that it was too dangerous.
As family or friends, we believe we have the older person’s best interest in mind when we decide they need to move. However, unless the person is in an advanced stage of dementia or other illness/disability where they really cannot take care of themselves, it is important to let the person make the decision for her/himself. To maintain a good relationship with our loved one, it is better to objectively lay out the reasons we believe it is no longer safe for her/him to live at home and, also, listen to their reasons for wanting to stay. We need to be respectful and not manipulative. We might offer several suggestions, but we also need to listen to suggestions they offer. If they are adamant about staying in their home, we might consider looking into ways of making home safer. The following website https://www.nia.nih.gov/health/aging-place-growing-older-home
lists several ideas for helping someone age in place.
If your dear one decides to follow your suggestion and move to a safer place, it’s better to avoid automatically deciding where they should go. Let them find the right place, or you can offer to assist if they prefer. You can cause resentment and distrust if you try to run the show. The amount of help you can give and still maintain a trusting relationship will differ. And even when you do your best not to push your loved one, your eagerness to help may be misinterpreted-- as was the case with some friends of mine who always resented their daughter and son-in-law’s attempts to find the most appropriate place for them.
When you are looking for or supporting the search for a new place, keep in mind the characteristics of your loved one/friend that need to be addressed so that they won’t lose their sense of purpose, security, or belonging. For example, research the types of activities offered. If they sound interesting, visit in person to see how they are conducted and what type of interactions occur. Be sure to check on the details regarding the dining situation. Is any personal or health assistance offered? Find out the amount of room there is for personal items. After the decision is made, support your loved one in planning what to bring and how to dispose of the rest of their property. Suggest that they plan the layout of their new room/apartment. Even after they move, you will be needed to support them while they adjust to their new life.
One other aspect of moving when you are older— besides the loss of independence, purpose, security and belonging— is the loss of comfort. Perhaps a person is used to sleeping in a king size bed and now must sleep in a twin. Perhaps they get indigestion easily with certain foods, but now have lost the option to choose what they eat. This loss of comfort can be true for anyone, but is even more true for those who are HSPs** I’m finding out from personal experience that an HSP's comfort is easily threatened by others. These days when I get headaches from cooking smells and loud voices, as well as become over stimulated by being around a lot of people or watching television, I realize that a group home situation would make me very uncomfortable.***
The experience of loss when a person moves because of health reasons is, perhaps, inevitable. While I've been discussing the situation of the elderly, the same ideas can be applied to people of any age whose health or cognitive needs are great. Caring family and friends can help with the transition of moving by finding ways to support their dear one’s sense of belonging, security, purpose, and comfort. Remember to honor the person’s independence and self worth by not taking control more than is necessary because of their state of health. When someone’s health has deteriorated, simple choices between two or three options is better than no choice at all. When you honor your loved one’s preferences as much as possible, you are affirming the value of their personhood and helping them to transition to a new lifestyle without suffering inconsolable loss.
*I tell the story of how Mom came to live with us in my post https://www.caregiversalmanac.org/post/if-the-workload-is-too-much-enlarge-your-family-caregiving-team
**There is a section in this website dedicated to needs of HSPs--both caregivers and care receivers. (HSP --Highly Sensitive Person or someone who has Sensory Processing Sensitivity as defined by Dr. Elaine Aron.)
*** For further discussion on this topic, see my post https://www.caregiversalmanac.org/post/my-future-home-an-hsp-s-vision-of-caregiving-utopia
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