For decades, a large percentage of the older population has remained on the homestead for nearly a lifetime, in sharp contrast to today’s generation that frequently moves or resides in temporary housing. Unfortunately, as our parents and elderly relatives age and their health becomes frail, the agonizing decision to move them to a safe and supportive environment becomes necessary. Resistance and grief are common reactions to leaving the home that is comfortable, familiar and full of treasured memories.

Adult children and other family members are often faced with the reality of their loved one’s limitations and inability to safely remain in their current setting due to dementia, progressive disease processes, diminishing eyesight or caregiver fatigue. Other factors that necessitate change are: wandering, confusion, weight loss, falls, medication incompliance, sleep disturbances, driving accidents, lack of self care and isolation. In addition, finding and financing adequate home care services may present a barrier to remaining at home. This dilemma is difficult for families as they attempt to weigh all of the factors and ultimately prepare for a move away from the homestead. Sadness, guilt, helplessness and anxiety are just some of the feelings that can arise during this time of instability and uncertainty.

As the need for change becomes clearer, a sense of grief and loss can be felt by all members of the family. Just as in death, the five stages of grief can apply to this difficult transition in life.

1) Denial about the reality of the health and safety conditions at home.
2) Anger at the changes that have occurred, at the loss of security of one’s personal space and at the family members who may be responsible for this change.
3) Bargaining to remain in the home longer, promises to fix the problems and making deals to avoid a move.
4) Depression that may be present or develop as the result of moving and having to let go of one’s current lifestyle.
5) And finally acceptance of the change; a chance to refocus, gain energy and set new goals in a different environment.

Here are some suggestions to help caregivers and family members grieve and assist in the transition from a lifetime home to assisted living or another care setting:

• Plan a family meeting where all concerned parties can come together and thoroughly discuss needs and moving options. Be truthful and realistic about the need for a loved one to move. Initially, keep emotions to the side and focus on the facts at hand, especially if your loved one is unable to comprehend the situation and see the bigger picture.

• Talk with others who may have already traveled on this journey and learn from their experiences. Find others who can ‘walk’ beside you during this transition such as a physician, clergy, friend, social worker, caregiver consultant or the care provider of the residence in which your loved one will reside.

• Be prepared for good days and bad days as change and loss are realized by all who are involved. Be aware that decisions and emotions may waiver during this transition process. Remain focused on the risks and facts surrounding the need for change and continue to move forward. Offer reassurance when resistance surfaces and keep a positive attitude about the move and the opportunities that may be available at the new residence.

• Involve the family member or loved one in the planning and preparation to move by touring several housing options and allow choices for items to take along such as antiques, furniture or photos that generate fond memories.

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