An interesting research paper has been published by My Home Life Charity, on the transition from home or hospital into full time care:
Moving to a care home is a major life change, often the last move people will ever make (Cheek et al., 2007; Ellis 2010). It can mean the loss of relationships as well as of an environment in which many emotions and memories are invested. For many, the move may be necessary because of a decline in physical and mental health, a reduction in or the end of independence, or the death of a partner. However, while such a move often has negative connotations, if properly planned and managed it may bring benefits and a better quality of life (Koppitz et al., 2017).
There are various ways to make the change a positive one, including avoiding pressure being brought on the older person; ensuring that the decision about where to live is jointly made by the older person and their family; providing relatives and the prospective resident with adequate information; and allowing the older person to retain control over decision making (Chao et al., 2008; Johnson et al., 2010; Fraher and Coffey 2011; Lee et al., 2012).
The ‘try it and see’ approach, where potential residents are able to stay in care homes for a few hours or even a few days, is a useful way in which residents can start to make an informed choice. Older people and their carers need to feel supported in managing any feelings of guilt, sorrow, loss, grief or anger associated with the change. Overall, the process of entering a care home should be considered as much an opportunity to realise new opportunities and challenges as it is a result of some form of loss of independence or health status.
Older people can be proactive in choosing to move into a care home and choosing which one they prefer. Where an admission is planned and where residents are involved in the decision- making process, the adjustment to care is easier. The decision to move into a home can be particularly difficult when it is triggered by need rather than desire. Additionally, there is evidence that inappropriate admissions occur. This has obvious financial implications but it also raises the question of whether people are sometimes being placed in care homes unnecessarily.
There is evidence to suggest that the physical care home environment can facilitate or hinder transition processes (Tsai H-H and Tsai Y-F, 2008; Bradshaw et al., 2012; Cooney, 2012; Ericson-Lidman et al., 2015; Krizaj et al., 2016). Decision making The extent to which individuals are able to control the choice of moving to a care home is an important factor to their relocating experience (Ryan et al, 2011; Brownie et al. 2014). Ideally, any decision should be made jointly between the older person and relatives/ carers, with involvement and input from health and social care professionals and care home staff. T
he most positive way is where ‘making the decision’ is a relatively proactive and planned approach that leads to deciding that a placement is necessary. Less positive is ‘reaching the decision’, which happens without a planned or rational basis, and the least positive is ‘realising the inevitable’, which usually occurs following a crisis and is often making the best of the situation. Many carers continue to try to care for loved ones at home until they reach ‘breaking point’.
The decision for their loved one to go into a care home can then be taken out of their hands. Support from a ‘broker’ in finding a care home can be helpful but, without this, distress can be made worse and can even lead to the choice of an inappropriate home (Brodaty and Donkin, 2009). From the perspective of relatives, research suggests the transition has three stages: ‘making the best of it’, ‘making the move’ and ‘making it better’ (Davies and Nolan, 2004).