Often it seems that the easiest solution to an elder's needs is to move them from their home or apartment to a more protected environment. That environment can include a relative's home, an assisted living facility, or even an extended care facility with 24-hour supervision. No matter the choice, the act of moving can bring its own set of problems and issues.
Even if the elder made his or her own decision to move, grieving will occur related to the loss of the previous home. The extent of grief, and whether it has long-term effects, is dependent upon our reaction and the amount of assistance the elder will accept to aid the grieving process.
We not only grieve for lost loved ones, but also for lost roles, lost belongings, and lost health and independence. When an elder moves from his or her beloved home of 20, 30, 40, or even 50 years or more, all of the above issues may be involved.
Moving from a familiar neighborhood involves the loss of the role of neighbor and friend. Many of the people involved in the elder's life while they lived at home will no longer be visiting on a regular basis. If moving to a more protected environment, they will no longer need the visits from the neighbor who did the lawn work, the mobile meal delivery person; even the kids next door whose ball would bounce into the elder's yard will no longer be "bothering" the elder. These people will probably no longer be visiting and enhancing the elder's life with their unique presence.
When a move involves going to a smaller apartment (as it almost always does in the case of an elder), many belongings must be packed up for storage, to give away, or to sell at auction or yard sales. Experience has shown this to be one of the most traumatic events in the lives of elders. Imagine your own mementos, knick-knacks, photo albums, decorations, kitchen items, clothing, etc., lovingly gathered throughout your lifetime. Imagine sorting through them all to determine which will go where, to whom, for how much. What items are worth keeping; which memories are the most important to you -- and which memories are expendable?
Moving to a more protected environment often entails the unspoken message that one's health and independence is waning. This becomes real to the elder during the moving process and must be acknowledged. Questions need answering in a realistic yet loving manner.
We have all moved in our lives from one home to another. Never lose sight of the first-hand feelings that you had as your life was uprooted and transplanted in a new place, often a new city; almost as a tornado would uproot your farmhouse and drop it in the next county. Your life lies in the scattered debris around you and must be regrouped and redeposited in an orderly and meaningful fashion.
To whatever extent possible, the elder needs involvement in the decision-making process. They need to feel some amount of empowerment in this frightening time of upheaval. Some ways to enhance this process are as follows:
1. Allow the elder to choose which facility they will move to, among a range of facilities that have available space. Take them to visit the facility several times before the move, to get acclimated to its atmosphere, the size of the rooms, and to visit with the staff and other residents. If moving in with a relative, make the transition over a several-week period, moving more of the elder's personal belongings with each visit.
2. Invite familiar faces to visit the elder, and make it easier for them -- offer them a ride if necessary. Continue the mobile meals for a time, if possible, and if the delivery person has become an important part of the elder's day. Take the elder to visit neighbors back in the old community if feasible, or enable him or her to keep contact in some way.
3. If the packing of belongings is too cumbersome a task to complete in one session, break the sessions up into small parts. If the home must be vacated quickly, offer to help the elder box the belongings up and store them. Then each box can be dealt with, whenever the elder feels up to it. People need to be ready to do this in their own time. Often, the elder is able to come to terms with their new situation and finds the task less cumbersome than first thought. Giving beloved objects away to particular loved ones can become a therapeutic act in itself, an acceptance of the situation as a whole. Bottom line: Don't push this issue if at all possible -- let the elder decide when it is time.
4. Be prepared to answer questions about health honestly and completely. Depending on your elder's given health problems and degree of understanding, help them understand that everyone's health deteriorates. Acknowledge their grief: "I realize it must be very difficult to move at this time in your life." Make positive statements as often as possible: "Isn't it wonderful that our community has this facility available?"
Griefwork includes the tasks of anger, bargaining, sadness, denial, and acceptance. Watch for signs of depression, and expect to see them to some degree. Sleep disturbances, changes in eating habits, frequent and uncontrollable crying bouts, and an inability to partake in previously enjoyed activities, are cause for concern. We all grieve at different rates and in a different manner. But, unresolved grief needs to be addressed before it turns into full-blown clinical depression.