Adjusting to Life in Aged Care - Navigating Aged Care Podcast Ep.3

Posted 31st May 2024

Facility Manager Mark Aros (left) and Clinical Psychologist Zoe Falster (right) on the Navigating Aged Care Podcast set

In this episode of St. Vincent's Care's Navigating Aged Care series, the hosts discuss the emotional challenges of transitioning a loved one into aged care.

They are joined by residents and their families, as well as aged care staff, a geriatrician, and a psychologist.

"It often can't be done with a single interaction. Sometimes as you said before, we're working through this professionally. We've got a certain outcome in mind, but we need to be prepared to give families and my patients people time to work through these really complex decisions."

Dr. Richard on families processing a potential move to aged care

The guests share their personal experiences and offer advice on coping with the emotional journey of moving a loved one into aged care. They discuss the importance of support networks, therapy, and maintaining healthy relationships during the transition. The experts also provide tips on navigating family dynamics, maintaining boundaries, and creating a comfortable and personalized environment in the aged care facility. Overall, the episode emphasizes the need for empathy, understanding, and self-care during this challenging time.

Hosted by: Nicole Lessio

Produced by: MSQUARE Productions

Nicole:
Welcome to episode three of St. Vincent's Care's five-part navigating Aged Care series. I'm your host, Nicole Lessio, and in this episode we're talking about integrating our loved ones into their new aged care community because feeling that sense of belonging is crucial for their wellbeing and adjustment to their new home. We'll be joined by true experts in the field, again, residents and their families as well as aged care staff are geriatrician and a psychologist. We're delighted to welcome back, grace and Sheridan. Welcome back. Thank you. I'm so excited that you're here to talk about integration because it's a really big part of getting to be part of your new community and Sheridan, what is it that you did for mum or with the aged care staff that helped integrate money to her community? Supports? Did you give
Sheridan:
Multitude of things? One that the facility themself offer, but also for myself, I have the good fortune of living in very close proximity to the facility, so that made it so much easier for me. So me personally, what I would do in the initial parts, I would say every day I'd go and see mum. I'd come home from work, I'd go in and I'd see her and so that she didn't feel like I'd just sort of dumped and run kind of thing. But I think the facilities assistance in that was crucial in that knowing that I was coming outside of visiting hours. So the nurses or staff would still let me in after hours just so that I could go in and see her and reassure her that I am not abandoning now. And then things like I would get the activities calendar sent to me from management and then I could say to mum, Hey, are you aware Bingo's on tomorrow, are you going to go? Things like that. Other things along the lines of, I'd take in cakes and biscuits and things like that on the weekends for them to have a morning tea to try and encourage mom to have morning tea outside of her room in the dining room with other residents and things like that. Just little things like that to try and encourage her to integrate, I suppose to assimilate into the new environment that she's in because it's very difficult in the beginning for her and for me, I suppose in some ways as well. Yeah, yeah,
Nicole:
Absolutely. It's a big transition, especially if you've been in your home for a long time or you've been in one living situation for a long time. It's a huge transition to go into a completely new community. Grace, what advice would you have for families on helping residents to integrate into their new communities?
Grace:
I think to get involved as soon as you can into things. Yeah.
Nicole:
Are you saying for your residents, fellow residents to get involved? Yeah. What about for families? What do you think the things that Sheridan was doing, how was that helpful
Grace:
For you? Very, very helpful. Yeah, I think just to see your family while you are getting used to a new facility, it's very, very important.
Nicole:
Yeah, for sure. And what do you love most about where you're living?
Grace:
It's another home. Yeah. Yeah.
Nicole:
It's all new, but
Grace:
It's still home. It's all new, but you can make it your home. Yeah.
Nicole:
Yeah. What makes it home for you then?
Grace:
I just think the way I've done my room up with photos everywhere and that I can come and go as I please. Also
Nicole:
Your room, what's the thing? Have you got a great view? Tell me about your room.
Grace:
I look out onto a garden or a hedge really? And my room has got all my family photos everywhere and it's just comfortable.
Nicole:
Is it nice to know that Sheridan's across the street too?
Grace:
Of course.
Nicole:
That is very handy. Sheridan. That
Grace:
Is very, very important.
Nicole:
Not everyone gets that luxury,
Sheridan:
Obviously. No. Yeah.
Nicole:
How does it feel for you, because obviously putting your parent into an aged care facility of any kind, moving them into a different community, it's a really challenging time, so how does it feel for you knowing that mom's somewhere she loves and is
Sheridan:
Part of something? It's such a relief because in the beginning you don't know it's uncharted territory and you're worried about so many things. You're worried about one, will she be happy, will she be taken more care of? If she's not, will she tell me? There's all these different things that run through your head and ultimately you want, obviously to her to be happy is the number one thing, but obviously her care is important, making sure that she's treated well, so to see how happy she was and how she's changed and grown, and then the impact that that's had on other residents and now her working at reception and doing all these things to do, seeing the transformation of her, I would never have anticipated that was going to happen. I'm very glad it did. But yeah, for me now, it's just a huge relief to know that it was the right decision and that it has worked out so well.
And to her benefit, it's like any, you'd know even as a mother when you're taking a big leap with your child, not saying you're my child, but when you're taking a big leap with a child, putting 'em in daycare or putting 'em in school, their son, there's this anxiety attached to it because this is unknown and you dunno what to expect and you have all these fears. And that's even for me with my own mother was like, I was like, oh, the roles felt like they changed for a bit and it's a bit confusing. But yeah, no, it was a great relief to see that over time. Watching her adapt and grow was just amazing. And you've
Nicole:
Grown a lot, haven't you, grace? Oh yeah. Yes. Yeah. Yeah. What do you think has made the biggest change for you? How have you grown in your community?
Grace:
It's really the people. It's the other residents and the staff particularly. I was very, very fortunate at that time. The staff was just, they would check on me all the time and yeah, I was just one of the very lucky ones,
Nicole:
But I think you become part of a community the more you interact with that community. And so at the start you were really quite reticent to get involved. For
Grace:
You, it was such a different change to my life and it's bewildering because you're used to doing your own thing and all of a sudden you've got to conform. Breakfast is at a set time, so is lunch, so is dinner, and you're used to just wandering around doing what you want to do. You can't do that anymore.
Nicole:
Yeah, that is
Grace:
Quite a challenge. It's restrictive, but you do adapt. It takes time, of course. It just takes time.
Nicole:
How long do you think it took you to really come out of your shell?
Grace:
It would take me a good 12 months. Yeah.
Nicole:
Do you think that that's the same if we're moving into a new community of any kind, if you were moving to a new house in another suburb?
Grace:
I think so. Do you think it would take that time? I think so. By the time you get to know your neighbors and what your activities are going to be like in that situation. Yeah. Yeah, definitely.
Nicole:
What's your favorite activity? Grace?
Grace:
Everything.
Nicole:
Everything. I want to know what I'm looking forward to. Grace,
Grace:
I love reading. I love doing crosswords. I love good movies. I love
Sheridan:
You win at Bingo a fair bit.
Grace:
Yeah, but I don't do that anymore. I did, yeah.
Nicole:
It's a bit hard to win at Bingo when you're also manning the front desk. It might look a little suspicious.
Grace:
I used to,
Sheridan:
They did think it was rigged for a while there. She was winning all the time and I would get all the spoils of her victory. It was our chocolate and stuff like that. She'd be like, I've got this for you. I'm be like, yes. Good job at bingo, mum. Yeah.
Nicole:
Nice work. You're bringing home the Bacon again, bit your interaction with the community Sheridan. You clearly can live across the road. You can come back and forth as you please to visit mum, but it's not just mum because she's in a whole new community. So what's your interaction with mum's whole new community these days?
Sheridan:
Well, initially I walk through there obviously being very friendly, saying hello, all that kind of stuff to anyone who happens by, because you are not going to walk in their cell face, I suppose. But over time you start to get to know people. They become familiar, whether it be the nurses, residents or other staff members. You start to get to know them and you do actually start to build these unique little relationships with them. And then, like I was saying to you before, I've now become a volunteer in there and I love it. They don't get a huge amount of time out of me. I don't have a lot to give, but what I do give, I really enjoy and I've made new friends. I've met some just amazing people, and I think the most amazing people I've met in there are actually the residents because some of them are just remarkable human beings. They've got these amazing backstories and there's one in particular that I remember and I was just blown away by her. She's so humble and so didn't think she was a big deal, but I think just, I couldn't believe I was in the presence of this human being. And yeah, it's invaluable for me, I think, to have those experiences.
Nicole:
So it's made a big difference for you as well as for mom. Absolutely.
Sheridan:
Yeah. Absolutely. It has. Yeah. Yeah. It's changed my whole perspective of life. It's changed our relationship. Everything's changed, which initially I was probably a little bit resistant to, there was probably almost maybe a little bit of almost resentment, not towards mom, but just towards this sudden change of life. My life's going my way, my trajectory, how I want it now. Suddenly I've got to pivot and it's not intentional. You don't intentionally feel that way, but that was there and you're like, okay, you have to make a decision. And that was to embrace it and just go with it and see where this ends up. And like I said before, would never have anticipated this is where my life was going to end up, and I'm excited to see what's next going on this journey with this being unreal.
Nicole:
You're excited to see what's next too, aren't you? Grace? Of course. Yeah. Yeah. Did you imagine that you would see a difference in your own daughter as well as yourself in this whole situation?
Grace:
Yes. No, it's been a growing experience for both of us. You don't anticipate what's going to be around the corner, especially as you get older. And yeah, it's been life changing and I'm embracing it because I didn't think it was going to be this good.
Nicole:
So when you were going in at first and really not coming out of your shell, what was the thing that you think made the difference? When did you decide I'm going to get involved?
Grace:
That's a very hard question to answer because a lot of it, I still think I was maybe grieving for a while and I didn't realize I was. And I think you can shut yourself off to certain things because you really don't understand why you are the way you are.
Nicole:
So the support that you've had from your community, is it from your peers, is it from the staff? Where do you get your support to be able to keep doing all the things that you enjoy
Grace:
Doing? I get it from everybody there now. Yeah, from the other residents, the staff. Yeah. It's just everywhere now.
Nicole:
Could you imagine it any different now that you're all integrated and happy in your new community?
Grace:
In what way?
Nicole:
Can you imagine if you weren't in aged care where you're living now in your community, what would your life be like? How would it be different?
Grace:
Oh, we would probably still be traveling. Yeah. Yeah.
Nicole:
You were traveling a lot before you came in. Yeah. And where's the best place for us to put on our list? Grace.
Grace:
There's so many lovely places around this beautiful country of ours, and you can't just drive through a town. You've really got to spend a week or two, which you don't ever have the time to do. No,
Nicole:
It's never enough time is
Grace:
There? No.
Nicole:
What about when you are in your room and you are just enjoying the piece that you've got, looking out of your view, what are you thinking about the next day and what are you looking forward to?
Grace:
Whatever's going to turn up, whatever's going to happen is going to happen. Yeah. Yep.
Nicole:
You're just ready for it all now.
Grace:
Yeah. Just take everything in my stride now. Yeah. Yep,
Nicole:
Yep. With new residents to your community, how do you help them when they're coming into a new community?
Grace:
If I know that they're coming into the facility, I try and make myself known and just tell them that I know how they feel because I felt the same way. And if you can help somebody to integrate into the community or you just do the best you can.
Nicole:
Yeah. Well, in the same way that if you move to another suburb, you'd probably go next door and take them some banana bread or say hi.
Sheridan:
Is this the same banana bread that Tom bought?
Nicole:
Definitely. Yeah. We know that you are the baker though, aren't you?
Sheridan:
And there's no banana bread getting cooked in my kitchen. No,
Nicole:
Not
Grace:
Anymore. I'm the only one that likes bananas.
Nicole:
But you would, wouldn't you if you've moved into
Sheridan:
A new Absolutely. Well,
Nicole:
If someone's moved into your new community, you try as much as you can to walk. Of course
Grace:
You do.
Nicole:
Of course you do. So it's no different really than any other place that we're moving into. Apart from it's a slightly different flavor of new community. That's right. That's right. When your time is kind getting close to being ready to be into an aged care facility, what are you looking forward to? Sheridan. You
Sheridan:
Seen? I've already joked with my kids that when that time comes just roll me, literally just push me out the front door, it's all downhill and roll me across the street. I think I'm actually most looking forward to not having to clean or cook ever again.
Nicole:
Yes. We haven't even talked about that grace. How do we miss that?
Sheridan:
I don't have to do any domestic chores ever again. And I think that's the bit I'm most looking forward to. Most moms I'd probably say would agree with that. It'd be like a permanent holiday. Yeah, I think that'd be it for me.
Nicole:
That's a bonus grace. Yeah,
Grace:
It is. It is. Yeah.
Nicole:
It's hard to kind of get used to it first, I imagine.
Grace:
Yeah. Well, it's an adaption. You've got to adapt.
Nicole:
Well, and we keep doing that. We as we get older, you do from Everest stage. Yeah, exactly. If we're lucky, we get to keep adapting and changing. That's it. Exactly. Any advice that you would have Sheridan for families? Not all of us are lucky enough to live across the road from an age care facility is beautiful as your mom lives in. So what kind of advice would you have for people to help them integrate? Yeah.
Sheridan:
Oh gosh. I think initially for me, emotionally, you've got to put your own emotions in check. So you have to think, okay, yeah, there's a mention before. There's a little bit of resentment of the change of your life if that's what's happened in your circumstances, there's also guilt. You do feel guilty, you feel immense guilt. And again, you have to put that into perspective of what's best for your parent. I think then also you need to then put your relationship with your parents into perspective too and realize that anything that, any issues you may or may not have with your parents, you need to understand that you're now all adults and that they were also growing when they were raising you. They didn't have it all sorted out. They don't know you have to put all of anything like that. All has to be put aside and you now have to consider and think about what's in their best interest, not what's in yours.
And yes, be mindful of your own needs as well, of course. Because if you put your parents in a facility that's two hours away from your home, you're going to have limited opportunities to see them. So do consider the proximity to you and the rest of the family because you do have a limited number of days. How long? That way you don't know, but it is a limited number so you don't want to waste it. But then actually going forward into it, I think the most important thing to do is honesty is being really honest and having a really honest conversation, which is difficult, which can be very, we've had them, we've had them, we still have them to this day, and they're very difficult because if you've had a parent child relationship your whole life, that probably hasn't been the most honest one. Children don't normally divulge a lot of stuff to their parents and vice versa. So you have to, I
Nicole:
Do mom, if you're listening, tell you everything,
Sheridan:
You have to get past that is what I'm saying. You have to kind of be, okay, this is no longer parent child, this is adult. Adult. And we have to be really honest and we have to talk about good bits, bad bits, because I need to know if not saying whatever has happened will happen, if there's any sort of mistreatment towards mom, I want to know, but she's not going to come and tell me if she doesn't feel safe to do so. So it's creating that safe space to be really honest. And I had to be honest with her and tell her why she couldn't live with me anymore, why we couldn't manage it. It was damaging our relationship. It was going to cause, it was going to cause immense damage. And it was just, I'm not trained. I don't have the training required to do this. My house wasn't set up for it. It was all very sudden it all got thrown at us very quickly. So there was a lot of decisions had to be made quickly, and so we had to be honest with each other about how we felt. And sometimes that honesty isn't the nicest, it's not the kindest, but it's necessary to be able to move forward and create a relationship that we have now that's so vastly different to what we had before.
Nicole:
Yeah, it does get into that.
Grace:
It does
Nicole:
Change of connection between the two of you. Oh, very
Sheridan:
Much so.
Grace:
Very aggressive. I think as long as you don't feel complete abandonment, that is the key.
Nicole:
You would see that as well, wouldn't you?
Grace:
Oh, definitely.
Nicole:
And that's really hard. So having volunteers like yourself Sheridan to go in and have a chat is so important to be able to make sure that people get to integrate into their new community. Definitely. Any other advice that you'd had for people who maybe can't get in and visit? Maybe they are two hours away or maybe they are on the other side of the world? I
Sheridan:
Think try and integrate the world that we have now. We are very fortunate to live in a time where we have things like FaceTime, zoom, all those kinds of things. If you are in a position to do so, mom's got one, buy them an iPad or whatever and teach them how to have FaceTime. I have noticed there's one resident that I take coffee to and her husband FaceTimes her numerous times a day. Often when I'm taking her a cake and her coffee, she's FaceTiming him. So I now know him too because I'll have a chat to him when I take her at a treat. He's
Nicole:
Jealous. He doesn't get cake. He
Sheridan:
Probably, yeah. But yeah, I think that would be, try and keep in contact as much as you can. My brother lives in South Australia and I know he's infrequent contact with mom. We
Grace:
FaceTime each other all the time. Yeah,
Nicole:
Yeah. Magic, isn't it? It's
Grace:
Great. They can show me what he's done out in the backyard and I can be watching it. It's terrific.
Sheridan:
But mom actually went in just before we got put into lockdown for Covid. So even though I was across the road, I actually still couldn't go and see. Couldn't see her. She couldn't see. So yeah, it was invaluable having FaceTime, having even just being another caller wave at it from the window
Nicole:
Smoke.
Sheridan:
Yeah, pretty much. Yeah. But yeah, so we have had a period where we couldn't actually see each other all the time. And to be honest, I think that actually kind of did a good, it kind of forced her hand to not be so reliant on me and it forced her to actually say, oh, okay, I'm going to have to actually step out of my room now and actually integrate with other people because I couldn't be there. But
Nicole:
It's hard to get over that grief period at
Sheridan:
First, isn't
Grace:
It Grace? Yeah.
Nicole:
What do you think helped you?
Grace:
Again, I'm going to repeat myself. I think it was the facility and the people there.
Nicole:
So you got to know the staff pretty well. Yeah. Made some friends, not just with your peers.
Grace:
A lot of the staff that were there then have sort of moved on now, but I was particularly fortunate. Yeah,
Nicole:
You get to make new friends though. You
Grace:
Do. Some of them are still there. Better put that in.
Nicole:
We'll be talking to one of them later. Yeah, definitely. But that opportunity to have that uninterrupted time, actually funnily enough, might've forced, like Sheridan said, forced your hand a little
Grace:
Bit. You do because you can make a choice. Do I just sit here and do nothing or do I help myself? So I decided I'm going to help myself. I'm not going to let this beat me. So do you get in and you do what needs to be done?
Nicole:
Yeah. I imagine Sheridan, I'm feeling really proud of your mom just sitting here. I imagine you feeling really proud
Sheridan:
Of your mom, so proud of her. I know. That's what I was saying before about the adult child relationship, how it flipped. The script's been flipped on us kind of thing where it's like, wait, aren't you meant to be proud of me? Not saying she's not, but yeah, you kind of go watching what she does and watching her change, watching her grow, even if she wasn't working at reception beyond that, just watching how she's advocated for herself, watching her advocate for others and just the changes in it are just amazing. It's amazing. And yeah, I'm immensely proud of her.
Nicole:
That's wonderful. And it's a really cool thing to have between your parent and yourself as well as an adult relationship rather than that you are being the child, you're actually going to be adults together.
Sheridan:
Yeah, very much so.
Grace:
That's great. I'm just so lucky we get on so good.
Nicole:
And you've got a great lot of people that are in that facility with you, and we're going to talk to them in just a little while as well. So I want to thank Sheridan and Grace for joining us today. Thank you. And we've been looking forward to talking to you more about your whole aged care journey. Yeah,
Grace:
Thank you. Thank
Nicole:
You so
Sheridan:
Much. Thanks. Fabulous.
Nicole:
We've had two experts so far and we've got another two sitting on the couch, so I wanted to welcome Mark Aros. Thank you, Nicole. Mark, you are the facility manager at Heath Coat, so I'm really excited to welcome you here and welcome to Zoe Foster, who's our clinical psychologist at the Darlinghurst Clinic in Sydney for St. Vincent's. Welcome, Zoe. Hi,
Sheridan:
Great to be
Nicole:
Here. Really excited to chat to you both because you've got a wealth of experience in this area for our aged care residents and families. It's the first and possibly only time they're doing it, but you guys are doing it every day, all day. So I'm really keen to get your perspective, mark. We're talking about integrating into aged care, and it's not just about the person who's moving in to the facility, is it? It's about the family that comes with them and the people that are making those decisions on their behalf. So what are the guilty feelings perhaps that those family members have? What do they do with all of those feelings and emotions once they've moved their family member into H Care?
Mark:
I'm glad you touched on that because I think it is a family journey and quite often roles have flipped, but I think it's really important. I do truly believe it's really important that you have honest conversations so those roles don't flip. So the resident feels like they have their own agency and are able to make decisions for themselves and not have their children or next to kin, assuming that they know the person to the point where they're disempowering them. So it's about those conversations and well before you come into age care.
Nicole:
Yeah, that's the hope. Absolutely. But that's not always the case, is it, Zoe? It's not always what families do.
Zoe:
Absolutely. I definitely agree with Mark there. I think if you can have these conversations well ahead of time, that's always the best way to approach things. But things do sneak up on us and families often get surprised and people themselves will get surprised I guess, at where they find themselves and the decisions that they're faced with. I think it's still worth really encouraging that sense of open dialogue. And I think as much as you can bring the person along in the decision making process, the better. We know from the research that proactive decisions about entering age care and one of the better predictors of adjustment. So as involved as that person can be is the better Guilt can play out in a lot of different ways. So we do see people who from that feeling will tend to run away from it and maybe avoid their loved one moving into aged care and feel too confronted by the feelings that it brings up for them. We see some people overcompensating for it and actually starting to do too much for their loved one in aged care potentially then robbing them of some of the empowerment and the autonomy that they need to adjust. So we really need to look at the guilt and see how is it functioning? How is it working for us? How can we use the guilt in an adaptive positive way to build the relationship and help the adjustment process along.
Nicole:
Yeah, I didn't even think about that possibility that you could do too much and then that makes it such a disempowering experience for the person who's moving in. You want them to feel as empowered as they can going in there, don't you, mark?
Mark:
Absolutely. And I think you're absolutely right. You have to identify where that guilt is coming from. And in part I think is, again, I think it goes back to the conversations don't wait till the last minute to have these conversations because then a lot is assumed and it does. I think it creates that guilt and that sense of for the person, I have no doubt that your next extra kin or your children that are helping you in that journey into aged care will always try to do the best for you. But as you say Zoe, that sometimes the intentions are not always for the want of a better word, I guess, that don't always yield the results that you want. They can be quite disempowering.
Nicole:
And you obviously see people coming in and moving in all the time, and it's your day-to-Day work. What is the best way that families can help their loved one integrate into their community even with all those guilt feelings perhaps?
Mark:
I think it's just support acknowledging that it's a huge transition coming into residential aged care and just being there but not overtaking, not controlling. And I think one of the best outcomes is for people when they're coming in is to come with an open mind. It's not see this as a possibility to new experiences rather than a door closing on you. So I think if you come in with an open mind, you are coming into a community that offers so much. There are opportunities to participate as little as you want or as much as you want. There are at the home that I manage, there are 213 individuals that live there. So there's a lot of people that will really interesting have richness in life experience that I think it's really important to seek those connections. And I think that helps to establishing those relationships that will help the person settle into residential care.
Nicole:
But it's not just the other residents that you have a relationship with. When you're a resident, you have a relationship with the staff. How many staff have you got at Heath Co?
Mark:
Well, Heath Coat, it's a particularly large site and we have about 307 staff that work
Nicole:
There. So they're all part of the community too, aren't they, Mike?
Mark:
Absolutely. So when you're in residential care, the community is the residents, the community is the staff and families, and you've got all the other people that come in contractors. And that's our community. It's a large community and I think it functions because it's that respect and that sense of home and having the person, the residents, being at the center of everything we do our why, we are there to serve them, and relationships are key for us to achieve that.
Nicole:
Oh, relationships are everything.
Mark:
Everything. You're quite right,
Nicole:
Zoe. The relationship between what is often a child, an adult child, having their parent move into an aged care facility, that can be quite a challenging one at that time. But once they've made that decision and they've got that time on their hands perhaps that they're no longer being the carer, what do people do with their emotions and their time after that?
Zoe:
I'm so glad you asked because I think I see a lot of people who they work up to this decision and they approach with this sense of, once I've made this decision, then it's done. And it's really not. The relationship changes definitely, but the caring role does continue. It's so important for family members to still see that their emotional support, their social support is still an integral part of the person's kind of journey into aged care. I guess some of the guilt that we've spoken about as well does also follow and that can kind of get reminded and re-brought up, I guess each visit that they might have with their person in aged care. I think it's really important just to tune in to the person that is your parent or your aunt or whoever it might happen to be. Tune into them, listen to them and try and understand what it's like for them. I think we can go into it with a lot of preconceptions and ideas about what it might be like for us or what we think of it, but it's really important to listen to what their experience is and what they want. And if they're asking for help, great, we can kind of step in. But if they're actually asking for a little bit more space and autonomy, we can give them that as well.
Nicole:
I love that you're telling us about that because I think for so many of us when we are making those decisions, it will be really hard to step out and make sure that people get their own feel for their community and get their own integrating happening. But that person then is they have time on their hands that they might not necessarily have had before, and that could bring up a lot of things too, I imagine. For the person who's put their loved one or helped them integrate into aged care, what is the best advice that you would have for someone about those feelings of guilt, about the time that they've got to think perhaps? What can they do with themselves to help them make themselves feel better about that decision?
Zoe:
I think they can probably do a few things. So the first is meaning and purpose. So I think for a lot of carers it might've been quite a gradual increase in their care duties at home. They may have finished up with work, they may have cut down on their own social activities, their own medical appointments, those kinds of things. We see a lot of carers actually giving all of themselves to caring for their loved one, and then that suddenly kind of reduces drastically when they go into care. And that can be a huge adjustment for them. So that's a real opportunity to then go back to some of those things that gave them meeting and purpose previously, reconnect with friends, reconnect with other family, maybe start volunteering or doing some kind of learning, but also using that time to stay connected with their person in aged care
Nicole:
As well. And to be kind, I think to yourself, because it's quite a challenging time, isn't it?
Zoe:
Yeah, it absolutely is. We see a lot of people who just need to talk that through with someone.
Nicole:
Mark, when someone comes in and they're coming into their community, they're integrated in there as best that they can be. They're not always going to be like Grace and wanting to volunteer and be on the front desk and out and about. What are the best strategies that you see that people are using to integrate themselves into the community when they move in? Right.
Mark:
First, I just want to say that I loved them finding meaning and purpose, and it doesn't have to be to the level that Grace is doing at the front desk. There are many, many other options, and we have residents volunteering in helping us with organizing newsletters sitting in front of a desk to do that. So there are scopes. There is scopes to be able to volunteer and have a sense of purpose. And you're contributing to the wider community? Yeah.
Nicole:
Just as
Mark:
You would community. That's right, that's right. Yeah, sorry. And of course, out of that, you get so much. I think when you feel engaged, when you feel useful, when you feel connected, I think it gives you a greater sense of satisfaction.
Nicole:
And what do you see when people are not integrating into the community? What does it look like?
Mark:
Well, I can tell you when you integrate, I think it's terrific for your mental health when you don't integrate, I think that's when you draw into yourself and you focus on all the things that perhaps your body's changing and you focus on the negative. I think when you integrate, I think you see the bigger picture, and I think it's an incredible, I guess for the medicine for you, for your mental health, yeah,
Nicole:
I guess you would echo those sentiments, would
Zoe:
You say? Absolutely, yes, absolutely. I think there's a sense of openness and willingness with integration when a person arrives and they're flexible and willing to take on new experiences to meet new people, to put themselves out there a little bit, which can be a really scary and daunting thing at any point in our life. But let alone, I think when you're moving into an aged care facility, it's a little bit, I know we've heard a little bit of an analogy about maybe starting a new school or moving into a new suburb. It's doing all of that at once. It's like starting a new job in a new city with a new team of people, and you live there, so it's 24 7. It can be very daunting when I see people who haven't necessarily adjusted that well. It's a lot of isolation, it's a lot of staying in the room, not joining the group meals, not joining group activities, not staying in touch with people by phone or by email or any other way. And that very quickly can spiral. Sorry, that very quickly can spiral down into depression. So yeah, having those connections and having those invitations and the structure in an aged care place where those activities are available is so important.
Nicole:
Yeah, I love that you touched on the depression angle because often we know that those who are aging, not necessarily whether they're in aged care or not in aged care, but those who are aging tend to be a little bit more, tend to have a little bit more challenge with depression. Is that the key, that connection?
Zoe:
It's a big part of the key. And what we actually know about depression is that actually the rates of depression are highest in our middle years and they decrease as we age. But there are some predictors, I guess, of depression in late life and one of them is isolation. So yes, social activity is vital, exercise, good diet, good sleep, good self-care, all of those things.
Nicole:
All those things. And the purpose part I think is really critical as well. Finding something. I love that you said that Mark about it doesn't have to be as big as Grace's purpose. Grace has clearly really integrated herself into that community,
Mark:
But very capable individual.
Nicole:
A lot to give. Yeah, absolutely. But your purpose can be, I want to read five books before the end of the year, can't it?
Mark:
Absolutely.
Nicole:
Yeah. It's what it looks like for you. How do you get that out of a resident? How do you figure out, how do your staff build those relationships to work out how best to pull them out of their shells?
Mark:
Well, I think this is, it's two. When you come into residential aged care, I think you have to, as a family member, as a resident, I think you have to acknowledge you're coming to live in the community. And I truly believe that to get the best out of the community, I think you have to be a little bit generous in spirit so you can develop those relationships. How do we get the best out of people? I believe is when we get to know people as people. And that's part of that generosity of spirit. When you're kind, you're accepting and you are open. I think people get to know what you want. I think it's incredibly important also to learn how to communicate with people as well. Don't sit back and assume that people will somehow guess what your story is and what you want to do become. You'd become a member of a large community. I think it's important to ensure that you take steps to proactively engage with not only the other residents in the home, but with staff and share and say, this is what I want from the experience. And staff are only more than willing to assist you with that.
Nicole:
And what about families? Can they help in that process?
Mark:
We love family. I think we'd like to partners with families to provide care, and I think that's essential. I think the most successful, as you saw with Grace, the most successful transitions are where the family is involved and support the resident and develop good relationships with the staff as well. It's all about the relationship. It really is.
Nicole:
And that kindness and respect I think always runs through
Mark:
As well. Well, absolutely. And getting to know the person, and you can only do that when you have that shared respect and we humanize the whole process. I think that's the beauty in life when we see each other, not as the older person, but as the person that I'm helping and supporting, but we are people first and foremost, and we connect at a very human level. I think that's when we get the best out of our staff and get the best of our residents and our families.
Nicole:
Zoe, not everyone is going to be as cognitively and physically able and capable as Grace is when they move into aged care. And that can be super challenging, not just for them, but for their families. What advice might you have for families in those situations?
Zoe:
Yeah, absolutely. Look, typically there are reasons why people are moving into aged care. There are certain kind of functions that may be becoming more difficult at home, and as you say, they can be physical things like being able to manage a flight of stairs or cognitive reasons, so mild cognitive impairment or maybe even a diagnosis of dementia. I think what Mark said absolutely rings true Here more, it becomes even more important that at the end of the day, this is a person and this person has a person hood, and they have values and they have an identity and they have a personality. And those things persist beyond those diagnoses. And so what we really need to do is to help that person identify what their underlying kind of core values are so that they can enact them and live by them still in the aged care facility.
Now, sometimes it's often a little bit easier if it's a physical issue because there are some very practical things that we can often do to help with that. Cognitive issues can be a little bit harder to navigate. It's really important to get a good sense of what the strengths and deficits are so that you can then look at what different kind of strategies you might be able to remediate those for the person so they can continue to function as best as they can. And then where there are areas where they really are struggling, whether it be memory or an executive dysfunction, what other kind of environmental or situational aids can you put in place to help them? Is it as simple as having a big calendar on the fridge that tells them exactly what's happening today or little reminders set up or having a carer or a family member call them every so often just to remind them that something's happening that day?
Nicole:
Yeah, those little things we don't really think about too much, do we? Mark? But you have to think about that all the time.
Mark:
We do, and I'm glad you set that, Zoe, because that's where coming into aged care, we do have an expertise or experience. And even when you're living with advanced dementia, we have got processes to help us engage with residents. And when things like memory boxes where we can help families because they find that awfully hard. The relationship is deteriorating when you can't communicate with your parent. But if you have some things like memory boxes for example, you can actually pick up things and begin a conversation at the level of your parent is at and still make it meaningful so your visit is meaningful and you both are getting some benefit out of it.
Nicole:
Yeah, that is a great idea that obviously we as people who don't have a day-to-Day experience with Aged Care don't necessarily know about. And we love that there are experts like yourselves who actually have that experience day-to-day to be able to help us navigate that. I'm so grateful for your advice and your candor. I appreciate it, both of you. In this episode, we've covered the integration of our loved ones into aged care communities, so thank you to Grace and to Sheridan and to Mark and to Zoe for sharing their stories. We really appreciate it. Thanks for tuning in. If you enjoyed today's episode, be sure to hit the follow button and share it with your friends and family. And don't forget to visit our website, www.svcs.org au to watch the videos from our latest campaign, which inspired this podcast. You can also stay connected with us on Facebook, Instagram, or LinkedIn by searching St. Vincent's Care. And if you've enjoyed this podcast, leaving a rating or review would mean the world to us. It really helps other people find this content. So join us in our next episode as we look at ways to help our loved ones flourish within these communities. Bye for now.

Nicole:
Welcome to episode three of St. Vincent's Care's five-part navigating Aged Care series. I'm your host, Nicole Lessio, and in this episode we're talking about integrating our loved ones into their new aged care community because feeling that sense of belonging is crucial for their wellbeing and adjustment to their new home. We'll be joined by true experts in the field, again, residents and their families as well as aged care staff are geriatrician and a psychologist. We're delighted to welcome back, grace and Sheridan. Welcome back. Thank you. I'm so excited that you're here to talk about integration because it's a really big part of getting to be part of your new community and Sheridan, what is it that you did for mum or with the aged care staff that helped integrate money to her community? Supports? Did you give
Sheridan:
Multitude of things? One that the facility themself offer, but also for myself, I have the good fortune of living in very close proximity to the facility, so that made it so much easier for me. So me personally, what I would do in the initial parts, I would say every day I'd go and see mum. I'd come home from work, I'd go in and I'd see her and so that she didn't feel like I'd just sort of dumped and run kind of thing. But I think the facilities assistance in that was crucial in that knowing that I was coming outside of visiting hours. So the nurses or staff would still let me in after hours just so that I could go in and see her and reassure her that I am not abandoning now. And then things like I would get the activities calendar sent to me from management and then I could say to mum, Hey, are you aware Bingo's on tomorrow, are you going to go? Things like that. Other things along the lines of, I'd take in cakes and biscuits and things like that on the weekends for them to have a morning tea to try and encourage mom to have morning tea outside of her room in the dining room with other residents and things like that. Just little things like that to try and encourage her to integrate, I suppose to assimilate into the new environment that she's in because it's very difficult in the beginning for her and for me, I suppose in some ways as well. Yeah, yeah,
Nicole:
Absolutely. It's a big transition, especially if you've been in your home for a long time or you've been in one living situation for a long time. It's a huge transition to go into a completely new community. Grace, what advice would you have for families on helping residents to integrate into their new communities?
Grace:
I think to get involved as soon as you can into things. Yeah.
Nicole:
Are you saying for your residents, fellow residents to get involved? Yeah. What about for families? What do you think the things that Sheridan was doing, how was that helpful
Grace:
For you? Very, very helpful. Yeah, I think just to see your family while you are getting used to a new facility, it's very, very important.
Nicole:
Yeah, for sure. And what do you love most about where you're living?
Grace:
It's another home. Yeah. Yeah.
Nicole:
It's all new, but
Grace:
It's still home. It's all new, but you can make it your home. Yeah.
Nicole:
Yeah. What makes it home for you then?
Grace:
I just think the way I've done my room up with photos everywhere and that I can come and go as I please. Also
Nicole:
Your room, what's the thing? Have you got a great view? Tell me about your room.
Grace:
I look out onto a garden or a hedge really? And my room has got all my family photos everywhere and it's just comfortable.
Nicole:
Is it nice to know that Sheridan's across the street too?
Grace:
Of course.
Nicole:
That is very handy. Sheridan. That
Grace:
Is very, very important.
Nicole:
Not everyone gets that luxury,
Sheridan:
Obviously. No. Yeah.
Nicole:
How does it feel for you, because obviously putting your parent into an aged care facility of any kind, moving them into a different community, it's a really challenging time, so how does it feel for you knowing that mom's somewhere she loves and is
Sheridan:
Part of something? It's such a relief because in the beginning you don't know it's uncharted territory and you're worried about so many things. You're worried about one, will she be happy, will she be taken more care of? If she's not, will she tell me? There's all these different things that run through your head and ultimately you want, obviously to her to be happy is the number one thing, but obviously her care is important, making sure that she's treated well, so to see how happy she was and how she's changed and grown, and then the impact that that's had on other residents and now her working at reception and doing all these things to do, seeing the transformation of her, I would never have anticipated that was going to happen. I'm very glad it did. But yeah, for me now, it's just a huge relief to know that it was the right decision and that it has worked out so well.
And to her benefit, it's like any, you'd know even as a mother when you're taking a big leap with your child, not saying you're my child, but when you're taking a big leap with a child, putting 'em in daycare or putting 'em in school, their son, there's this anxiety attached to it because this is unknown and you dunno what to expect and you have all these fears. And that's even for me with my own mother was like, I was like, oh, the roles felt like they changed for a bit and it's a bit confusing. But yeah, no, it was a great relief to see that over time. Watching her adapt and grow was just amazing. And you've
Nicole:
Grown a lot, haven't you, grace? Oh yeah. Yes. Yeah. Yeah. What do you think has made the biggest change for you? How have you grown in your community?
Grace:
It's really the people. It's the other residents and the staff particularly. I was very, very fortunate at that time. The staff was just, they would check on me all the time and yeah, I was just one of the very lucky ones,
Nicole:
But I think you become part of a community the more you interact with that community. And so at the start you were really quite reticent to get involved. For
Grace:
You, it was such a different change to my life and it's bewildering because you're used to doing your own thing and all of a sudden you've got to conform. Breakfast is at a set time, so is lunch, so is dinner, and you're used to just wandering around doing what you want to do. You can't do that anymore.
Nicole:
Yeah, that is
Grace:
Quite a challenge. It's restrictive, but you do adapt. It takes time, of course. It just takes time.
Nicole:
How long do you think it took you to really come out of your shell?
Grace:
It would take me a good 12 months. Yeah.
Nicole:
Do you think that that's the same if we're moving into a new community of any kind, if you were moving to a new house in another suburb?
Grace:
I think so. Do you think it would take that time? I think so. By the time you get to know your neighbors and what your activities are going to be like in that situation. Yeah. Yeah, definitely.
Nicole:
What's your favorite activity? Grace?
Grace:
Everything.
Nicole:
Everything. I want to know what I'm looking forward to. Grace,
Grace:
I love reading. I love doing crosswords. I love good movies. I love
Sheridan:
You win at Bingo a fair bit.
Grace:
Yeah, but I don't do that anymore. I did, yeah.
Nicole:
It's a bit hard to win at Bingo when you're also manning the front desk. It might look a little suspicious.
Grace:
I used to,
Sheridan:
They did think it was rigged for a while there. She was winning all the time and I would get all the spoils of her victory. It was our chocolate and stuff like that. She'd be like, I've got this for you. I'm be like, yes. Good job at bingo, mum. Yeah.
Nicole:
Nice work. You're bringing home the Bacon again, bit your interaction with the community Sheridan. You clearly can live across the road. You can come back and forth as you please to visit mum, but it's not just mum because she's in a whole new community. So what's your interaction with mum's whole new community these days?
Sheridan:
Well, initially I walk through there obviously being very friendly, saying hello, all that kind of stuff to anyone who happens by, because you are not going to walk in their cell face, I suppose. But over time you start to get to know people. They become familiar, whether it be the nurses, residents or other staff members. You start to get to know them and you do actually start to build these unique little relationships with them. And then, like I was saying to you before, I've now become a volunteer in there and I love it. They don't get a huge amount of time out of me. I don't have a lot to give, but what I do give, I really enjoy and I've made new friends. I've met some just amazing people, and I think the most amazing people I've met in there are actually the residents because some of them are just remarkable human beings. They've got these amazing backstories and there's one in particular that I remember and I was just blown away by her. She's so humble and so didn't think she was a big deal, but I think just, I couldn't believe I was in the presence of this human being. And yeah, it's invaluable for me, I think, to have those experiences.
Nicole:
So it's made a big difference for you as well as for mom. Absolutely.
Sheridan:
Yeah. Absolutely. It has. Yeah. Yeah. It's changed my whole perspective of life. It's changed our relationship. Everything's changed, which initially I was probably a little bit resistant to, there was probably almost maybe a little bit of almost resentment, not towards mom, but just towards this sudden change of life. My life's going my way, my trajectory, how I want it now. Suddenly I've got to pivot and it's not intentional. You don't intentionally feel that way, but that was there and you're like, okay, you have to make a decision. And that was to embrace it and just go with it and see where this ends up. And like I said before, would never have anticipated this is where my life was going to end up, and I'm excited to see what's next going on this journey with this being unreal.
Nicole:
You're excited to see what's next too, aren't you? Grace? Of course. Yeah. Yeah. Did you imagine that you would see a difference in your own daughter as well as yourself in this whole situation?
Grace:
Yes. No, it's been a growing experience for both of us. You don't anticipate what's going to be around the corner, especially as you get older. And yeah, it's been life changing and I'm embracing it because I didn't think it was going to be this good.
Nicole:
So when you were going in at first and really not coming out of your shell, what was the thing that you think made the difference? When did you decide I'm going to get involved?
Grace:
That's a very hard question to answer because a lot of it, I still think I was maybe grieving for a while and I didn't realize I was. And I think you can shut yourself off to certain things because you really don't understand why you are the way you are.
Nicole:
So the support that you've had from your community, is it from your peers, is it from the staff? Where do you get your support to be able to keep doing all the things that you enjoy
Grace:
Doing? I get it from everybody there now. Yeah, from the other residents, the staff. Yeah. It's just everywhere now.
Nicole:
Could you imagine it any different now that you're all integrated and happy in your new community?
Grace:
In what way?
Nicole:
Can you imagine if you weren't in aged care where you're living now in your community, what would your life be like? How would it be different?
Grace:
Oh, we would probably still be traveling. Yeah. Yeah.
Nicole:
You were traveling a lot before you came in. Yeah. And where's the best place for us to put on our list? Grace.
Grace:
There's so many lovely places around this beautiful country of ours, and you can't just drive through a town. You've really got to spend a week or two, which you don't ever have the time to do. No,
Nicole:
It's never enough time is
Grace:
There? No.
Nicole:
What about when you are in your room and you are just enjoying the piece that you've got, looking out of your view, what are you thinking about the next day and what are you looking forward to?
Grace:
Whatever's going to turn up, whatever's going to happen is going to happen. Yeah. Yep.
Nicole:
You're just ready for it all now.
Grace:
Yeah. Just take everything in my stride now. Yeah. Yep,
Nicole:
Yep. With new residents to your community, how do you help them when they're coming into a new community?
Grace:
If I know that they're coming into the facility, I try and make myself known and just tell them that I know how they feel because I felt the same way. And if you can help somebody to integrate into the community or you just do the best you can.
Nicole:
Yeah. Well, in the same way that if you move to another suburb, you'd probably go next door and take them some banana bread or say hi.
Sheridan:
Is this the same banana bread that Tom bought?
Nicole:
Definitely. Yeah. We know that you are the baker though, aren't you?
Sheridan:
And there's no banana bread getting cooked in my kitchen. No,
Nicole:
Not
Grace:
Anymore. I'm the only one that likes bananas.
Nicole:
But you would, wouldn't you if you've moved into
Sheridan:
A new Absolutely. Well,
Nicole:
If someone's moved into your new community, you try as much as you can to walk. Of course
Grace:
You do.
Nicole:
Of course you do. So it's no different really than any other place that we're moving into. Apart from it's a slightly different flavor of new community. That's right. That's right. When your time is kind getting close to being ready to be into an aged care facility, what are you looking forward to? Sheridan. You
Sheridan:
Seen? I've already joked with my kids that when that time comes just roll me, literally just push me out the front door, it's all downhill and roll me across the street. I think I'm actually most looking forward to not having to clean or cook ever again.
Nicole:
Yes. We haven't even talked about that grace. How do we miss that?
Sheridan:
I don't have to do any domestic chores ever again. And I think that's the bit I'm most looking forward to. Most moms I'd probably say would agree with that. It'd be like a permanent holiday. Yeah, I think that'd be it for me.
Nicole:
That's a bonus grace. Yeah,
Grace:
It is. It is. Yeah.
Nicole:
It's hard to kind of get used to it first, I imagine.
Grace:
Yeah. Well, it's an adaption. You've got to adapt.
Nicole:
Well, and we keep doing that. We as we get older, you do from Everest stage. Yeah, exactly. If we're lucky, we get to keep adapting and changing. That's it. Exactly. Any advice that you would have Sheridan for families? Not all of us are lucky enough to live across the road from an age care facility is beautiful as your mom lives in. So what kind of advice would you have for people to help them integrate? Yeah.
Sheridan:
Oh gosh. I think initially for me, emotionally, you've got to put your own emotions in check. So you have to think, okay, yeah, there's a mention before. There's a little bit of resentment of the change of your life if that's what's happened in your circumstances, there's also guilt. You do feel guilty, you feel immense guilt. And again, you have to put that into perspective of what's best for your parent. I think then also you need to then put your relationship with your parents into perspective too and realize that anything that, any issues you may or may not have with your parents, you need to understand that you're now all adults and that they were also growing when they were raising you. They didn't have it all sorted out. They don't know you have to put all of anything like that. All has to be put aside and you now have to consider and think about what's in their best interest, not what's in yours.
And yes, be mindful of your own needs as well, of course. Because if you put your parents in a facility that's two hours away from your home, you're going to have limited opportunities to see them. So do consider the proximity to you and the rest of the family because you do have a limited number of days. How long? That way you don't know, but it is a limited number so you don't want to waste it. But then actually going forward into it, I think the most important thing to do is honesty is being really honest and having a really honest conversation, which is difficult, which can be very, we've had them, we've had them, we still have them to this day, and they're very difficult because if you've had a parent child relationship your whole life, that probably hasn't been the most honest one. Children don't normally divulge a lot of stuff to their parents and vice versa. So you have to, I
Nicole:
Do mom, if you're listening, tell you everything,
Sheridan:
You have to get past that is what I'm saying. You have to kind of be, okay, this is no longer parent child, this is adult. Adult. And we have to be really honest and we have to talk about good bits, bad bits, because I need to know if not saying whatever has happened will happen, if there's any sort of mistreatment towards mom, I want to know, but she's not going to come and tell me if she doesn't feel safe to do so. So it's creating that safe space to be really honest. And I had to be honest with her and tell her why she couldn't live with me anymore, why we couldn't manage it. It was damaging our relationship. It was going to cause, it was going to cause immense damage. And it was just, I'm not trained. I don't have the training required to do this. My house wasn't set up for it. It was all very sudden it all got thrown at us very quickly. So there was a lot of decisions had to be made quickly, and so we had to be honest with each other about how we felt. And sometimes that honesty isn't the nicest, it's not the kindest, but it's necessary to be able to move forward and create a relationship that we have now that's so vastly different to what we had before.
Nicole:
Yeah, it does get into that.
Grace:
It does
Nicole:
Change of connection between the two of you. Oh, very
Sheridan:
Much so.
Grace:
Very aggressive. I think as long as you don't feel complete abandonment, that is the key.
Nicole:
You would see that as well, wouldn't you?
Grace:
Oh, definitely.
Nicole:
And that's really hard. So having volunteers like yourself Sheridan to go in and have a chat is so important to be able to make sure that people get to integrate into their new community. Definitely. Any other advice that you'd had for people who maybe can't get in and visit? Maybe they are two hours away or maybe they are on the other side of the world? I
Sheridan:
Think try and integrate the world that we have now. We are very fortunate to live in a time where we have things like FaceTime, zoom, all those kinds of things. If you are in a position to do so, mom's got one, buy them an iPad or whatever and teach them how to have FaceTime. I have noticed there's one resident that I take coffee to and her husband FaceTimes her numerous times a day. Often when I'm taking her a cake and her coffee, she's FaceTiming him. So I now know him too because I'll have a chat to him when I take her at a treat. He's
Nicole:
Jealous. He doesn't get cake. He
Sheridan:
Probably, yeah. But yeah, I think that would be, try and keep in contact as much as you can. My brother lives in South Australia and I know he's infrequent contact with mom. We
Grace:
FaceTime each other all the time. Yeah,
Nicole:
Yeah. Magic, isn't it? It's
Grace:
Great. They can show me what he's done out in the backyard and I can be watching it. It's terrific.
Sheridan:
But mom actually went in just before we got put into lockdown for Covid. So even though I was across the road, I actually still couldn't go and see. Couldn't see her. She couldn't see. So yeah, it was invaluable having FaceTime, having even just being another caller wave at it from the window
Nicole:
Smoke.
Sheridan:
Yeah, pretty much. Yeah. But yeah, so we have had a period where we couldn't actually see each other all the time. And to be honest, I think that actually kind of did a good, it kind of forced her hand to not be so reliant on me and it forced her to actually say, oh, okay, I'm going to have to actually step out of my room now and actually integrate with other people because I couldn't be there. But
Nicole:
It's hard to get over that grief period at
Sheridan:
First, isn't
Grace:
It Grace? Yeah.
Nicole:
What do you think helped you?
Grace:
Again, I'm going to repeat myself. I think it was the facility and the people there.
Nicole:
So you got to know the staff pretty well. Yeah. Made some friends, not just with your peers.
Grace:
A lot of the staff that were there then have sort of moved on now, but I was particularly fortunate. Yeah,
Nicole:
You get to make new friends though. You
Grace:
Do. Some of them are still there. Better put that in.
Nicole:
We'll be talking to one of them later. Yeah, definitely. But that opportunity to have that uninterrupted time, actually funnily enough, might've forced, like Sheridan said, forced your hand a little
Grace:
Bit. You do because you can make a choice. Do I just sit here and do nothing or do I help myself? So I decided I'm going to help myself. I'm not going to let this beat me. So do you get in and you do what needs to be done?
Nicole:
Yeah. I imagine Sheridan, I'm feeling really proud of your mom just sitting here. I imagine you feeling really proud
Sheridan:
Of your mom, so proud of her. I know. That's what I was saying before about the adult child relationship, how it flipped. The script's been flipped on us kind of thing where it's like, wait, aren't you meant to be proud of me? Not saying she's not, but yeah, you kind of go watching what she does and watching her change, watching her grow, even if she wasn't working at reception beyond that, just watching how she's advocated for herself, watching her advocate for others and just the changes in it are just amazing. It's amazing. And yeah, I'm immensely proud of her.
Nicole:
That's wonderful. And it's a really cool thing to have between your parent and yourself as well as an adult relationship rather than that you are being the child, you're actually going to be adults together.
Sheridan:
Yeah, very much so.
Grace:
That's great. I'm just so lucky we get on so good.
Nicole:
And you've got a great lot of people that are in that facility with you, and we're going to talk to them in just a little while as well. So I want to thank Sheridan and Grace for joining us today. Thank you. And we've been looking forward to talking to you more about your whole aged care journey. Yeah,
Grace:
Thank you. Thank
Nicole:
You so
Sheridan:
Much. Thanks. Fabulous.
Nicole:
We've had two experts so far and we've got another two sitting on the couch, so I wanted to welcome Mark Aros. Thank you, Nicole. Mark, you are the facility manager at Heath Coat, so I'm really excited to welcome you here and welcome to Zoe Foster, who's our clinical psychologist at the Darlinghurst Clinic in Sydney for St. Vincent's. Welcome, Zoe. Hi,
Sheridan:
Great to be
Nicole:
Here. Really excited to chat to you both because you've got a wealth of experience in this area for our aged care residents and families. It's the first and possibly only time they're doing it, but you guys are doing it every day, all day. So I'm really keen to get your perspective, mark. We're talking about integrating into aged care, and it's not just about the person who's moving in to the facility, is it? It's about the family that comes with them and the people that are making those decisions on their behalf. So what are the guilty feelings perhaps that those family members have? What do they do with all of those feelings and emotions once they've moved their family member into H Care?
Mark:
I'm glad you touched on that because I think it is a family journey and quite often roles have flipped, but I think it's really important. I do truly believe it's really important that you have honest conversations so those roles don't flip. So the resident feels like they have their own agency and are able to make decisions for themselves and not have their children or next to kin, assuming that they know the person to the point where they're disempowering them. So it's about those conversations and well before you come into age care.
Nicole:
Yeah, that's the hope. Absolutely. But that's not always the case, is it, Zoe? It's not always what families do.
Zoe:
Absolutely. I definitely agree with Mark there. I think if you can have these conversations well ahead of time, that's always the best way to approach things. But things do sneak up on us and families often get surprised and people themselves will get surprised I guess, at where they find themselves and the decisions that they're faced with. I think it's still worth really encouraging that sense of open dialogue. And I think as much as you can bring the person along in the decision making process, the better. We know from the research that proactive decisions about entering age care and one of the better predictors of adjustment. So as involved as that person can be is the better Guilt can play out in a lot of different ways. So we do see people who from that feeling will tend to run away from it and maybe avoid their loved one moving into aged care and feel too confronted by the feelings that it brings up for them. We see some people overcompensating for it and actually starting to do too much for their loved one in aged care potentially then robbing them of some of the empowerment and the autonomy that they need to adjust. So we really need to look at the guilt and see how is it functioning? How is it working for us? How can we use the guilt in an adaptive positive way to build the relationship and help the adjustment process along.
Nicole:
Yeah, I didn't even think about that possibility that you could do too much and then that makes it such a disempowering experience for the person who's moving in. You want them to feel as empowered as they can going in there, don't you, mark?
Mark:
Absolutely. And I think you're absolutely right. You have to identify where that guilt is coming from. And in part I think is, again, I think it goes back to the conversations don't wait till the last minute to have these conversations because then a lot is assumed and it does. I think it creates that guilt and that sense of for the person, I have no doubt that your next extra kin or your children that are helping you in that journey into aged care will always try to do the best for you. But as you say Zoe, that sometimes the intentions are not always for the want of a better word, I guess, that don't always yield the results that you want. They can be quite disempowering.
Nicole:
And you obviously see people coming in and moving in all the time, and it's your day-to-Day work. What is the best way that families can help their loved one integrate into their community even with all those guilt feelings perhaps?
Mark:
I think it's just support acknowledging that it's a huge transition coming into residential aged care and just being there but not overtaking, not controlling. And I think one of the best outcomes is for people when they're coming in is to come with an open mind. It's not see this as a possibility to new experiences rather than a door closing on you. So I think if you come in with an open mind, you are coming into a community that offers so much. There are opportunities to participate as little as you want or as much as you want. There are at the home that I manage, there are 213 individuals that live there. So there's a lot of people that will really interesting have richness in life experience that I think it's really important to seek those connections. And I think that helps to establishing those relationships that will help the person settle into residential care.
Nicole:
But it's not just the other residents that you have a relationship with. When you're a resident, you have a relationship with the staff. How many staff have you got at Heath Co?
Mark:
Well, Heath Coat, it's a particularly large site and we have about 307 staff that work
Nicole:
There. So they're all part of the community too, aren't they, Mike?
Mark:
Absolutely. So when you're in residential care, the community is the residents, the community is the staff and families, and you've got all the other people that come in contractors. And that's our community. It's a large community and I think it functions because it's that respect and that sense of home and having the person, the residents, being at the center of everything we do our why, we are there to serve them, and relationships are key for us to achieve that.
Nicole:
Oh, relationships are everything.
Mark:
Everything. You're quite right,
Nicole:
Zoe. The relationship between what is often a child, an adult child, having their parent move into an aged care facility, that can be quite a challenging one at that time. But once they've made that decision and they've got that time on their hands perhaps that they're no longer being the carer, what do people do with their emotions and their time after that?
Zoe:
I'm so glad you asked because I think I see a lot of people who they work up to this decision and they approach with this sense of, once I've made this decision, then it's done. And it's really not. The relationship changes definitely, but the caring role does continue. It's so important for family members to still see that their emotional support, their social support is still an integral part of the person's kind of journey into aged care. I guess some of the guilt that we've spoken about as well does also follow and that can kind of get reminded and re-brought up, I guess each visit that they might have with their person in aged care. I think it's really important just to tune in to the person that is your parent or your aunt or whoever it might happen to be. Tune into them, listen to them and try and understand what it's like for them. I think we can go into it with a lot of preconceptions and ideas about what it might be like for us or what we think of it, but it's really important to listen to what their experience is and what they want. And if they're asking for help, great, we can kind of step in. But if they're actually asking for a little bit more space and autonomy, we can give them that as well.
Nicole:
I love that you're telling us about that because I think for so many of us when we are making those decisions, it will be really hard to step out and make sure that people get their own feel for their community and get their own integrating happening. But that person then is they have time on their hands that they might not necessarily have had before, and that could bring up a lot of things too, I imagine. For the person who's put their loved one or helped them integrate into aged care, what is the best advice that you would have for someone about those feelings of guilt, about the time that they've got to think perhaps? What can they do with themselves to help them make themselves feel better about that decision?
Zoe:
I think they can probably do a few things. So the first is meaning and purpose. So I think for a lot of carers it might've been quite a gradual increase in their care duties at home. They may have finished up with work, they may have cut down on their own social activities, their own medical appointments, those kinds of things. We see a lot of carers actually giving all of themselves to caring for their loved one, and then that suddenly kind of reduces drastically when they go into care. And that can be a huge adjustment for them. So that's a real opportunity to then go back to some of those things that gave them meeting and purpose previously, reconnect with friends, reconnect with other family, maybe start volunteering or doing some kind of learning, but also using that time to stay connected with their person in aged care
Nicole:
As well. And to be kind, I think to yourself, because it's quite a challenging time, isn't it?
Zoe:
Yeah, it absolutely is. We see a lot of people who just need to talk that through with someone.
Nicole:
Mark, when someone comes in and they're coming into their community, they're integrated in there as best that they can be. They're not always going to be like Grace and wanting to volunteer and be on the front desk and out and about. What are the best strategies that you see that people are using to integrate themselves into the community when they move in? Right.
Mark:
First, I just want to say that I loved them finding meaning and purpose, and it doesn't have to be to the level that Grace is doing at the front desk. There are many, many other options, and we have residents volunteering in helping us with organizing newsletters sitting in front of a desk to do that. So there are scopes. There is scopes to be able to volunteer and have a sense of purpose. And you're contributing to the wider community? Yeah.
Nicole:
Just as
Mark:
You would community. That's right, that's right. Yeah, sorry. And of course, out of that, you get so much. I think when you feel engaged, when you feel useful, when you feel connected, I think it gives you a greater sense of satisfaction.
Nicole:
And what do you see when people are not integrating into the community? What does it look like?
Mark:
Well, I can tell you when you integrate, I think it's terrific for your mental health when you don't integrate, I think that's when you draw into yourself and you focus on all the things that perhaps your body's changing and you focus on the negative. I think when you integrate, I think you see the bigger picture, and I think it's an incredible, I guess for the medicine for you, for your mental health, yeah,
Nicole:
I guess you would echo those sentiments, would
Zoe:
You say? Absolutely, yes, absolutely. I think there's a sense of openness and willingness with integration when a person arrives and they're flexible and willing to take on new experiences to meet new people, to put themselves out there a little bit, which can be a really scary and daunting thing at any point in our life. But let alone, I think when you're moving into an aged care facility, it's a little bit, I know we've heard a little bit of an analogy about maybe starting a new school or moving into a new suburb. It's doing all of that at once. It's like starting a new job in a new city with a new team of people, and you live there, so it's 24 7. It can be very daunting when I see people who haven't necessarily adjusted that well. It's a lot of isolation, it's a lot of staying in the room, not joining the group meals, not joining group activities, not staying in touch with people by phone or by email or any other way. And that very quickly can spiral. Sorry, that very quickly can spiral down into depression. So yeah, having those connections and having those invitations and the structure in an aged care place where those activities are available is so important.
Nicole:
Yeah, I love that you touched on the depression angle because often we know that those who are aging, not necessarily whether they're in aged care or not in aged care, but those who are aging tend to be a little bit more, tend to have a little bit more challenge with depression. Is that the key, that connection?
Zoe:
It's a big part of the key. And what we actually know about depression is that actually the rates of depression are highest in our middle years and they decrease as we age. But there are some predictors, I guess, of depression in late life and one of them is isolation. So yes, social activity is vital, exercise, good diet, good sleep, good self-care, all of those things.
Nicole:
All those things. And the purpose part I think is really critical as well. Finding something. I love that you said that Mark about it doesn't have to be as big as Grace's purpose. Grace has clearly really integrated herself into that community,
Mark:
But very capable individual.
Nicole:
A lot to give. Yeah, absolutely. But your purpose can be, I want to read five books before the end of the year, can't it?
Mark:
Absolutely.
Nicole:
Yeah. It's what it looks like for you. How do you get that out of a resident? How do you figure out, how do your staff build those relationships to work out how best to pull them out of their shells?
Mark:
Well, I think this is, it's two. When you come into residential aged care, I think you have to, as a family member, as a resident, I think you have to acknowledge you're coming to live in the community. And I truly believe that to get the best out of the community, I think you have to be a little bit generous in spirit so you can develop those relationships. How do we get the best out of people? I believe is when we get to know people as people. And that's part of that generosity of spirit. When you're kind, you're accepting and you are open. I think people get to know what you want. I think it's incredibly important also to learn how to communicate with people as well. Don't sit back and assume that people will somehow guess what your story is and what you want to do become. You'd become a member of a large community. I think it's important to ensure that you take steps to proactively engage with not only the other residents in the home, but with staff and share and say, this is what I want from the experience. And staff are only more than willing to assist you with that.
Nicole:
And what about families? Can they help in that process?
Mark:
We love family. I think we'd like to partners with families to provide care, and I think that's essential. I think the most successful, as you saw with Grace, the most successful transitions are where the family is involved and support the resident and develop good relationships with the staff as well. It's all about the relationship. It really is.
Nicole:
And that kindness and respect I think always runs through
Mark:
As well. Well, absolutely. And getting to know the person, and you can only do that when you have that shared respect and we humanize the whole process. I think that's the beauty in life when we see each other, not as the older person, but as the person that I'm helping and supporting, but we are people first and foremost, and we connect at a very human level. I think that's when we get the best out of our staff and get the best of our residents and our families.
Nicole:
Zoe, not everyone is going to be as cognitively and physically able and capable as Grace is when they move into aged care. And that can be super challenging, not just for them, but for their families. What advice might you have for families in those situations?
Zoe:
Yeah, absolutely. Look, typically there are reasons why people are moving into aged care. There are certain kind of functions that may be becoming more difficult at home, and as you say, they can be physical things like being able to manage a flight of stairs or cognitive reasons, so mild cognitive impairment or maybe even a diagnosis of dementia. I think what Mark said absolutely rings true Here more, it becomes even more important that at the end of the day, this is a person and this person has a person hood, and they have values and they have an identity and they have a personality. And those things persist beyond those diagnoses. And so what we really need to do is to help that person identify what their underlying kind of core values are so that they can enact them and live by them still in the aged care facility.
Now, sometimes it's often a little bit easier if it's a physical issue because there are some very practical things that we can often do to help with that. Cognitive issues can be a little bit harder to navigate. It's really important to get a good sense of what the strengths and deficits are so that you can then look at what different kind of strategies you might be able to remediate those for the person so they can continue to function as best as they can. And then where there are areas where they really are struggling, whether it be memory or an executive dysfunction, what other kind of environmental or situational aids can you put in place to help them? Is it as simple as having a big calendar on the fridge that tells them exactly what's happening today or little reminders set up or having a carer or a family member call them every so often just to remind them that something's happening that day?
Nicole:
Yeah, those little things we don't really think about too much, do we? Mark? But you have to think about that all the time.
Mark:
We do, and I'm glad you set that, Zoe, because that's where coming into aged care, we do have an expertise or experience. And even when you're living with advanced dementia, we have got processes to help us engage with residents. And when things like memory boxes where we can help families because they find that awfully hard. The relationship is deteriorating when you can't communicate with your parent. But if you have some things like memory boxes for example, you can actually pick up things and begin a conversation at the level of your parent is at and still make it meaningful so your visit is meaningful and you both are getting some benefit out of it.
Nicole:
Yeah, that is a great idea that obviously we as people who don't have a day-to-Day experience with Aged Care don't necessarily know about. And we love that there are experts like yourselves who actually have that experience day-to-day to be able to help us navigate that. I'm so grateful for your advice and your candor. I appreciate it, both of you. In this episode, we've covered the integration of our loved ones into aged care communities, so thank you to Grace and to Sheridan and to Mark and to Zoe for sharing their stories. We really appreciate it. Thanks for tuning in. If you enjoyed today's episode, be sure to hit the follow button and share it with your friends and family. And don't forget to visit our website, www.svcs.org au to watch the videos from our latest campaign, which inspired this podcast. You can also stay connected with us on Facebook, Instagram, or LinkedIn by searching St. Vincent's Care. And if you've enjoyed this podcast, leaving a rating or review would mean the world to us. It really helps other people find this content. So join us in our next episode as we look at ways to help our loved ones flourish within these communities. Bye for now.

Adjusting to Life in Aged Care - Navigating Aged Care Podcast Ep.3

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Adjusting to Life in Aged Care - Navigating Aged Care Podcast Ep.3

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