We always knew the day would come when dad would have to move to nursing care.
From the outset his dementia has been a sliding scale of needs and competencies. Like anyone else he had his good days and bad days. The residential home accommodated him for as long as they could – but they were not equipped, and did not have the staff, to deal with more advanced needs.
And so, we moved him into a nursing home to live for the last stage of his life. This was his last home.
When you can no longer live in our own home nursing care may be the only option – if you are lucky enough to find one.
The sad thing is that a room only becomes available once someone else dies. And so, when you view a room for your loved one, the personal effects of the previous occupant may still be there.
Nursing care is a one-way door that people enter, and rarely leave.
For residents of nursing homes the big world outside largely disappears.
As we get older the body becomes the focus of needs; psychological, physical. Getting up and going to bed become the big events of the day: a sign that one day is over, and the next begins. Every day blends into the next.
In residential care people are more able to move around, engage and interact with others. There are more activities – which means greater participation and engagement in the social life of the community.
In nursing care, because of their personal health needs, people are quieter and more inclined to stay in their own room. There is not the same level of fun, or spirit. For socially-minded people like my father, it would take time to adjust to the different vibe.
In a body-centred world, when mobility is compromised, food provides a world of treats and delight. Hot and cold, sweet and savoury. Tastes are subtle, sweet, textured, flavourful and omni-sensory.
Eating adds variety and focus to the day.
Porridge in the morning, a big meal at lunch time and at tea, punctuated with drinks of tea, juice with biscuits, buns and scones: sustenance combines with pleasure.
But then there may come a point when swallowing becomes difficult.
Nursing homes cater for people who have different levels of swallow: thickened drinks, puréed foods and softened/mashed meals. It is not fine dining. It is real food that they pulverise into different consistencies – enhanced by ketchup or HP sauce.
When he moved into his room we were allowed to re-arrange the furniture to suit his needs. On the wall, the same pictures from his own home, and from his last care home.
Perhaps this was more for our benefit.
We felt it was a way of connecting him to ‘home’, and to us, and to his life before. All his belongings reduced down to a few personal bits and pieces – and clothes.
My father passed away surrounded by his family in a lovely, bright and airy room. It overlooked a garden of beautiful, mature trees and caught the light of the evening sun.
Those last few weeks were about keeping him comfortable. He had his family around him and we knew we could spend as long as we liked with him.
In a hospital he would have been bothered by noise, other people and the constant activity. We would have been restricted by formal visiting times and parking.
Here it was quiet, and calm. He was comfortable and cared for.
As his health deteriorated we knew he wouldn’t have to go through the trauma of being moved to hospital and needlessly distressed. In nursing care they have the right levels of staffing, know-how and experience. There is nothing that they haven’t seen before. As professionals in care they deal with every situation that is part of the body’s slow, but natural, decline.
They have special equipment and facilities to make people as comfortable as possible. Clean sheets, pleasant surroundings and cheerful staff. This is not a sad environment. It is an environment that is purposely designed for people at a stage of life where they need specific care to see them through their last days.
The care home world never stops, 24/7, 365 days a year. The demand for beds is huge. And just as we used to visit dad here, another resident and family have taken his place, and our place. Someone else, whose needs mean they cannot live where they lived before.
This bed, this room, this place, was for a short time, the entire focus of his life – and ours. Now, it belongs to someone else. It will be their last home too.