Q: My father is in a skilled nursing facility following a hospital stay. He is complaining and wants to go home, but we cannot care for him at home until he gets stronger. How can I make him understand he needs to be there?

A: Having rehabilitation in a skilled nursing facility after a hospital stay is very common and, in most cases, necessary. In a skilled nursing facility, the staff will assess the patient’s needs and provide physical, occupational, and speech therapy, if necessary. In addition, they provide 24-hour care to assist him with transferring, bathing, and any other care needs during his stay.
You see his level of care needs and can understand why you could not meet those needs at home. This is fair and prioritizes your father’s safety. If you know he is getting the care he needs in a safe place then you can rest assured you are making the best decision for you and for him. I hope you can find family and friends you to support your decision and help normalize your feelings of concern.

In order to help your father feel more comfortable and accept his stay in the facility, start by trying to see it from his perspective. He is most likely uncomfortable in the facility and wants the comfort of his own bed and a quiet home. Skilled nursing facilities are often noisy, they do not have privacy, and it has a hospital like feel that does not always lend to quality rest.
If your father is able to express his needs to you, start by asking him what he dislikes about being there and what he does like. He may need help identifying what he likes, but you can prompt him with things like the safety aspect, the extra physical therapy, and the medication management. Once he returns home he may have Home Health Care come to the home for physical therapy, but that will be a couple times a week versus every day in the facility.

Listen to what he identifies as his dislikes and start there. If he mentions the food, perhaps you or another family member or friend can arrange to bring a meal once every couple of days. If he talks about the noise at night, t consider noise canceling headphones, a dark eye shade, or a blanket from home that will make him more comfortable.

Show him that you are listening and responding to his needs. Sometimes that is all it takes. When someone feels heard and supported, they no longer complain. Validate his concerns and align with his complaints. You can agree that you wish he could come home, too, while also understanding there is a need for the help of the facility right now. You can explain you need to make sure he is stronger and able to remain at home without going back to the hospital right away because he was not safe and at risk for a fall. This happens often so it is better to wait until he is ready.
If you find that he has complaints about the care he is receiving and you do not feel the facility is responding properly, you can report complaints to the Ombudsman’s office. The Ombudsman is a federally mandated program that assist residents in long-term care facilities with issues related to day-to-day care, health, safety, and personal preferences. They have representatives who will come and talk to your father directly and they work to resolve complaints on the behalf of the residents. You can reach the Ventura County Ombudsman at 805-656-1986 or the Los Angeles County Ombudsman at (310) 394-9871.

It can feel very upsetting to hear your father complain when you know you cannot do what he wishes. Remind yourself that you are seeing the big picture and making sure he is safe and cared for. Get support for yourself and take breaks to get the rest and you need as well.

Martha Shapiro can be reached at Senior Concerns at 805-497-0189 or by email at mshapiro@seniorconcerns.org.

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