I Need To Make A Tough Decision This Christmas

A very difficult dilemma involving older adults in nursing homes often emerges during the holiday season. The question is well illustrated in the letter below from a reader in Louisiana.

Dear Dr. LeCrone:

What things should a family consider in making the decision about bringing home their family member or friend who is in a nursing home?

My father wants to join our large family in our home very much for several hours on Christmas day. He is very frail, takes multiple medications several times a day and can’t leave his wheelchair.

Additionally, his short-term memory, ability to make decisions and judgment are impaired, and he sometimes becomes confused, agitated and irritable.

At times he makes statements which are inappropriate and even embarrassing, especially when children are present at the gathering.

I am not sure he will live to see another Christmas and many of our family members want him to attend the festivities very much. I feel that he should probably not leave the nursing home but need some guidance in making this decision.

Dear Reader:

Let me respond to your question by suggesting that you first consult with your father’s caregivers at the nursing home. They are in the best position to know how your father would function in a situation like you have described above.

Some of the elements in deciding whether to bring your father home include:

• Is any special equipment or professional skills needed to assist him such as using a breathing apparatus or injectable medications?

• Can special dietary requirements for him be made available if necessary such as low sodium intake, soft foods if he has difficulty chewing or swallowing, and caffeine-free beverages?

• Can someone help him with his toileting needs?

• If he requires time to rest, is there a secluded place for him to sit or lie down?

• If his behavior becomes unacceptable, will you be prepared to take the steps necessary to deal with the situation?

• Will you have the support and understanding of all family members and guests to welcome him into your home for this occasion?

• Can environmental concerns such as temperature, allergies to pets, lighting and noise be modified to meet his needs?

Too much excitement, too many people, too much noise and unforeseen, unplanned events during your father’s visit can produce more confusion, agitation and potential health problems for your father.

Happy Holidays. I hope these pointers help you in making this difficult and important decision.