Sunday, January 15, 2006

visiting homebound and institutionalized elderly

Often individuals who visit the elderly, whether out of a sense of duty or because they enjoy it, find that they do not know what to do during such events. Fortunately experience has shown that there are particular ways to create pleasant and meaningful times for the visitor as well as for homebound or institutionalized persons. Taking snapshots of family, friends, and events of past times can be pleasant and helpful in keeping the individual in touch with reality (reality orientation), and, when left behind, these can continue to be a source of entertainment for the older person. Bringing a gift of a small craft to work on together can be fun, especially so if the older person is withdrawn or unable to talk. Flowers, or perhaps small plants, are always appropriate and can serve as a topic of conversation. Taking along small, unobtrusive pets (like a cat or small dog) can be desirable if appropriate in the surroundings, as can sharing exercise either by going out of doors or walking up and down hallways. Getting acquainted with a roommate, if there is one, and other visiting friends creates an atmosphere of sociability.
If an older person has difficulty with chatting, then taking along a book, or letters new and old, to read aloud can help. Reading the same book from visit to visit can provide structure and substance to times passed together. Games and card playing are also suitable.
Gifts do not have to be limited to birthdays or to holidays. Even bringing needed items of clothing or other practical articles brightly wrapped in packages can provide excitement for the visitee. Planning ahead with regard to conversational topics, having in mind a list of interesting family news items, or asking about favorite TV programs, sports shows, and current news events can also contribute. Tactile communication, as in giving a massage, brushing hair, embracing, and kissing, is gratifying.
Generally, short, frequent visits are much better than long occasional ones. Regularity is important too. The elderly tend to be more content if they know that visits will occur with consistency-an observation that holds true for telephone calls, letters, or mailed cassette tapes.
A positive attitude during a visit is highly important--everyone experiences days when everything goes wrong, and it is best not to visit when one has had one of those days. It is unwise to overload the older person with unnecessary concerns, and discussion of one's personal problems should usually be avoided because there is little that the older person can do about them but grieve. Avoiding criticism of the institution (as well as the person being visited) is wise, as problems should be addressed in contexts where solutions are possible, not where anxieties will simply increase.
When dealing with a confused individual, it is often not what is said or done that is important. The visit itself is the message the reality of one's physical presence is enough. If nothing is said or done, but one is simply there, perhaps holding hands or lightly touching the individual, one conveys a message of care and consideration. One's silent presence, after all, may be all that is needed by homebound or institutionalized people.
Gillies, J. A Guide to Caring for and Coping with Aging Parents. Nashville: Thomas Nelson Publishers, 1981.
Kohut, S., et al. Reality Orientation for the Elderly, 3rd ed. Oradell, N.J. Medical Economics, 1987.

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