Why do seniors often resist living in a nursing home?

Anthony Cirillo
Geriatric Medicine
"Once the kids realize what is going on, convincing mom and dad is not easy either," shared Sherri Tucker-Neff, a former assisted living activity director. "They grew up in an era where nursing facilities were horribly stereotyped."

Some people take the first step by going into continuing care communities that have assisted and nursing facilities attached to them. But it is still not easy. "Many of the people who come into an independent living facility do not want to see someone who is frail, in a declining state because they are seeing their future selves in the mirror," said Donna Loftus, a former assisted living activities person. "You overcome that with a lot of sensitivity." Some facilities will stage big events in a main area where all residents - independent living, assisted living and nursing - are invited.

Demographics are another part of the equation. People are indeed living longer and healthier. In the past, people would enter nursing homes in their 60's and 70's. Now they are entering in their 80's and 90's, with perhaps another 10 to 12 years to live. Sometimes someone will decide to go into the independent living part of a community or the assisted living section only to find within weeks or months that they need more intense care. That can be a hard adjustment.
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Because they loose their independence.

Seniors are adults who have been responsible for raising their families, supporting their spouses, developing a career, etc. This self-image is hard to change comfortably. Over time, adults come to realize they do not run their children's or grandchildren's lives and let go of that image. They come to the point where maintaining the career is no longer an option and let go of that image. They may have even lost a spouse in spite of all the medical efforts to prevent that. The last thing they want to relinquish is control over themselves. That makes them child-like rather than the responsible adult they have been for decades. This is particularly true if they have lived in the same house for a long time and established family memories. Moving is like leaving the family behind. Some seniors believe that a nursing home is where you go to die. Once you go in, you don't leave except when you die. From this perspective, you can understand why seniors resist. 

A minority of seniors are able to make the decision themselves to go into a nursing home. They see the dangers of living alone in their frail state and are happy to have the comfort of knowing help is available without calling their adult children. However, most seniors need to be coaxed by their worried children who do not want them being found in a heap at the bottom of the stairs days after a fall. If the senior can be afforded as much dignity and semblance of maintaining control over their lives as possible, the process should go more smoothly.

There are professionals available to assist both the senior and their family cope with the transition to residential care. The family physician or other health care provider can speak to the senior's physical condition. Many facilities have placement staff to help if the transition comes after a hospitalization. Nursing homes have professional staff that assess the applicant and can work with the family to answer questions and smooth the transition.

Sharine Forbes
Geriatric Medicine

Seniors often resist living in a nursing home as there are many taboos that surround them. For example, in the "old" days people would send their parents to nursing homes and they would die. So, people began thinking that nursing homes were a place to die. This is certainly not true. Nursing homes, nowadays, are places where seniors can thrive and live happy lives. 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.