Factors Influencing Institutionalization of the Elderly

Choosing institutionalization as a means of caregiving for elderly family members is an extremely difficult, and possibly even stressful, situation to be in. Most families prefer to act as the primary caregiver to their parents or grandparents. However, despite the goodwill and desire to provide primary care for elderly parents or grandparents, it isn't always an option for the long term.

Providing primary care for an elderly individual generally requires a great deal of commitment and caregivers end up giving up portions or their daily lives. Some of these sacrifices include income due to a reduction of working hours per week, less time to oneself, an addition of another role to those already existing, less time with family (which can in turn cause a strain in relationships), emotional and physical health (often stress, sleep disturbances, exhaustion, and the like). When all of these things, and possibly others, come to a head many initial caregivers come to the realization that acting as primary caregiver is no longer a viable option for them, or their family.

Other factors may also influence a family's decision to place an elderly family member into an institution. A 1994 clinical research study found that the relocation decision was commonly made by a physician in response to the individual's health condition (Johnson, Schwiebert, & Rosenmann, 1994). Cognitive ability is a large factor in determining whether institutionalization is appropriate as well, and patients with such cognitive impairments as those posed by dementia and Alzheimer's Disease are commonly placed in nursing homes (Hooyman, Kiyak, 2002). This makes a lot of sense for the caregiver since these sort of cognitive impairments can be hard to deal with, not to mention significantly increase the amount of stress a particular caregiver experiences during the course of the day.

Despite placement in an institution for care, the role of caregiver isn't relieved. Many of the burdens the position may have entailed are, however, a previous primary caregiver still has a substantial role to play as an informal caregiver. Playing a significant role after placement can also help to relieve any guilt or stress that may have resulted from the loss of the role and the change in relationship between caregiver and care recipient.

As an informal caregiver, individuals can visit often and play a more supportive role than their previous. While this no longer entails attending to the every need of the care recipient, it does entail what can be significantly less stressful and more relationship building activities. Many "visitors" choose to take the time to talk, play games with, and take walks with the new patient which can improve what might have been a strained relationship due to former duties. Support centers and educational literature is available both in senior centers and online for more information on the role of the "informal" care provider.

References:

Hooyman & Kiyak. (2006). Social Gerontology 6^th Edition. Pearson Education Company. Boston, MA.

Johnson, R., Schwiebert, V., & Rosenmann, P. Factors Influencing Nursing Home Placement. Clinical Nursing Research, 3, Retrieved July 6, 2007, from http://cnr.sagepub.com/cgi/reprint/3/3/269