by Theodore Hardgrove, M.S.W. L.I.C.S.W.
Dreading your next visit to the nursing home to see Mom or
Dad? Do you feel frustrated and exhausted after every visit to
the nursing home? You're not alone.
Visiting a nursing facility, (or nursing home), can be a daunting
experience for family members. Once the admission process is
over, a family member must face trying to help Mom or Dad feel
comfortable in their new environment. But how can a family member
help their loved one feel comfortable, when the family member
themself is experiencing a high degree of discomfort as well?
The nursing home resident will openly express their discomfort
to those who visit, but the visitor rarely has that same opportunity.
This can be frustrating, especially since family members are
often reluctant to admit their own uneasiness. Family members
frequently give, without recognizing their own needs. They walk
through those nursing home doors full of vigor, find the person
they came to visit, and leave looking virtually exhausted.
Here are some pointers for friends and family members. They
may help make your visit more productive and, hence, more meaningful.
1. What to Talk About??
Many family members never had the experience of spending
a full hour, in any capacity, sitting face to face with their
Mom or Dad in a bedroom just talking. While they are visiting
in a nursing home, they find themselves either running out of
what to say in ten minutes or talking excessively, in order to
fill every second of the visit with words. Residents have remarked,
following a visit from their children, that they had no idea what
their children were talking about. They explain how exhausted
they both seemed with the unusual amount of talk provided, and
how seemingly hundreds of topics were covered in a very short
The manner in which we interact with our family members may
change when one is placed in a nursing facility. Talking is not
as important to the visit, as just being there is. Sitting quietly
can be more rewarding than the need to fill a room with syllables.
Children of parents need to give themselves permission not to
feel the necessity to always talk. It is more important to respond
to what a loved one is saying. If they express discomfort with
the environment, do not try to fix it right away, but admit the
difficulty both of you face with having to see each other in a
Simple is better when it involves conversation during visitations.
Most residents want you to help them feel connected to the outside
world, as well as to their extended family members. Reviewing
what is going on in each family member's life, from the
grandchildren all the way to the family pet, is a great means
of increasing a sense of connectedness. Bringing in recent pictures
of these same people/pets can encourage memory and conversation.
In addition, a visitor should not assume that nothing occurs
in the resident's day. They are often involved with a
whole host of professional staff and are attempting, at a much
later age, to make and sustain relationships with a great many
caregivers. Talk about these people, regardless of whether or
not your parent recalls their respective names, and discuss the
role each one plays in their daily life. Do not accept 'nothing'
as a resident's response to the question, 'Tell me about
your day.' A visitor, as well as the resident, shares
in the responsibility of communication when a visit occurs. Ask
to see what they have done in some activity - artwork, etc., if
2. Where and How Loud?
Most people feel uncomfortable with raising their voice in
casual conversation. If the person you are visiting is hard of
hearing, position yourself in a comfortable manner closest to
the resident's best hearing side, but not so close so that
it is difficult for the person that you are visiting to read your
lips. If a resident is in bed, it can be overwhelming to have
a visitor come into the room only to place themselves in the towering
position over the bedside and attempt to have a conversation in
a pitch which is close to actual yelling. Have a nurse make the
person you are visiting get into a comfortable position before
the visit occurs. Realize that residents themselves have a lot
of frustrations with their attempts to find fellow residents who
not only can remember things that are being said to them, but
who can basically hear what is being said as well. Finally, realize
that the staff of the nursing facility is in many ways used to
people speaking loudly in order to accommodate a productive visit.
3. Quality not Quantity
'Should I visit daily?' ' How long should
These two questions are commonly asked in nursing homes.
The answer is unique to the person visiting, and the person being
visited. It is important to look at the visitor's time
and ability to visit on a consistent and convenient level. What
is helpful to a facility, is that a family member attempt to provide
established times when visits may occur. In other words, establish
in a resident's calendar, and alert the nursing staff of
when you will be visiting and the approximate time this may occur.
This can help a resident have something to look forward to, as
well as help the staff provide you with updates, knowing that
you will be arriving on a certain day. There are always exceptions
to this rule. When your loved one asks, 'Where is my daughter?'
by checking the calendar the nursing staff can reassure them that
your visit will occur on a particular day. Do not set days and
times that are not realistic to your time schedule. Visits can
be exhausting, and you do not want to start a visit in an already
The fact that you visited, is more important than the actual
time you spent. An hour can be too much time for certain residents,
and exhausting as well. A resident's sense of time in
a nursing facility is different than ours. Clocks and timeframes
lose some of their meaning in a nursing facility, and are replaced
by a connection to an established routine. If a visit feels complete
in ten minutes, do not feel that you have done a disservice to
your loved one by leaving at that time. They will not recall
the time you spent, as much as they will recall that you took
the time to visit.
4. Things to Do Together
When we look back at the way we visited our family members
before they entered a nursing home, it is often rare for us to
see ourselves one on one, face-to-face in a prolonged conversation
with a family member sitting in their bedroom. Most visits, prior
to a nursing facility stay, occurred over an activity. It may
have occurred while the television was actually on, while dinner
was being prepared or over an actual meal. It also was commonplace
to visit family members with more than just one person in the
room. Children of an elderly parent will usually visit their
Mom or Dad at home, and do a chore for them, during which time
a visit would occur. This also helps a family member stay in
a helpful role, as well as having a meaningful interaction with
their Mom or Dad.
Thinking about the visit, before the visit occurs, can make
an interaction with a person in the nursing home more meaningful.
The goal is to attempt to find something that you can both do
together, while the visit is occurring. This could mean even
watching TV. A humorous television program can act as a positive
distraction, if the visit is becoming uncomfortable. If you do
watch TV, realize that the staff is very used to the volume of
television shows being louder than what most people are normally
used to. Bring in a food item and, after checking with staff
to make sure that the resident may have the item, feel free to
enjoy that food item in the room together with your loved one.
Do not feel that it is rude, by any means, to pull the curtain
in the room if you need privacy to be with your loved one. You
need to feel comfortable. Shopping catalogs to pursue clothing
and gift ideas is also a wonderful activity for a resident in
a nursing home. Even though the catalog shopping may not involve
coming to a purchase, the act of just sitting and looking at items
in a catalog can be fun for a resident who is not able to shop
the way they may have been used to. Bring the newspaper in, and
read it bedside to your Mom or Dad. If you do the laundry at
home, bring it back unfolded and fold the laundry together with
the resident, making them do some of the work needed to help.
Find an activity posted within the facility which encourages
family participation, and bring yourself to taking your family
member to that program, where you'll find other family
members doing the same thing. Also, arrange to have the staff
at the facility bring your Mom or Dad to the front seat of your
car. With proper positioning and assistance, take them for a
long or short drive around the community.
5. When to Visit
A family member, or friend may visit a nursing facility in
Massachusetts at any time. It is not required to let the staff
of the facility know when you are visiting, but it is always advisable
to do so if you plan a late, or a night visit. Some facilities
have posted visiting hours, but they are only guidelines.
The worst possible time to visit may be during any change
of the nursing shifts. In my consulting of family members, they
are discouraged from visiting between the hours of 2:00 to 4:00
PM. This is when the staff of the day shift closes out the written
work, and reviews the events of the day with the next shift.
The staff's attention during this time is usually focused
on getting everything in its place, so that the new shift may
enter the facility with relative ease. Hence, it can be a time
when the noise level and the sense of responsibility of the staff,
is at its highest.
As a visitor during this time, you may sense this disruption.
Facilities try to minimize the transition from shift to shift,
but it can be difficult to do so. Having excess visitors during
changeover times accentuates the level of activity on the floor,
and can be very distracting to having a meaningful visit.
6. Be Patient and Flexible!
The best thought out and planned visits, require a moment
by moment approach. If your loved one falls asleep then let
them! Alert the staff of your departure, and do not make a big
deal about it. If you visit, and find that your family member
is in an extremely bad mood, it is all right to come back a little
later, or just have a shorter visit and return on a different
day. Take a break if a visit is not going well. It is fine for
a family member to leave the building to take a walk, and come
back if they need to.
Visiting a nursing home is not easy for anyone who is not
used to the experience. There are people in nursing homes who
can help. The worst thing a visitor can do, is to not talk about
the experience, frustration, or discomfort that they experience
when the visit occurs. Isolation never leads to progress in visiting
a loved one in a nursing home. It is important to recognize how
hard it is to cope at times. Talk with people who are familiar
with your experience and are able to listen and provide a sense
of understanding. Ask for help. The Department of Social Work,
the Nursing Department, the Director of Recreation or the recreational
staff, have a great deal of experience in helping family members
cope with the experience of what it is like to be in a nursing
home. Many facilities have family support groups that connect
families who share similar circumstances. Together they discuss
their concerns and come through with remedies to work them out.
Most staff working in a nursing facility want to help families.
It is important for families to recognize their role on the care
team. Seek out one of the staff members to sit and talk privately
about some of the frustrations you encounter when visiting your
family member in a nursing facility. Together, the experience
can be a lot less daunting, and actually quite rewarding as well.