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Nursing Home Toolkit

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Visiting the Nursing Home

Once a family member moves to an adult or nursing home, family and friends may find it difficult and uncomfortable to visit. The resident needs your visit because it provides crucial emotional contact with his or her family; you need to continue to participate in the person's care.

Conversation on nursing home visits may be strained. You may not know what to say or do. If the resident is still able to communicate, start a conversation and then listen. Give the patient your full attention and listen with your heart as well as your mind. Watch the body language and be alert to the feelings that may be expressed beneath the words. Complaints may be an indication of loneliness.

If the resident is withdrawn or resists talking, try doing an activity together, such as arranging flowers or assembling a photo album. This may help stimulate conversation.

There are a number of physical activities that can be stimulating for both patient and visitor and can make visits a positive experience.

Give your loved one a backrub or gentle arm and leg massage. These can relieve discomfort caused by immobility and lack of exercise. Just rubbing the skin with body lotion is very soothing. Alzheimer's patients are good at reciprocating with a backrub.
Give the patient a manicure or pedicure. Bring a file, clippers, lotion, and a pan for soaking the feet. Women especially enjoy having their nails polished.
Many nursing home residents spend a great deal of time in bed or wheelchairs. A staff member can demonstrate how to help the patient with arm or leg exercises to maintain flexibility and function. If possible, take the resident for walk up and down the halls or around the grounds.
To stimulate the patient's sense of sight, bright colors and bold forms are best. Bring large, clear family photos, a large calendar, posters, mementos, and picture books with animals, flowers, or birds. If there is no problem with the resident eating flowers, bring them. Bring children’s drawings or craft projects.
To stimulate hearing, bring in a tape player and listen to music together, or bring a tape of children and grandchildren talking and singing. You might record descriptions and impressions of a trip, messages from distant relatives and friends, or movie soundtracks. Tell jokes, read poetry aloud, listen to birds singing. You might even make a long distance call to a friend while you're visiting. Many residents can no longer write letters but do wish to keep in touch with old friends. When visiting, you can also help write letters and prepare general cards as well as birthday or holiday cards.
Touch becomes a very important part of the Alzheimer's patients life. Hugs are most welcome, as are kisses and hand holding. Be sure to give lots of them! Bring in pebbles, wooden objects, and stones when you visit. Bring or wear garments with different textures--bulky, plush, crisp, and smooth, for example. Bring swatches of different textured fabrics, or make a small quilt of them, to leave with the resident. Provide bed sheets with different sensations, such as smooth, cool satin; soft, warm flannel; or crisp percale. To encourage memory, bring sea shells, driftwood, candles, or patch work, as well as knitted, crocheted, woven, and embossed items.
Stimulating the taste buds can be another good visiting pastime. As long as there is no violation of diet restrictions, bring favorite foods or beverages. Share vegetables from your garden for a special treat. Contrast crunchy foods like peanuts, popcorn, chips, and carrots with smooth foods like avocados, and milkshakes. For chewy items, choose steak, caramels, and brownies. You might also try sweet, sour, spicy, hot, cool, and mellow foods. Find a favorite!
Residents always appreciate fresh fruit and most persons with Alzheimer's disease love sweets. Possibly your loved one would enjoy a glass of wine or beer. Check with the staff to make sure there are no medical contraindications and whether a doctor's order is required before offering any alcoholic beverage.
Having a meal together is a wonderful visiting activity. Arrangements can be made with the staff for family members to eat a meal with the resident in the dining room or take him or her out to eat. If the diagnosed person enjoys cooking but the facility kitchen is off-limits, the visitors may be able to use an activity room to prepare a favorite dish with their loved one. Perhaps the family and resident can prepare a batch of cookies and have the staff bake them in the facility kitchen.
Smell is one of the most powerful evokers of memories and emotions. Bring perfume, powder, lotion, or tobacco. The smell of vanilla may remind the resident of baking; mint extract may bring to mind the mint patch in the backyard. Liquid smoke can evoke memories of cookouts or wiener roasts. Provide the fragrances of flowers, plants, incense, and air freshener to stimulate the resident. If possible, take him or her outside to smell springtime, autumn, rain, and snow.
Remember that whenever you visit a resident in an adult or nursing home you should bring joy and, if possible, laughter. Try to include other residents in your visits. They need friendship just as much as your loved one does.
It is permissible to cry all the way home if it helps you! Just keep in mind that when you walk into the facility, you want the residents and staff to be happy that you've come.

What do say/do when there's nothing to say/do?

Say I love you, I came to see you, and I'll be back again (regardless of their reaction to your visit).
Sit close, away from window glare, at eye level, and touch or hold as preferred by your relative.
Look for clues to feelings in body language, eyes, or repeated phrases.
Gentle teasing or joking provides a sense of continuity and pleasure to those who have always communicated this way in their families.
Silence can be golden--tender moments watching birds, listening to music, or praying can be wonderful for you both.
Respect personal space and possessions. Ask before moving things around or sitting on the bed. Go slow ... keep pace with your relative's concentration, tolerance, etc.
Substitute shared activities for limited conversation: manicures, massages, looking at photo albums, watching TV, walks, writing letters.
Reminisce about your favorite Christmas, first car, baking in the old home, the smell of a wood fire. Note: If your relative is very impaired, you will need to talk about earlier events.
Use the arts and your skills--music, poetry, photos, video or audiotapes, art work--to stimulate your loved one. Play games (even if your relative can't play as well, he or she still might enjoy the activity).

Whatever you do, do not:

Rush in, standing at the door as if you are on way out.
Stare out the window, check your watch, or look bored.
Apologize for your guilt or feelings of failure--it's not your fault and you and your relative are in this together.
Give advice, nag, or talk down (baby talk).
Provide a litany of your problems or obstacles to visiting.
Change the subject when your relative express negative or sad feelings.
Talk about your relative as if he or she is deaf.
Spend all your time with other residents or staff.

Courtesy of Lisa Gwyther, M. S. W.

Visiting in the Adult or Nursing Home

For more information about Visiting in the Adult or Nursing Home, please contact the Chapter's telephone Helpline at 703-359-4440 or 800-207-8679.