The decision is made. The facility was selected—the move-in date was marked on the calendar. Aside from making the physical move (and all the logistical headaches of paring down beloved contents of a home into what fits in one room), it feels like the worst is behind you.
But because the first 30 days living in a skilled nursing facility (SNF) are a big adjustment for many seniors, it’s wise to prepare yourself and your loved one. Relief, novelty, resistance, grief, guilt, and even anxiety and depression may surface through the transition. Starting from a place of understanding that many of these are both common and expected, you can plan how to support yourself and your loved one–and leverage the tools and resources of the skilled care home for the best possible outcomes.
Take heart. Everyone will adjust with the right support.
I’m moving Mom to an SNF. I’m feeling relief, but what else can I expect?
Adrenaline carries you through the move-in, and it makes sense to feel relieved when a loved one makes the move to skilled care. A quality facility means they’ll have the full-time care they need to stay as safe and healthy as possible, and you no longer have the daily hours of care work and ongoing stress.
Moving to an SNF is a big change, leaving many people feeling like they’re on an emotional rollercoaster. Some seniors feel nervous, scared, angry, or sad, while others may look forward to a new kind of freedom away from the complexity of family caregiving. With their kids or spouses no longer acting as caregivers, they can focus on quality time and nurturing these relationships. Even when seniors and caregivers both feel relieved by the move, it’s not uncommon for them to experience grief, guilt, and homesickness, too.
Some seniors will travel through this variety of feelings more slowly or quickly than others and some will revisit certain emotions more often (or intensely). No matter what your experience, it’s normal for caregivers and seniors to feel a complex melting pot of emotions when a skilled care move is needed.
What are common emotional and behavioral responses to the move?
Do I have my own room? What’s the food like? How often will I go to therapy? These are the types of questions we hear with each new resident. They illustrate the worries and fears seniors face as they consider their next chapter.
There’s no wrong way to feel about this major life transition. Some seniors feel grief and loss. Others may be angry and express resistance against help or be critical toward the staff or facility. Feelings of depression, fear, or anxiety leading to withdrawal from social situations and changes in sleep and appetite also present for some seniors in the first 30 days.
It can be a disorienting and confusing experience to transition to skilled care after living decades of adulthood independently. It’s normal for seniors to need extra time to adjust to the new environment and routine. Quality skilled care facilities know to expect it all, and they’ll reassure both their new residents and their families with patience, care, and steady routines to help through the adjustment period.
At The Restoracy, this starts with conversations before the move and a warm welcome at move-in day. Each resident also receives a welcome binder. It’s a simple way to help them acclimate and includes information like: restaurants in the area, the TV channels, and their room phone number.
Each Restoracy home only houses 12 residents and feels like a house instead of a facility, so residents adjust more quickly and develop new routines that support their quality of life. One of the biggest benefits of the small home model is how it impacts meal times. When residents are invited to the table and can see and smell the delicious food served hot and fresh, agitation is replaced with conversation and connection between residents and support staff.
How can families support seniors moving to skilled care?
Not every move comes with ample time to prepare. If you have a few weeks or months before the move to a skilled nursing facility, a gradual introduction to the SNF can help. Talk about the facility, review their social media to learn about some of the activities and services offered, and connect with your coordinator to help address any objections (like needing to rehome a beloved pet or how laundry is handled).
Plan for what special items will travel to your loved one’s new home. They won’t be able to bring everything; sentimental items that may remind them of happy memories, a sense of familiarity, and a connection to those they love support a successful transition. Put together an album or photo book of favorite memories and people as a housewarming gift for their new space. A favorite blanket can bring comfort during the first 30 days, too. Facilities have guidelines stating which personal items are welcome and which ones cannot be brought, so consult with your care coordinator on what’s allowed to avoid additional disappointment.
Visiting loved ones living in a skilled care home is welcomed and encouraged, but in the first 30 days it’s a good idea to give them space and time to connect with the care team and learn about their new home. Talk about what kind of visiting schedule will work for your loved one in the first month and any adjustments you’ll need to make once they’re settled in. Establishing expectations and consistency can reduce feelings of being abandoned and give seniors visits to look forward to.
Remember the staff when you visit, too. Making connections with the care team and getting to know them helps everyone work together to provide the best care. Staff should be ready to hear any concerns and answer your questions with warmth and honesty. They can also help support you as you navigate your own feelings alongside your loved one’s.
What support can I expect from the SNF or skilled care home?
An excellent facility will support every senior’s transition with empathy and patience. A welcoming, warm environment with hospitality details like inviting snacks, drinks, and activities helps residents and their families ease into new routines. Social events held around meals and activities help new residents adjust more quickly.
The Restoracy’s Ryan Levengood starts supporting the transition before the move. “I go out and visit them before they even come—sometimes while they’re still in the hospital. I talk to them about the clothes they might want to bring, how the dining room works, the layout. I show them what it looks like, where they’re going, and I tell them not to bring their hospital gowns. We want people to feel good, to feel like themselves when they’re here.”
Ryan adds, “We meet with families within the first 72 hours, after residents have had a chance to acclimate. But before a resident even moves in, we’re already talking with families and asking, ‘What’s your home like? What do you need for this to be successful?’”
The staff at an SNF can be the difference between a successful adjustment and a rocky one. They must provide emotional support throughout the process. Quality facilities understand this and work to ensure that team members are prepared to give residents time and support their needs, by also allowing them time off to rest and reset and keeping resident to caregiver ratios low. When a care home is not properly staffed, the team is set up to fail, and residents may also suffer in the process, especially in an adjustment period.
Staff consistency allows residents and their families to get to know team members and start building the trust and connections needed for comfort and positive outcomes. This connection also supports the care team in creating the first care plan to support a new resident’s needs and preferences. Clear communication with the new resident and their family builds the trust essential to providing quality care and working toward the best possible outcomes.
When is it time to seek more help?
Typically, the emotional rollercoaster new residents and families experience in the first 30 days starts to smooth out with fewer bumps and more acceptance and enjoyment as time goes on. While many seniors will struggle to adjust in a skilled care setting to some extent, there are times when expected difficulties that are normal to the process become warning signs for serious concerns. Prolonged depression, significant withdrawal, expressions of hopelessness, attempts or discussions of self-harm, unmanageable anxiety, and refusal to bathe or otherwise manage personal hygiene all point to serious concerns requiring professional intervention.
Skilled care facilities provide a full range of care and services. Asking for extra help is advocacy that SNFs should welcome from family members. Likewise, team members should offer support and services when they first begin to notice warning signs. Seniors who need psychiatric support should be able to access services quickly. Likewise, opportunities to speak with a social worker, chaplain, or another support member should be easily accessible to residents and families.
Transitions at The Restoracy.
For most seniors and their families, a transition to skilled care comes with many feelings. The quality of life seniors experience in the first 30 days is essential to feeling like they’re at home in their new home.
Our small home model supports success because it supports the thing seniors need most: relationships. Ryan observed, “In large nursing home settings, where staff are spread thin, it’s almost like they’re checking boxes rather than providing real care—showers given, meals served, activities logged—without the time or resources to actually meet a resident’s needs. It looks like care on paper, but it doesn’t always meet the mark.”
See The Restoracy difference for yourself. We welcome families to visit our cozy homes, learn about our best-in-the-state caregiver-to-resident ratios, and share their goals for a skilled care transition.