You’re happy that your loved one has survived a serious health problem — then you realize with a jolt, perhaps with a nudge from a social worker, that you must figure out where that person will go when they are discharged tomorrow. But . . . how do you decide where? We haven’t been trained for these kinds of decisions.
Although hospital social workers won’t express an opinion, they’ll give you names and, if you live in Columbus or another metropolitan area, probably will tell you that you’re lucky because there are many options. Sometimes, however, broad choice can be less a blessing than a curse. How do you narrow the field down to the one place that is the best choice for your loved one?
There’s lots of information out there, but what does it mean? There are ratings on-line, but how are they developed? If you’re in your 50s, talk to your friends and you’ll learn that many of them have already gone through the process with their parents. They may recommend a place or warn you away from a place that they describe, in awful terms, as a kind of institutional hell on earth. You appreciate the warnings, but it also scares you to know that such places may exist and a bad decision may land your loved one there. The significance of your decision seems increasingly overwhelming.
So you go visit places, because everyone says to do so — and you realize that the places look pretty much the same. There’s a chipper female administrator who takes you on a tour. The facilities are ranch-style, with no stairs, and are brightly lit and decorated. You hear about the therapy equipment and nurse-and-therapist-to-patient ratios as the professional staff walk briskly past, look in at a resident’s room that looks just like the resident’s room you saw in the last facility you visited, and scan the therapy room with its machines and balls and mock stairsteps. They all look pretty much the same, too.
You see the residents, of course. After the initial shock of seeing crumpled figures in wheelchairs and beds — poor, hurting, older people unlike the healthy, vigorous folks you see every day — you realize that’s why the facility is there. You can’t disqualify a place because you encounter a groaning older person gesturing at you with an outstretched, scrawny, grasping arm and a haunted look in their eyes, because virtually every place has them. You just try not to imagine your loved one eating next to that poor soul, because you can’t.
You soon understand that the tours and the chipper administrators and recommendations and warnings from your friends can only get you so far. How can you tell whether this place, or that place, has the kind of patient, upbeat therapists who can give a scared, exhausted person the incentive to get out of bed and try to walk again, or talk again, or use their injured arm? How do you know how the food will taste if it must be prepared in low-sodium, pureed form because your loved one needs to relearn how to swallow — and is it even possible for bland pureed food to be appetizing? How do you know whether the seemingly competent staff will really pay careful attention to your loved one, rather than the angry man causing the commotion three doors down?
You really can’t know, of course. It’s an impossible decision that you must make, but you do the best you can, trying to weigh the competing considerations and hoping that your instincts move you in the right direction. Mostly, you hope.