Transitions in care: Family carers' experiences of nursing home placement

With demographic trends predicting an increase in the number of older people and a reduction in the number of family carers (Royal Commission on Long Term Care, 1999), it is likely that admission to nursing homes will continue to increase. Although it might be expected that entry to a nursing home, with an anticipated reduction in 24-hour care, would result in a reduction in stress for carers, evidence to date does not support this expectation. Study findings indicate that this experience is associated with guilt, anger, despair, resentment and general psychological distress (Kellett, 1999; Ryan and Scullion, 2000a; Nolan and Dellasega, 2000; Davies, 2001). Therefore, although the physical burden of caring is relieved following nursing home placement, the emotional turmoil often continues, and is exacerbated by the circumstances surrounding the decision to end home care. Although there is evidence to suggest that, following placement, families are often expected to relinquish their dependent older relative to the bureaucracy of the institution, this is not always in the best interest of the resident, the family or the nursing home staff. This paper examines recent literature on the transition from home care to nursing home care and highlights the need for greater collaboration between families and nursing home staff.