Nursing Homes: A Family's Journey

Peter S. Silin, Nursing Homes: The Family's Journey: A Guide to Making Decisions as a Family, Choosing a Facility, and Getting the Best Possible Care. (The Johns Hopkins University Press, Baltimore and London: 2001).



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For many people, being the family member of a loved one in a nursing home is a totally new and often difficult experience. It's a situation that can bring up feelings of guilt, anger, grief and frustration. But these feelings can be less painful if family members know what to expect in advance and how to cope with the emotions that inevitably arise.

Geriatric social worker Peter Silin has written this invaluable book to give families just this sort of preparation for the nursing home experience. Nursing Homes: The Family's Journey helps prepare family members in two important ways: it offers wise counsel on what happens during a typical nursing home stay and it provides compassionate emotional support to families struggling with their choices in this difficult area. Silin comes across as such an extraordinarily sensitive commentator that you often feel he is right there chatting with you. Between chapters, Silin presents the voices and stories of family caregivers who have confronted many of the issues he examines.

The book begins by offering family members help with the difficult task of laying the emotional groundwork for a move to a nursing home: how to discuss the need for more care with the loved one, how to cope with feelings of guilt, and how to involve the whole family in decisions. This is followed by a discussion of finding a good home and how nursing homes work. An entire chapter is devoted to the different staff roles in nursing homes, and later we learn what takes place on a typical day in a facility. The book's third part looks at what to anticipate when the resident first moves in, including how to deal with mundane issues like clothing and laundry.

As is the case throughout, Silin isn't preoccupied solely with the new resident's experiences, but also addresses the emotional adjustments the caregiver must make once the loved one moves out of the house. The book's final section deals with the ongoing process of being the family member of someone in care, including the basic standards of care to expect, how to 'work the system,' and how often to visit. The last chapter is appropriately concerned with difficult decisions at the end of life.

Author Peter Silin manages a geriatric care management company in Vancouver, British Columbia, but his book is equally suited to U.S. and Canadian audiences. The Appendices include a list of U.S. state ombudsperson offices and a helpful questionnaire for assessing a nursing home.