Chapter 13: Bridging Community and Long-Term Care Settings

1. Chapter 13: Bridging Community and Long-Term Care Settings C H A P T E R 13 Bridging Community and Long-Term Care Settings Elaine Wiersma and Stephanie Chesser

2. Bridging Community and Long-Term Care Settings: Key Points • Definition of community • Transition from community to long-term care settings • Challenge long-term care facilities as institutions (continued)

3. Bridging Community and Long-Term Care Settings: Key Points (continued) • Long-term care settings as communities • How health care professionals can support older adults as they transition from community into long-term care settings

4. Definitions • Long-term care vs. long-term care home • Total institutions • Community

5. Long-Term Care • Long-term care—ongoing indefinite care for those people who can no longer care for themselves • Long-term care homes (LTCHs)—publicly subsidized institutional facilities designed to care for seniors, also referred to as nursing homes, skilled nursing facilities, or long-term care facilities

6. Creating a sense of community in LTCHs involves supporting and maintaining relationships that are fulfilling for residents.

7. Total Institutions • A place of residence where like individuals lead an enclosed way of life, removed from wider society • Residents have little or no control over the administration of the institution

8. Community • Geographic location • Groups of which one is a part • Sense of connectedness

9. Aspects of Community • Social networks • Role identities • Sharing

10. Social Networks • Interpersonal ties • Connect individuals to each other • Connect individuals to services and organizations

11. Role Identities • Social meaning of one’s position within a group and social relationships • Defining a person as a social object

12. Sharing • Common experiences, history, and goals • Contribute to a sense of community

13. Adjusting to life in a long-term care home can be difficult, but often it results in new social networks, new neighbors, and new friends.

14. Transition From Community to LTCH • Homelessness • Learning the ropes • Getting used to it • Claiming a place and creating a neighborhood

15. Homelessness • Grieve the loss of what many consider their home. • Can leave older adults with feelings of loss and isolation.

16. Learning the Ropes • Become socialized into the long-term care environment. • Involves learning how to maneuver in a new space, becoming oriented with residents and staff, and learning the rules and routines. • Can leave residents feeling like prisoners.

17. Getting Used to It • For some this means simply living in the facility while time passes. • Some try to fit in by purposefully meshing with the circumstances of long-term care life, while others try to fit in by not fitting in.

18. Claiming a Place • Occurs approximately two to three months following admission. • Involves creating a neighborhood within long-term care. • Neighborhood provides a place where new memories, new social networks, and new neighbors can be made.

19. Community in LTCHs • Internal community—the LTCH as a community • External community—the geographical area in which the LTCH is located, and the sense of community associated with the residents, staff, and families of the LTCH

20. Leisure in LTCHs • Sharing, as a concept of community can be fostered through leisure that is integrated with the external community. • Social networks and relationships developed through leisure can reduce sense of loss. • Leisure can provide residents with role identities.

21. Creating Community in Practice • TR practitioners can build community in LTCHs by • facilitating sharing with the external community, • encouraging the development of social networks, and • fostering residents’ role identities.