Grief in Assisted Living

Before I owned my assisted living homes, I owned and managed several rental properties.

One of the most striking differences between managing assisted living and regular rentals was the aspect of death.

Near the top of the list for scary scenarios in my rental properties was the thought of someone dying in them. Besides the obvious sadness I would feel for the tenant, it seemed like it would be really bad for business. Would other people want to rent the property knowing someone had died in it?

Fortunately it never happened.

Contrast that with assisted living. When I started managing my assisted living homes, I was struck by how easily my employees accepted death as just part of the business.

Early on in my assisted living career I remember being shocked when I received a text from an employee:

“Good morning. Bob died.”

That was it. Wheel Bob out. Let’s get a new one in his place.

I understand death is a pretty common occurrence in the assisted living business. That doesn’t mean it has to be handled as if we were setting up a medical appointment for our residents.

I do my best in my homes to get to know my resident. I want to know the family as well. With close to 40 residents it’s difficult to become close to everyone. Some families definitely become closer to me than others. I encourage my caregivers to do the same.

These days I don’t get the ‘Bob died’ texts any more. We meet with the family. Talk to them. Ask them what we can do to help. We offer to send flowers and in many cases fill out a card with all the caregivers signing it.

In some cases the families invite us to the funeral. I consider every one of those invitations an honor.

Some of my best caregivers become really close to the families. We’ve had multiple residents where my caregivers and I have cried at their death.

Our grief is not anywhere near the grief of a family member. However, it still stings. Even when you know death is coming. Even when you know it’s coming. Even when the resident is on Hospice and in bed 24/7, it’s still hard when they do pass.

Psychologists will tell you there are five stages of grief:

• Denial

• Anger

• Bargaining

• Depression

• Acceptance

When I’ve lost close family members, I’ve recognized a bunch of these stages after the death. In our professional assisted living setting, I don’t notice the phases as much after they pass. There is definitely sadness and depression and acceptance. Not so much on the anger and bargaining after death.

Maybe it’s because we see the day-to-day decline?

Or some of the stages may hit before the resident actually passes away. Sometimes it seems like the more we fight the less effect we have. At least at some point:

• Denial - I want to fight for all our residents and do everything I can to stop death from occurring. Some times I just have to listen to the Hospice nurse.

• Anger - When I see some of the side effects of medication, I become upset. Or I see the shear volume of medications some of our residents take. Maybe I need to bite my tongue more.

• Bargaining - Trying to talk to their doctors about reducing medications. Or changing their diet. Or more exercise maybe? It’s hard to give up and just let nature take it’s course.

• Depression - There are definitely times in this business when you realize you can’t fix them all. Or you wonder if what you are doing is really making a difference.

• Acceptance - At some point as the decline sets in, we realize we have to let God take over.

We’re all programmed to deal with traumatic events through the grieving process.  Don’t ignore it. Let it happen. Eventually with time, you’ll come out of it. Be thankful for the time you had with the loved one that you lost. I sure appreciate the gift I have been given to be so close to so many wonderful people.