“The hospital told me I need to go to a nursing home…”  

Buffalo Occupational Therapy | Aging with Purpose


Michelle Eliason, MS, OTR/L, C.DS., CKTS


One of the most difficult scenarios to go through is to be confronted with a reality you are not expecting. It is an even worse scenario when you are seemingly forced to face an unexpected reality that has no substantial support. Being told that you or your loved one (regardless of age) has no hope of being independent and is going to require 24-hour assistance or a skilled nursing facility (nursing home) leaves most people feeling frazzled. Many times, this news leaves you confused when you know they have only been observed by one therapy professional for 15 minutes, nursing has barely spoken to him/her, and the social worker is as detached from your situation as a ship unanchored in the middle of a tropical storm. But what can you do? What do you know about the situation? What do you know about the potential of therapy to change things around? Needless to say, you feel helpless…and you aren’t alone. It’s happening to many people.

What are some questions to ask when told there is no hope of independence?

  • Has prior level of function been considered? 
    • If you know you or your loved one was functioning independently or with a high level of function two weeks prior to hospitalization/medical event, this is an acute change. Therapeutic potential has not been established!
  • Has occupational therapy given a full comprehensive functional evaluation?
    • Without an occupational therapy evaluation, it is difficult to know how much function remains and how much potential for improvement of independence can be made. Without the opportunity to demonstrate function and ability to compensate, how can hospital administration make this type of judgment?
  • Has home environment been made a factor?
    • People perform differently in their home. Hospitals and unfamiliar environments cause increased confusion and disorientation, increased stress and perfomance anxiety, and finally an inability to demonstrate potential for safety in his/her home. Going right to a nursing home removes even the option for independence.
  • Have options for home therapy been given prior to recommendation for a nursing home?
    • As an occupational therapist, home-based healing is always recommended! The benefits include decreased risk of developing infection, increased quality of sleep, and quicker healing in a familiar environment.

For more information on why home healing is always better than recovery or transition to a nursing home, click here.

 Remember there is always hope and other options. Second opinions are available! If something isn’t quite sitting right with you, chances are it’s because the facts aren’t lining up! A second opinion by an occupational therapist with functional, neurological, and physical knowledge may offer you hope you didn’t believe was there. 

What are some things a community-based productive aging occupational therapist offer? 

  • Assess in-home function/independence: light housekeeping, light cooking, medication management, getting up from various surfaces, getting up from the floor level, 
  • Assess functional mobility: traversing stairs, traversing curbs, endurance for walking specific distances, transfers
  • Body systems check-up: Balance, memory, strength, coordination, and reaction time.
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Caregiving and helping your parents remain independent is both rewarding and challenging! You don't need to do it alone! Whether you live in a different state, are transitioning your loved one into your own home, or your loved one is in a long term care setting -- questions will arise, and you need instant answers!!! Join our newsletter for tips, support, and service options for caregivers of elderly parents! 

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