Secondary Caregiving: Providing Care to a Loved One in Assisted Living

When we transition a loved one to an assisted living facility, it may feel as if our role as a caregiver has ended. However, most caregivers who move a loved one into assisted living instead experience a change in their caregiving role rather than an end to this role entirely. With this change can come new responsibilities and sources of stress. As secondary caregivers, we will most likely:

• Continue to visit our loved one regularly
• Assist on occasion with their day-to-day activities in the facility
• Communicate with facility staff
• Handle financial and medical-related care arrangements

While some caregivers will find this change gives them more daily freedom, others may struggle with having a loved one in a facility due to: 

• Difficulties scheduling visits
• Changing COVID-19 protocols
• Disagreements with staff
• Coping with feelings of guilt and lack of control

If we are adjusting to a transition of becoming a secondary caregiver to a loved one in assisted living, we should consider the following tips to help make the transition smoother and less stressful for us:

1. Find a healthy visitation balance

When a loved one is living away from us, it is only natural to want to visit them often to provide assistance and company, and to monitor their condition. However, visiting too frequently can often increase stress, especially if our visitation hours conflict with important responsibilities at work or home. On the other hand, visiting too infrequently can make us feel guilty and even cause tension with our loved one. (Aneshensel, C.S., Pearlin, L.I ., Mullan, J.T., Zarit, S.H., & Whitlatch, C.J. (1995). Profiles in caregiving: The unexpected career. San Diego: Academic Press).

Because of this, it can help to strike a balance in how often we visit. If we find visiting every day or several times throughout the week too stressful, we can cut down to a few times per week, or whatever amount we feel our schedule can handle. The amount of time is not as important as how meaningfully we spend the time we have together.

2. Communicate effectively with staff

Though having professional staff to help manage a loved one’s care cuts down the amount of responsibilities we’re juggling, it can also be difficult to have more limited control over a loved one’s care. We may find ourselves disagreeing with the staff’s choices, whether it’s the food our loved one is given or how the staff interacts with them.

However, these disagreements can often lead to regular conflicts with the staff, which can in turn increase the stress of both parties. Instead of letting the situation get too confrontational, we should stay calm when bringing our concerns to the staff and be willing to hear them out. We can ask them to explain the reasons behind the care decisions they make and how each choice impacts our loved one. 

If we are still unhappy or have serious concerns with the care a loved one is receiving, we can:

• Schedule a meeting with key staff at the facility to discuss care planning
• File a complaint directly through the facility, or through the state licensing agency
• Hire a geriatric care manager to assist us in advocating for a loved one’s needs
• Reach out to an ombudsman. An ombudsman is a professional advocate for residents of care facilities who handles complaints and champions residents’ rights. The Ombudsman Program is free to use. To find an ombudsman in your area, use The National Consumer Voice’s online locator.

3. Cope with your emotions

Moving a loved one to assisted living may leave us feeling guilty that we have not done enough as a caregiver, especially if our loved one is unhappy or having trouble adjusting. If we are struggling with guilt, doing the following may help us cope:

• Acknowledging our feelings and recognizing that they are a natural part of going through this change
• Communicating our feelings to someone we trust, or with a mental health care professional if they interfere with our everyday life
• Recognizing the benefits the facility can provide our loved one in terms of care and medical assistance
• Using our new role to spend time focusing on our relationship with our loved one rather than just their care

4. Give yourself time to adjust

Adapting to the change of having a loved one in assisted living can be a difficult process, and the stress we feel may not immediately go away. However, a study on long-term adjustment showed that after three years of having a loved one in a care facility, most caregivers reported improved emotional well-being and less strain in balancing their work-life duties (Aneshensel et. Al 1995).
Adjusting to any major change in our lives takes time, so we should stay positive and allow ourselves the time we need to adapt to our new role.