How long does it take to settle into a care home?

How long does settling in take?

In a French study that followed 528 older people who entered nursing homes, quality of life dropped at the move. Afterwards it held steady, falling no faster than for people who stayed at home.

In 47 residents of Swiss nursing homes, memory and loneliness got worse over the first three months. By six months they were no different from the first measure, at one month.

So the first three months are often the hardest part.

How common is distress after a move?

Fairly common. In a US study of long-stay residents moved from one nursing home to another, about 3 in 10 met the study’s measure of distress after the move: 30.5% in 2018 and 30.7% in 2019. Most did not. No study we found measured this for moves into California care homes.

Should we stay away for the first week?

No study we found supports staying away. In the Swiss study, an exploratory analysis linked visits from friends, and taking part in activities, with adjusting to the move.

The resident has the right to visitors of their choosing, at reasonable hours, in private and without notice. Health and Safety Code §1569.269(a)(24)

What helps?

Reviews of many studies point to the same thing: control over the decision to move. In 91 people new to assisted living in Alabama and Maryland, how the move went for them depended on how much say they felt they had.

A real say means visiting, comparing, and a real choice. Smaller things also help, and the law backs each of them:

• Their own things. The resident may keep and use their own belongings. Health and Safety Code §1569.269(a)(30)
• Their routine. The resident may make choices about their daily life in the home. Health and Safety Code §1569.269(a)(8) Tell the home the fixed points of their day.
• Their visitors. Early visits, as the Swiss study suggests. Health and Safety Code §1569.269(a)(24)

The resident’s column of the visit checklist holds these, in their own words.

Are there programs that prepare people before a move?

Not yet. A 2024 review found eight studies of programs to ease the move. None started before the move; all started within three months after it. The preparation is ordinary: the people who know your family member, and the choices above.

Are moves between homes harmful?

A large US study compared 1,375 long-stay nursing home residents who moved to another nursing home with 1,375 who stayed. Those who moved were not more likely to be in hospital within 90 days, or to die. Deaths were too few to report, so the study cannot rule a difference in or out.

It studied moves between nursing homes, not a first move into a care home.

What should we ask around day 21?

About three weeks in, ask your family member one question: “Is this what you expected?” Then listen. If the answer is good, tell the home. If it is not, talk to the home’s administrator first.

When should we talk to the home, or the ombudsman?

If their needs change, the home must update its appraisal of their needs. Title 22 §87463(a) Ask to take part.

For a problem the home does not fix, call the long-term care ombudsman, free, 24 hours a day, 7 days a week: 1-800-231-4024. The ombudsman’s local contacts are in the admission agreement. Health and Safety Code §1569.885(d)

The resident may also choose to move. Health and Safety Code §1569.269(a)(23)