A7 · Difficulty adjusting to a care home
Actual Older adult
Definition
Moving to a new setting causes stress, confusion, or sadness.- Loss of home
- unfamiliar setting
- change
- reduced freedom
- Withdrawn
- sad
- refuses help
- confusion
📋 Scenario
A woman cries after moving to a care home.
Subjective (S): "I want to go home."
Objective (O): New care home resident; tearful; withdrawn; refuses meals.
Assessment tools for this scenario: CP-OLDER Older Adult Check
Validated scales to consider: 4AT / CAM, Mini-Cog
**CarePath diagnosis:** Difficulty adjusting to a care home related to loss of home, as evidenced by withdrawn and sad.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Orient her. | Showing her the layout, routine and staff reduces fear of the unknown and helps her feel in control of her new surroundings. |
| Allow personal belongings. | Familiar items such as photos and a favorite blanket give comfort and a link to her old home and identity. |
| Involve family. | Family visits and involvement keep her relationships strong and help her feel less alone and abandoned. |
| Keep routines. | Keeping routines she is used to, such as meal and wake times, gives a sense of normal life and lessens confusion. |
| Give emotional support. | Listening and acknowledging her sadness shows respect, lowers distress and builds trust with staff and a trusting relationship helps her accept help and settle in. |
**Expected outcomes**
- Settles within weeks.
- Joins activities.
- Eats well.
- Says she feels more at home.
**Linking the data to the diagnosis**
The patient says, 'I want to go home.' She is a new resident, tearful, withdrawn and refusing meals. She is already showing distress, so this is an actual problem, not a risk, and the evidence is her withdrawn, sad behavior. It fits better than a general low mood statement because it began with the move. The plan aims for her to settle within weeks, join activities, eat well and say she feels more at home.
CarePath diagnosis
Difficulty adjusting to a care home related to loss of home, as evidenced by withdrawn and sad.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Orient her. | Showing her the layout, routine and staff reduces fear of the unknown and helps her feel in control of her new surroundings. |
| 2. Allow personal belongings. | Familiar items such as photos and a favorite blanket give comfort and a link to her old home and identity. |
| 3. Involve family. | Family visits and involvement keep her relationships strong and help her feel less alone and abandoned. |
| 4. Keep routines. | Keeping routines she is used to, such as meal and wake times, gives a sense of normal life and lessens confusion. |
| 5. Give emotional support. | Listening and acknowledging her sadness shows respect, lowers distress and builds trust with staff and a trusting relationship helps her accept help and settle in. |
Expected outcomes
- Settles within weeks.
- Joins activities.
- Eats well.
- Says she feels more at home.
Linking the data to the diagnosis
The patient says, 'I want to go home.' She is a new resident, tearful, withdrawn and refusing meals. She is already showing distress, so this is an actual problem, not a risk, and the evidence is her withdrawn, sad behavior. It fits better than a general low mood statement because it began with the move. The plan aims for her to settle within weeks, join activities, eat well and say she feels more at home.