Person in wheelchair moving down hallway of office

Nursing Home Transitions


As an Independent Living Specialist at Solutions for Independence, I have had the pleasure of transitioning someone from a nurs­ing home to their own home. I feel it is important to share what I have learned and help others who may be in the same position, or a family member, friend or other individual who is trying to assist someone in such a transition.

Many people have spoken who seem to believe that it is simple to find housing and move the person to that location. Transitions are multifaceted and very time consuming.

It is essential that anyone who provides such services takes the time to fully understand the personal needs, health needs, support needs, and emotional support necessary to assist someone in making such a change.

Initially it is important that the individual is ready for discharge according to the physician at the facility. Those of us working for agencies cannot transition an individual against medical advice.

Take time to learn the person’s story. How long have they been in the facility? What was the situation which triggered placement? What are their health challenges? Are they receiving all the necessary healthcare needed in the facility? How much are they earning via income (VA benefits, SSDI, SSI, SSA)? Do friends and family frequently visit? If so when and can you meet them?

Have the person explain what their goal is when leaving the facility. Know that housing in our area is very restrictive. Costs are high, people receive very low benefits . What insurance does the person have? Do they have monies saved?

It takes a considerable amount of time to effect a transition. If you are that person’s IL Specialist, social worker, counselor, family member, etc. understand that a person who transitions after a long period in any facility is going to expe­rience the world as a very new place. Technology, banking, paying bills, transportation, even obtaining groceries and going to a doctor’s appointment can become a challenge.

Understand that your role does not end when a person moves into their home, an entirely new phase begins. Depending on the individual you may initially be their sole means of  support. They will have questions  and need someone they trust to provide those answers.

This is another phase of their journey. They will need ongoing support and as you see them grow they will eventually make friends, connect with family, learn how to work in their new environment, learn new skills and overcome challenges.

Most importantly, remember this could be anyone of us. Due to my disability I was once unable to drive, unable to walk up or down steps, I was isolated and friends slipped away (a common occurrence among people with disabilities). I am very thankful to serve others like me, who needed one person to believe, the right mix of determination, medical care, and self-knowledge. And so it begins, “we will work together”

By: Debbie Hennessy, MS ILS