Admission Anxiety & the Three Gaps

In Episode Two of The Empathy Exchange, I wanted to share a powerful story about a family member named Mary. She and her husband, Bill, were facing the difficult reality of moving Bill into long-term care.

I met Mary during a visit to a client site where I was helping redesign their admission process. As part of this, I led an exercise with families called “Emotion Mapping.” It’s a simple yet effective method of asking people how they feel at different stages of their admission experience. Today, I’ll walk you through Mary’s journey and the impact of admission anxiety on both families and staff.

Mary recalled the morning she moved Bill into care: she felt overwhelmed and anxious. She had to fib and tell Bill they were just going to a doctor’s appointment—because she feared he wouldn’t agree to leave the house if he knew the truth.

When they arrived, things didn’t go as planned. There was entertainment in the lobby, confusing Bill even more. The staff member assigned to meet them wasn’t there. They waited, feeling lost, alone, and anxious. By the end of the day, Mary left the home in tears.

This moment stuck with her. And as she shared her experience with the group, I could see how much it helped to be heard by others who truly understood.

Other families also shared their emotions. Some felt relief, finally able to be a daughter again, not just a caregiver. Others felt sadness or worry about their loved one’s future. What struck me was the sheer range of emotions these families experienced, all tied to this pivotal moment in their lives.

While families like Mary’s face this emotional rollercoaster, staff experience their own version of admission anxiety. They worry about what to expect from new residents, how to work with new families, and whether the admission process will go smoothly.

There’s a lot that can go wrong. Maybe the paperwork is outdated. Maybe the resident’s room isn’t ready. Staff might even still be grieving the loss of the previous resident. These seemingly small issues can lead to big feelings of stress—for both staff and families. That’s why, in my work, I focus on making the admission process as seamless as possible to build trust right from the start.

Through my work, I’ve identified three main gaps that contribute to anxiety during admission: the knowledge gap, the emotion gap, and the identity gap.

1. The Knowledge Gap: Families don’t always know how senior care works, while staff know their processes inside and out. But staff don’t always know the specific needs and nuances of the resident. Bridging this gap is key to reducing stress on both sides.
   
2. The Emotion Gap: Families are often grappling with guilt, grief, and overwhelm. Staff are navigating these emotional waters while handling multiple admissions a week. Both sides need to recognize the emotions at play and offer support.
   
3. The Identity Gap: When a loved one moves into care, family roles shift. The caregiver identity is replaced by that of a “partner in care.” This shift can be challenging but acknowledging it helps families adjust to their new reality.

Admission anxiety can create common ground. Both families and staff want the best for the resident, and when we come together with empathy and understanding, we can build stronger relationships.

So, if you’re facing this journey as a family member or working in senior care, ask yourself: What gaps do you need to close? How can you foster a more empathetic exchange of knowledge, emotion, and support?

Remember: There’s power in your presence, so make your presence matter.