Nursing Homes and Guilt Traps in Dementialand

guilt over putting mom in nursing home

Moving your older adult into assisted living or a nursing home is one of the hardest decisions you’ll ever make. When caring for someone at home is dangerous or financially impossible, it’s necessary to move them to a place equipped to give the care they need. Even if it’s the best choice for their health and yours, the guilt and sadness can still be overwhelming. Dr. Elaine Eshbaugh explains why you’re not a bad person and why you shouldn’t feel terrible for making this tough decision.

 

If your loved one is living in a nursing home and this makes you feel like an awful person, STOP. Just stop.

You are not an awful person. You are a human being who is doing the best that they can.

 

Let’s face it. We don’t know many people who say, “I hope someday I get to live in a nursing home.”

Sure, some nursing homes are better than others. Yet, even the best nursing homes are not home – even if we allow people to move in their own furniture and plaster family pictures everywhere. Bringing a recliner from home doesn’t make a place home.




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If you’ve heard someone say, “I could never place my loved one in a nursing home,” and it broke your heart a little bit when you pictured your dad in his nursing home room…please know that this person has not experienced what you have.

They’ve never been at a hospital when a social worker told them that their mother absolutely, positively could not go back home but needed to be out of the hospital within 24 hours.

They’ve never had to have a talk with their dad about how the money the family had pooled for in-home care was depleted, and there was no way for him to continue living in his own home.

They have never been in a position where a nursing home is their best – although not a great – option.

 

In a perfect world, nursing homes would be unnecessary. We would all live healthy, independent lives until we dropped dead suddenly at the gym at the age of 95. We’d wave goodbye to fellow gym rats as we fell off the treadmill, and that’d be that.

I’d love for that to be my farewell to the world. My goal is to die very old and very suddenly – and to inconvenience no one in the process. As a gerontologist, I’m smart enough to know that’s unlikely.

 

Medical technology can cure us of ailments that used to kill us. We survive acute illnesses but must live with chronic ones.

And people, because of this annoying issue of having to earn a living, can’t always quit their jobs to provide 24-7 care to Grandma, Grandpa, Mom, or Dad. (And, to be honest, not everyone is physically and emotionally capable of being a full-time in-home caregiver.)

 

And then there are people who promise their loved ones that they will never place them in a nursing home. I once had a woman say to me, “My husband and I promised we’d never do that to each other.”

 

I can promise my spouse a lot of things. I can promise I’ll never cheat on him. I can promise I’ll never blow all our money at the casino. I can promise to always take the kitchen trash out when it’s overflowing. (Bill, I promise you the first two – I make no commitment to the third. The third was just an example.) You see, those are things I can control.

 

I can’t promise him I will never get in a car accident. I can’t promise him I’ll never lose my job. And I can’t promise him that he will never live in a nursing home.

 

There are things in life that are out of our control.

 

So we sometimes must consider a nursing home. Not because we love the idea – but because this is reality and we have limited options.

Few of us have the money to pay for round-the-clock home care. And our homes often aren’t equipped to provide the type of environment to keep an individual with Alzheimer’s or related dementia safe. So we check out nursing homes.




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And we get a sick feeling in our stomach when we see the people who live there. They are sitting in wheelchairs by the nurses’ station. They are waiting…but for what? For dinner? For bingo? For death?

Some of the staff members are smiley, pleasant, and kind. Others seem to hate their jobs. Most are rushing around without time to chat.

We identify what we consider to be the best nursing home in our desired area. Maybe it has a bed available; maybe it doesn’t. And that’s the sometimes ugly, often painful process.

 

We move our loved one with dementia into the nursing home. Sometimes they are aware of where they are and exactly what’s happening…sometimes they aren’t. Maybe they are pleasantly confused; maybe they are terrified.

Either way, we feel like the most disgusting scum on the face of the earth.

 

And what other people say doesn’t help.

Maybe someone in your support group says something like, “I’ll never put Harold in a place like that after what a great husband he’s been.” (In fact, this is a direct quote from a support group I once visited – except his name wasn’t Harold.) Maybe if Harold had been a jackass of a husband she’d already have placed him in a nursing home?

 

Perhaps someone in your own family makes a backhanded comment about how you didn’t invite Mom to live in your basement bedroom.

What they don’t understand is that you’d be terrified she’d fall down the steps to the basement and you can’t quit your job – and honestly don’t want to – to be home with her all day.

Maybe they don’t understand that her disease will leave her unable to bathe herself and use the toilet on her own. Your own physical health makes you incapable of taking on those challenges.

And you didn’t see a line of people volunteering to let her live in their spare bedroom.

 

Maybe your siblings weren’t anywhere to be found during this process. Maybe they weren’t willing to be involved in making a decision but showed up just in the time to tell you that you made the wrong one.

Perhaps they visited Dad once in the last year and he really rose to the occasion. He had the energy of a teenager and mental sharpness he hasn’t possessed in five years…for that one day.

(Yeah, that happens a lot when you’re trying to convince someone that your loved one is struggling – just like when your car doesn’t make that clunking noise when you take it to the mechanic.)

 

Now your siblings can’t figure out why you have turned into such a villain and are insisting on imprisoning your dad in a nursing home.

It wouldn’t be so awful that they thought you were a villain if there weren’t this voice in the back of your head echoing the sentiment each time you visit the nursing home.

 

So stop. Just stop. You aren’t a villain. You aren’t a bad person.

You are just a person – doing the best you can under circumstances that aren’t great.

And you’re not alone.

Sometimes a nursing home really is the best option. It doesn’t mean we like the idea. It doesn’t mean we’re abandoning our loved one. It means that we had to make a hard decision.

And sometimes the best of our limited options isn’t great.

 

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Guest contributor: Dr. Elaine Eshbaugh is the author of Welcome to Dementialand. She holds the Davis Professorship of Gerontology and chairs the Division of Family Services and Gerontology at the University of Northern Iowa. She’s on the executive board of the Northeast Iowa Agency on Aging and has collaborated with continuing care communities, adult day services, and hospices. Dr. Eshbaugh is also active in community outreach and does education on dementia for communities, families, and facilities. She often meets with families to provide support after a dementia diagnosis.

 

Image: Enhanced Home Care

 

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