This article was very instructive for me. I am facing the decision to place my mother in a nursing home in the near future. I, too, promised her to never put her in a nursing home. She has lived with us for 8 years. And we have been managing a team of caregivers for her 24/7 care since her return from rehab 5 months ago. I'm coming to see that we can no longer provide what she needs. Being able to see that my job as her son and a caregiver doesn't end when she enters a nursing home makes my decision a bit easier to accept.
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As Jeannegibbs, wrote ""If you haven't lived in my shoes, don't criticize me and what I have to do." And, really, no one can have lived in your shoes because every situation is different...

Every situation is unique. Many of our mothers didn't have outside jobs and they could be home to care for elders. In today's world, many of us must work for financial reasons. Even without that concern, there are many illness which demand more care than one home caregiver alone can provide. We all have to make the best choices we can for our loved ones and ourselves. No one else is in exactly the same situation.

I've seen people hate their assisted living or nursing home life, but I've seen many thrive. This, of course, is in a community where most of the care homes are good and several are exceptional. The decision to use nursing home services is harder when the available homes aren't very good. My heart breaks for those in such a situation.

It's good to see so much compassion and sharing in the community. You are wonderful people!
Carol
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Although I understand what "caregiver burnout" is all about, and I understand that I can't do it all alone; I can't give up on my Dad. I know my Dad's personality and he would not survive in a nursing home, and I would much rather deal with the stress of taking care of him than the guilt of him dying in a place like that. I took a 96 year old stranger out of a nursing home, because she deserved better care.
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My Dad died two months ago of cancer, he was 88. My mom, 86, lost the love of her life. My Dad took care of my Mom. I took my Mom to live with me and she fell and broke her pelvic bone going up my front steps. My husband had a heart attack last year. I have been through hell this past year. My Mom is in rehab now and we are looking into long term care for my mother. My Mom is making me feel so bad, saying she took care of her mother, that I don't want her anymore. I do want her, but I just can't do it, she needs 24 hour care. I feel so sad and helpless.
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I think it is irresponsible not to give our loved ones the best care they can have. I also think it is arrogant to assume that we and only we can provide the best care. While well-intentioned, it is not in anybody's best interest to continue to hang on to the sole-caregiver role past the point where we can handle it adequately, never mind at the "best" level. Some conditions, some diseases are "best" handled by trained professionals with plenty of backup help and specialized resources. It would be good if we could promise our loved ones we will always care for them ourselves, and that they could promise us they'd never get a disease we can't handle. But the world does not work that way.

mrst53, when you place your mother where she can get the best care, your role is not over -- it just changes. She will need you to be her advocate, to keep an eye on things, to represent her best interests. It is too bad that the care center isn't closer to you, but I have friends who commute an hour each way for work every day. I don't mean you need to be there daily, but you need to adjust your attitude about distance. It isn't going to be easy to have Mom in a care center, but I don't get the impression you are looking for the easy way ... just the way that on balance will be best for your mom, your husband, and yourself.

I attend a support group for caregivers of persons with dementia. I have listened to caregivers anguish over this issue again and again, and I have seen the positive results often associated with placing the loved one where around the clock specialized care is available. I also have seen that it is not an easy answer and does not eliminate the caregiver's challenges. And I think you are absolutely right,
"If you haven't lived in my shoes, don't criticize me and what I have to do." And, really, no one can have lived in your shoes because every situation is different.

Do what you have to do. Tell your mom how grateful you are to have had this time with her. Assure her that you will never abandon her. You will always be looking out for her best interest. You will visit often. You love her so much and you are glad you have found a wonderful place for her to be now that you can no longer give her all the care she needs. She deserves the best and that is what you are trying to provide for her.

Do what ya gotta do!
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I believe that home is best too... but today, since 2, my Mom has refused to take her meds and she has cried and yelled at me telling me, that I don't love her and I don't want her around. I have not been able to get her to eat... She is not at peace and is not happy. If my Mom did not have AZ, then yes, my Mom would be able to live happily and peacefully at home with me.. If you haven't lived in my shoes, don't criticize me and what I have to do. I never planned on placing my Mom in assisted living, but the AZ was never expected either.
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we should take care our parents instead of sending them to nursing home. home is the best environment, where they can live peacefully and happily.
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My Mom has Alzheimers and I swore I would never put her in a nursing home.When my Husband were first married we agreed that we would never put our parents in nursing homes.That has changed. We have had my mom for 3 years and my hubby has had it. My Mom is in stage 5 and he has given me till after Christmas to find a home. I know that taking care of Mom is affecting my mental and emotional health. She is in great physical health, her memory is shot. The nearest good homes are an hour away. I found a really great one yesterday. I know in my mind this is a good thing to do, it's just emotionally, I don't want to let go. I am an only child. My Dad was a Drunk and Mom is all I have left, even tho most times she doesn't even know who I am. My hubby can't or won't understand that. My problem, is, HOW do I tell her I am putting her in a home and I won't be coming back for awhile? It is a fantastic place. It is run by the Mennonites and the assisted living areas are such that they are like neighborhoods. Only 12 or 13 residents to each neighborhood. Each neighborhood has their own dining room, living room, kitchen and laundry room. It's set up like home,so the residents can feel better. They are free to wander the halls, but have a bracelet, so they can't go outside, except into their own courtyard. They have their own mascots or the ir own pets, if they can take care of them.They keep them busy 7 days aweek. They have church services and 3 chaplains. Why am I having such a problem???? Please help me....
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My sibling is bound and determined to care for my Father who has alzheimers and who is rapidly declining in health after several falls and infections at home. She has health issues herself and recently agreed to place him in a nursing facility that provided respite care while she recuperated. I'm worried she'd pushing her recovery period in order to get my Father back home because he wants to go home. His health and hers are my concern especially if she hurts herself and/or him trying to care for him. I also worry that while she is doing this a resentful relationship may develop from a loved one trying to do the right thing. I have suggested that we find a good facility where Pop will be taken care of by others and, without the stress and physical strain, my sister can better enjoy the time he has left. Am I wrong and do I need to back off?
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Hello, Pat:
I hope I don't seem insensitive, but you don't have to be a medical professional to give a insulin shot; otherwise, all diabetics would be in serious financial trouble. Why can't the person who will be looking after her while you're on vacation give her the shots? It is a needle that just goes under the first layer of skin, there's no medical training needed. As you said, it is a two-second process.
God bless you for caring for your parents
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Hi,
My husband and I were empty nesters for only a year and a half when my diabetic 80 year old mom had a demenia issue that caused her to forget to take her insuline for 3 days!! She ended up in a diabetic coma for a week. Since she and my dad lived 3 hours away we moved her to a skilled nursing facility near us for the 3 months of rehab. During this time, my 86 year old father lived with us. While learning how to give insulin shots and take care of my mom, my dad unexpectedly got sick and died 3 days before Christmas! They only lived in our house together for one week! It has been almost 3 years that we have been caring for my mom in our house.We feel fortunate we have had these extra years with her. She was always a great and loving mom! Unfortunately, she has been diagnosed with Lewy Body Dementia ..(Parkinson's and Alzheimers). We have her attending Easter Seals Adult Day Program while my husband and I work. I am a teacher. Since she requires more care now and my undivided attention, I have hired caregivers from 3-6PM while I stay at school, go to my teacher meetings, correct papers, plan etc. When I get home, the caregivers have thrown in a load of laundry and started dinner so I can give her the dinner shot and feed her. Then we spend a few hours together. Before I know it, it is time to test her, give her the bed time shot and put her to bed. Then we all get up at 6AM, eat breakfast retest her blood sugars and give her the AM insuline. Then she gets on the Easter Seals bus at 7AM. I would like to know if anyone has any suggestions for how I could get relief from giving shots. My husband and I haven't had a vacation together in 2 years because of the shots. All the PRN Nurses charge $175 an hour around my area. I refuse to pay that kind of money for a two second shot!! Since my mom gets 4 shots a day, we would quickly use up what little money she has left. I would rather save her money to use as leverage to get her into a decent nursing home when we make that final decision. (I have been told it will soon be impossible to continue to work full time and take care of her needs as the disease progresses.) Any suggestions? I have tried calling retired nurses, colleges that have nursing programs and have gotten nowhere. I'm wondering if an ad in the paper is a good idea? Maybe pay for a background check? I want to pay around $25 a shot...is that unrealistic?
Pat
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Dear Nancy,

I understand your tears, and feel for you. My heart goes out to you and your family over the loss of your Mom. What you are experiencing is a natural part of the grieving process. We go through the many stages, such as shock, denial, anger, bargaining, etc., until finally...comes acceptance. The process is different for all of us, but unavoidable. Some of the anger we direct at ourselves, and it sometimes takes the form of guilt, or better called "false" guilt.

It sounds like you did the best you could given the circumstances. It also sounds as if you were a wonderful daughter, caring for your mother's needs in a very special way. How blessed she was to have you for a daughter! Please be gentle with yourself, allowing time to reflect on the love you showed her.

If you need some help with the emotional part of the grieving process, please seek support and wise counsel. Your own well-being is a very important in this process, too. I pray God gives you and your loved ones comfort and peace this Christmas.
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After my mother had a slight accident with her car, the police department said she needed to take a driving test before she could drive any more. At the time she was 89, and also blind in one eye. As long as she could drive, she was very independent. But when I took her to take a driving test, we realized that she would never be able to pass. This was the beginning of the end of her mental state. I could no longer trust her to take her medicine even though I put the pills in a container for daily does. I moved her in with me and my husband and cared for her almost 3 years. she got to the place where she got dementia or Alzheimer's and became incontinent. I had no other family here as I am an only child. I was lifting her in and out of bed and in the wheel chair. As a result I tore my rotator cuff and had to have surgery. I didn't think I had a choice so I did place her in a nursing home. She lost most of her memory, but did know me when I went in to see her until the last few weeks of her life. I went every day to see her, did her laundry and fixed her hair, did her nails and gave her a pedicure. I had promised I would not put her in a nursing home, but her doctor and my husband said I was ruining my own healthl. She died October 20, 2009 at the age of 96. I am still feeling guilty although I know she received excellent care at the facility. I know this because I did go at different times of the day and night to check on her. I hope that I can shed this guilt soon because I still cry a lot.
Nancy
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The best phrase for this I've heard is "honoring the spirit of the promise", which is doing the best we can. Circumstances change and we can't always do what we said we'd do. However, it's always best to not make that promise, but to say "I'll take the best care of you I can."

Unfortunately, we can't take back our words, thus "honoring the spirit of the promise."
Carol
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Wow, so many heartaches. Imw, I'm sure you had your mother's best interests at heart, and did the best you could. So sorry you have to face these difficulities with your mom and sister. Hoping it all works out well...

I loved cathrenn's words, though! And the foster home idea is also a good one, naheaton! We forget that option, which can be an excellent one for some folks.

I am thankful for the care my dad and FIL get at their nursing homes. No place or locale is perfect, and even home care has it's limitations, but we've been blessed, and our dads have lived longer than they could have elsewhere. They are content, well cared for, and we choose to be thankful rather than feel guilty. I am thankful I realized our limitations and made the nursing home choice, and so is my husband. Now our visits are for their enjoyment, pleasure, or some auxillary caregiving. We're there a lot, and the staff is thankful for our family's support. They allow us to be as much a part of Caregiving as we desire, and have been more than wonderful to our family and loved ones.
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Thank you for this article. I too fell into the trapf of saying my parents will never go into a nursing home. But after watching my mother's health decline at home I realized she was suffering there. I didn't want to see her fall and get hurt anymore. Also, she would refuse to take her medicine. The consistency of care she now receives keeps her in better health and less pain.

I think it is important that we make sure our own children know that it is okay to transition us to nursing homes when our own health issues require it. We need to establish the conditions now that will allow our children to make this decision without guilt.
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What about an adult foster home? We had my father-in-law in one for 6 months before he finally died. Wonderful people. He and one other man were the only patients there.
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People change, conditions change. So responses have to change. What I promised my partner was that I would keep her home as long as I could, which I think is the only genuine promise we can make. She's in a nursing home now and doing just fine. Sometimes "the strangers" know better what is needed and have less stress than we do, so can provide better care.
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I had to have my mother put in the nursing home last month. She is upset with me and my sister for making this decision. I am on disability and was the sole caretaker for my mother for five years. She fell several times in the home and at church, and I am disabled and unable to pick her up off the floor. Each time I had to call the ambulance to help. Fortunately all she had was bruises, but it scared both me and my sister, so we moved out of the beautiful two-bedroom, two-bath apartment we had and I moved in with my sister. I go over to see mom every day, she understands that my health was not good and I was unable to take care of her myself. She has had some improvement at the nursing home, but now all the damage has been done, I have moved to my sister's, mom's things are stored in the garage, etc, and now she is upset with me becuase I cannot move again and stay with her if she goes to Assisted Living. She has failed Assisted Living before and I had to come and take care of her. If they release her to go to assisted living and she gets hurt or runs into trouble, I feel a terrible sense of guilt and also that all this time I spent caring for her has been wasted. I do not think that things will ever be the same in our family again, as mom and my sister are embroiled in a legal battle for custody and trying to drag me into it, I am on the edge of a nervous breakdown over this. I promised mom I would never have to put her in a nursing home, now she is upset with me, I try to explain to her that she needs the care they are giving her. She is now wanting to go out and live on her own without my help, it is like saying I don't want your help and never needed it in the first place. I guess I will just have to let them send her to assisted living and hope that she will not get hurt or wander off (which she has tried to do before).
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To me, the best indication of a good nursing home is watch how the hands-on caregivers (usually CNAs) are treated by other staff. Watch their attitudes about their jobs. If they are treated with respect by the nurses and others and they seem to like their jobs, there is less turnover of staff.. This is better for the residents.

Our elders will always have favorites among these caregivers, but if these caregivers are good, dedicated people who love their residents (most of them, as they are human) you will likely have found a good home.

Also, I'll repeat this as it can't be said too often: visit at times when you don't have appointments with admin people. Talking with them is good, but your observations are better.


Carol
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I think one thing you need to know is no matter how much you research or how many homes you visit there is no guarantee that you will get a good one. After numerous visits, questions, and online research we finally chose a rehab facility for mom. Believing this to be a short term stay to rebuild her strength so she could return to her own home and resume caring for herself. She was seriously injured and now after a year and a half we know this will never happen. If you find the one you think is "just right" visit often at different times of the day and night. Ask lots of questions and if you worry over one of their answers ask someone else. Some of the best to ask are the ones who actually provide care for your loved ones. Most administrators offer a lot of "lip service" and half truths.
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Dear helpme, I'm surprised no one has responded to your post. It is alarming to read about the bruises. What is Mom's condition? Is her Physician involved in her care? Have you addressed your concerns with him/her? Local Senior Centers, or your County's Commission on Aging can offer some assistance, and provide direction as well. A lot depends on your parent's particular needs and financial situation, but there are many things you can do to help them through the process. Be a squeaky wheel and steadfast, until you have them cared for. It's worth the effort, and sounds like they need you. Ask family for their help, as well. We'll be praying for you. Let us know how things are going...
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my parents are both 84 my dad takes care of mum, dad is not well himself and is tierd looking after mum all day.
mum has told me that dad is not being nice to her anymore she has a few bruisers on her hands ,when i ask her how did you get them she starts crying ,I know dad loves mum but it is hard for him what can i do to get him some help
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Carol,
What a wonderful article. My mother & grandmother went through the same struggle when it finally came time to make the decision to place my grandfather in a nursing home. He suffered from Alzheimer's Disease for 6 years, and my family did everything we could do to keep him at home for as long as we could, but as my grandmother grew older it became harder & harder for her to care for him, it was exhausting her and taking a toll on her own physical health. It is a very difficult decision to make, but in the end it was the right one. The retirement home we placed him in was wonderful and the staff were always so caring. My grandmother was still there with him everyday, but having the extra help allowed her to actually enjoy the time she had left with him & was such a relief to our entire family not to have to worry so much about something happening to either of them.

Best,
Tuesday
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Anne how beautiful! Thank You for your kindness, encouraging words, love, and prayers! With smiles and some tears, I so appreciated your writing to me in this way! My situation is not as dark as it seems. For now, God has blessed my husband with continued mobility and we have had immense freedom as full-time RV'ers for 4 years. I have been able to drive our motor home and I tow a small car and we have toured much of the East coast and part of the West until finally we must stay put more due to tight finances and my husband's needs for more physical therapy. I love travel and I am kind of a 'wanna be' writer - but not enough time to pursue it now. I hope someday to have a memoir about our travels the past 4 years. My husband helped me find love and a true home when we met 11 years ago. He was diagnosed about 10 years ago. For one of the years, 5 years ago his family placed him in an Assisted Living Center and he was also in and out of a nursing home due to falls. I am also a trained massage therapist. I took a 'breather' from 'us' and went away to care for a friend's mom who had a stroke and during that year, my husband's family sold his farm. So, I had time to think about my choices and how I truly felt. I decided I could do this and wanted to be with him. He feels very blessed not to be in the Assisted Living Center now - although it was a very lovely one - so in the future we do not know what will be comfortable if or when a nursing home is needed, but I trust God and know all will be well. I hope everyone who reads this knows how important 'Faith' is and that as you said, it and Love can get you through most everything. I do appreciate this fine web site and hope others are benefitting from it also.
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Dear Randyl, can only imagine your hardship and struggle. A dear friend of mine fought for her husband's final days, and lost him to Cancer. Even though he's passed, she struggles, still. I pray you have tons of support and loved ones who can see you through this difficult time in all your lives. Good heavens! Sometimes we wonder how much we can take. Thank God he's there when we cry out to him. Always there, and never leaves us, even in the darkest hours.

Randyl, my Dad was in a horrible place before this, and another that seemed OK, at first, in comparison, but that I came to greatly dislike. We were absolutely blessed to find a facility within 4 minutes of home, and that Mom allowed me to transfer her husband by me. As legal guardian, I had the ultimate say, and have now moved her, so all is working out...for the moment. Though NOTHING is perfect, including our very own homes. A couple very nice new belts and a borrowed book disappeared from Dad's place, so we limit the valuables there. Once in awhile someone else's clothing ends up in his drawers or closet. Sometimes his get misdirected or find new homes. No big deal. No sweat. Just things. The most important thing is finding good care. I would not tolerate poor care, for long. And still, no place is perfect. Humans aren't, and humans run facilities. But active consistent family involvement helps greatly. I realize everyone will not be as fortunate as my loved ones have been. Often families have to make tough choices and sacrifices. My hats off to you who are doing the best you can with what you have and where you are at. You are heroes! Love is the bottom line. Love will persevere, protect, heal, and conquer. And most of the people on this site are full of compassion and love. Take care of yourself, Randyl. I'm praying for you. It's a very tough place you're at. Glad you can come to this site and find encouragement and many people who care.
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I would like to find a location as lovely as where your parents are located, Anne. It sounds so nice and not at all like the nursing home my mom was in where clothing was lost and her things were misplaced or taken by others and where she suffered lack of care causing bladder infections along with staff inconsistency as to rules and assistance. My sister was working and lived near her and did her best to check in. I was only near her for a short time and have full time care of my husband who has Parkinson's disease. At this time, I cannot imagine living without him and I certainly do not want him to be in such a situation ever. I fully plan on spending every day with him if he must go into a nursing home later on. I am concerned, however, as to the length of time I can actually care for him myself because I am 60 years young this year. I too have promised him I will be here for him as long as I'm physically able. I thank Carol for her excellent article above and really like these last lines: "Honor the spirit of your promises by being the best caregiver you can be." I am not sure about getting on a list yet, but will look into it. Randyl
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This is an excellent article, Carol. I love the spirit of caring for our parents idea you presented. Thank God for all the choices out there, and the help it is to those of us caring for those who can no longer adequately care for themselves. My son is not uncomfortable in our Nursing Facility at all!!! In fact, they love him, and he asks to go. He plays the piano for the residents, plays ball with them, helps pick up dropped items, and the nursing staff love him as well. We love going to the facility for picnics, to watch movies, Laugh Club, garden parties, help bake cookies or do woodworking with Grandpa, go on the bus with Grandpa to a ballgame or to a local restaurant. For those who think facilities are uncomfortable, find one that isn't. I'd choose this one for myself! My Dad, and my Father-in-Law have thanked us for moving them there. It's a beautiful place, and the staff tells us everything we need to know about their care. We're there everyday to play Checkers, Chess, or build a puzzle. They have been such a blessing to us, and we don't have the grunge work, but have energy to enjoy our parent's final years... What a blessing the right facility can be for everyone. Thanks for the article, Carol. Anne
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This is a good article, and everyone knows their own situations and what they can handle. However, there's a difference between not putting people in a nursing home, and promising to personally provide all their care for them. My grandparents were promised they would never go to a nursing home, and as a family, we stuck to that. With all the outside health care options available, we still did all that we could, and got the help with what we couldn't do. It was good for my children to spend some time with their great-grandparents without the discomfort of being in a facility. It also made it easier for frequent visits from other people, because they were actually visiting a house they knew, not a facility. Of course it wasn't easy, but it's not always easy to keep a promise. Please be mindful, I'm not speaking against anyone who did put someone in a facility. As I said before, we know what we can handle.
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