Guilt is one emotion that every family caregiver will experience at some point during their journey. When you take on responsibility for another person, there is an enormous amount of pressure to consider all factors and make the best decisions regarding their health and finances. Unfortunately, care decisions are rarely black and white. No one always makes the right call in every circumstance. Mistakes are part of human nature, but we do our best with the information and resources we have at the time.
One of the most contentious and guilt-inducing decisions that many family caregivers face is whether nursing home placement is in a loved one’s best interest. Even if a parent requires an intensive level of care and around-the-clock supervision—something that a caregiver is unable to provide singlehandedly—this matter is commonly accompanied by a sense of defeat. Ironically, if the decision to seek out professional help is also in our own best interest, then the guilt looms even larger.
A Caregiver’s Experience Placing Her Father in a Nursing Home
Members of the AgingCare Caregiver Forum frequently ask questions about nursing home placement and share advice and experiences with one another regarding this multifaceted decision. Anxiety and concern are two very normal reactions for a caregiver who is considering making alternative living and care arrangements for an aging parent.
When my dad first needed nursing home care, I worried about every aspect of his needs simply because he was so vulnerable. My uncle already resided at the same skilled nursing facility, so I knew the staff well and was confident in the care they provided. Yet, I was still fearful for the first few weeks after the move that Dad would not receive the kind of attention he’d grown accustomed to. I was afraid he would decline further without my one-on-one care.
I couldn't stop wondering what more I could do. Why couldn’t I shake the feeling that I had let him down? Eventually, I had to learn to detach a little. I knew it was painful and impractical for me to be so wrapped up in each detail of his daily life. The facility was excellent. Dad was as okay as he could possibly be outside of his own home. His care was supplemented by several family members who visited regularly. At that point I decided that I had done my best arranging his care at the nursing home and that was enough.
Coping with the Guilt of Putting a Parent in a Nursing Home
The guilt I felt initially and the lingering self-doubt that I carried with me are common emotional reactions for caregivers who are grappling with nursing home placement. For many, even considering the idea evokes deep feelings of shame and apprehension. These negative emotions should never be so all-consuming, though.
It takes time to come to terms with how ill a parent is and accept that they need a higher level of care. Working through the following realizations can help you ditch the regret, feel more confident about this decision, and focus your efforts on visiting as a son or daughter rather than a primary caregiver.
How to Deal with Guilt Over Nursing Home Placement:
- Realize that you didn’t cause your loved one’s illnesses or age-related decline. Whether facing age related issues or a progressive illness like Alzheimer's or Parkinson's, your loved one would still have to deal with their declining health whether you continued functioning as their sole caregiver or chose to bring in outside help.
- Understand that professional care is often a necessary next step. A higher level of care provides both increased safety and comfort for an aging or ill loved one. Nursing homes don’t accept just any seniors. These long-term care facilities conduct thorough needs assessments of potential residents prior to move-in. If your parent is admitted because they require skilled nursing care and consistent supervision, then a nursing home is the appropriate setting for them. Yes, there are alternatives, such as around-the-clock in-home health care, but they are often cost-prohibitive. (Keep in mind that professional help is also necessary for you to avoid caregiver burnout and have a life and relationships outside of caregiving.)
- Take time to acknowledge and appreciate that you are doing the best you can. Being the primary caregiver for a parent is a huge responsibility. We must make decisions about situations that we’ve never encountered before and handle matters that often seem to have no right or wrong answers. Once we’ve made a care decision, we must endure the consequences. This may mean lots of fast-paced changes or it might mean maintaining the status quo for the time being. You've taken on a difficult role and you're doing your best to make decisions based on the information and resources you currently have.
- Learn to understand that you can’t live life for other human beings. You can only help so much. Total control of events isn’t in your hands. There might not be a solution that makes everyone happy or solves every problem. Do your best to handle what is within your abilities, and then let the rest go.
- Realistically assess your options. Most elders will be resistant toward the idea of entering a nursing home. Long term care facilities get a bad rap, but they provide a very important service for families. If you come to find that your loved one is being cared for in a substandard facility, or that they may be experiencing abuse or neglect, contact the long-term care ombudsman responsible for your area. You can find the contact information for your ombudsman on the National Consumer Voice for Long-Term Care website.
- If your parent is being well cared for, then let the facility do its job. The bulk of your loved one’s care is the nursing home’s responsibility now. Visit often, advocate for them, and do small things to brighten their day and make their life easier, but then move forward with your own life. You’ll have more energy and quality time to devote to all your relationships, and that benefits everyone.
What many family caregivers don't realize is that your role doesn't end with nursing home placement. You will still be part of their care team after they move. They will still need you as their advocate. Accept this newly defined caregiver role and the benefits it provides. A commitment to a life of your own will make you a more refreshed caregiver and protect against caregiver burnout. A reputable nursing home will provide your Mom or Dad with the care and engagement that they require. That’s a winning situation for both sides, so put aside the guilt and regret.