Do we ever come to terms with the decisions we are forced to make for our loved ones?

Are you a god? Omnipotent? A fairy with a wand? I suspect not.
"Guilt" insinuates that you have a choice; that you can cure this and because you are perverse or an evil doer you choose not to make things easier for Mom.
You are a human being, one who cares and is attempting to do the best you can.
Whatever decision you come to know that you are doing the best you can, and no matter what choices you make, not everything can be fixed, and not everything can have happy results.
The G-word I suggest is grief, because these choices are full of grief for our loved ones, and for us as we bear witness. Grief understands that there often are not answers or choices (unless of course we ARE God).
In a head and heart battle that involves the safety of one we love, I am afraid that the head has to rule and the heart has to grieve. But remember, you are not an evil doer who should feel guilt. If you were such a person you would not give any of this a second's thought.
You say you were in health care for many years. I was a nurse as well. You are lucky in that, as you have been witness to the grief and helplessness, hopelessness of others. You understand that not everything has a fix. Not everything has a happy outcome. Some things in life are worthy of grief. That they come near the end of life when we are so helpless in so many ways is tragic. I am so sorry for your grief.

I think that coming to terms with making decisions for parents, or for siblings or children with challenges, is difficult, if even possible.   The rationalization experience is emotional and often presents contradictory options, with which it's hard to come to terms.   Even after decision making, it's often difficult to be comfortable knowing that the right decision was made.

The fact that we're dealing with people, close to us, and not facts or business options as we would if these were employment situations, renders the decisions less convincing, and more emotional.

Are you kidding. I was a mess. I could barely function. I would be eating dinner and just start crying. The caregiving does not end when they are placed in an Assisted living. I go every day and make sure she is eating right, that her room is clean and she is stable. I have more energy to enjoy her company and laugh with her. Before, all I could think about was the next task. I did not realize how much I had lost myself in the process. I hated folks saying "give it time" but they were right. Time does help. You just have to live through that transition.

I am experiencing the same emotions with the decision to place my mom in LTC, I’m an only child and out of state, it’s hard but we have to do what’s right for them, I would rather have my mom with me forever but I know that’s not realistic I rather be in pain if it will give her peace and dignity as well as the care she deserves. I trust the universe and God will see us through

Lori, the truth is that your mother will fall wherever she is.

BUT as the previous poster says, in a good facility, you get to be her daughter and advocate, not a caregiver on call 24/7.

Lori1215, I faced the same issue. What I really wanted was my mother to be healthy again. I realized that no matter how hard I tried to take care of her, I was never going to make that happen. I cried for a full month planning the transition and am three weeks into her living in the ALF. She gets stronger every day. My heart still aches that I could not help her but my head is winning out now that a little time has past. I am her daughter again and not just her caregiver. That has been wonderful.