Do you talk to your elderly parent(s) about them having to go into a nursing home?

When I took over the care of my dad, it came at a time when it became increasingly more apparent that he could no longer live alone. We had a discussion about retirement homes, assisting living etc. His fear of moving out of his home was that once he was placed in a facility, his family would abandon him and he would be left with strangers. I asked if he would be willing to try it for 90 days and if he didn't like it, he could come home and we would look at other solutions. He agreed to give it a try and after 45 days, asked me to sell his home. In short, as we age, we lose more and more control over our lives. Whether it is losing our independence because we had to surrender our car keys or can no longer make good fiduciary choices on our own behalf. In giving my dad an "out" should he not like his new living situation, he felt as though he still had some control over his life and more importantly, he believed it would be his choice to stay or leave. All discussions with my dad were always honest. I tried very hard to give him as many options as possible and allowed him to make the final decision. The trick in all of this was to give him options and choices that were viable and I could live with as well. In caring for an aging parent, our choices are never easy. My primary goal was to treat him with the most respect possible and I found that what it really boiled down to was trust. If he felt he could make some decisions with respect to his life situation, his trust in me and our relationship grew stronger. After a few months, he realized I wouldn't do anything to make him feel less than who he was, and that his well being and safety were my primary concern. As a result, it was his choice to relinquish decision making to me. I hope this helps.

My parents told me their viewpoints on NH at least twenty years ago. My mother said she wouldn’t mind it and my dad wants to die sitting in his house, in his recliner.

Well the time came and my mother was resistant to the idea but once we got her settled she really does seem like she enjoys the other elderly people around her and the personnel too. She was always very sociable in her younger years. I guess that’s her personality.

My dad really needs some assistance back at the house. He was mom’s caregiver for a few years but he really didn’t know how to help her properly, she wasn’t getting enough food and her hygiene had slipped and he seemed oblivious. He takes care of himself but doesn’t want ‘strangers’ to come do lawn work or clean or do his cooking. HE WANTS MY DAUGHTER THERE 24/7. But I’m working toward him joining mom eventually in the AL facility. He visits her enough it should seem familiar when the time comes.

Mom’s dementia is come and go. I still can catch the old mom early in the day but as evening comes she gets ‘out there’. Dad’s right behind her, showing signs of dementia but it’s mild.

One day at a time!

Countrymouse, I think part of it is modesty; and the other part is that Mom still thinks she doesn't need help. Mom was a nurse for many years. She asks the aides how long they have been doing what the do. The hospice aide said that Mom knows what she wants and doesn't want. Finally, the other day, the hospice aide was able to get somewhere with Mom. This aide is kind and gentle, but is only here for an hour during the day. I had to change the paid caregiver agency after 2 weeks. It didn't sound like one of the aides was patient enough with Mom. Mom was crying (unusual), and we found some unexplained bruises on her hands and forearms. They look to be about the size of a thumb, as if someone was grabbing and pulling her too hard. Here's hoping the next agency will be better....

Your mother is aware. She has a right to know what is happening with her care, doesn't she? A right to an opinion?

You don't have to call a spade a bloody shovel. You don't have to keep rubbing it in. And you don't have to have the whole conversation all at once. But the "not in front of the elders" idea is neither respectful nor helpful; and besides don't you think it's possible that it's your brother who's uncomfortable with the discussion more than your mother?

Whatever your mother's care preferences, they can't, any more than anybody else's can, override reality. The day may dawn when her staying at home is no longer realistically possible; and in that event it would be as well for you and your mother to have a clear idea of where she might be made most comfortable. It's a fall back position, not the plan. Present it to her as a safety net - nice to know it's there should she need it.

Meanwhile, what is the problem with allowing the aides to help her? Are you happy with the aides' approach? They should have had training in putting their client at ease, but as in any walk of life some people are more naturally skilled than others. If she seems to like some of her aides more than others, it might be a good idea to make yourself scarce when these people are around so that she's encouraged to accept their help with personal care. You can't afford to make yourself indispensable.

If your Mother is competent, then talk to her. If she has dementia, then don't