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I found my mother lying on the floor of her home a few months ago. I don’t know how long she had been there. She had a part time care-giver and family caregivers but no one at night. She has dementia and balance problems and refused to use a walker. She has fallen many times these last few years. Once she broke her knee, then her shoulder, then her wrist. The caregiver found her naked lying on the floor one morning but was able to get her up and didn’t tell us until much later. She had forgotten how to use the controller on her lift recliner and refused to sleep in her bed at night (which is two steps from her bathroom). She developed swollen legs due to being in the recliner so much and rashes from refusing to bathe. She would not eat if someone was not there to put it in front of her. It was getting more and more difficult to get her out of bed to eat. When I found her this last time, she must have slid off her chair as the footrest was still up. She did not want to go to ER to get checked but EMTs advised her to go. She did not have any breaks this time but was placed in a very nice rehab for help with her balance problems. They determined that she cannot live alone and needs 24 hour supervision, She did not have the funds to hire someone round the clock and she had been wandering around at night and that is when she would fall. Neighbors were commenting on her behavior and even though she had an alarm necklace she didn’t remember to use it when she fell in her back yard last summer and laid there until a neighbor heard her yelling for help. So when the rehab said she should not be alone I placed her in their nursing home when her time was up at the rehab. I could not provide overnight care for her as I am in my 70s with health problems of my own. From the time she was in the rehab she was saying she wanted to go home and wasn’t staying there. I just kept telling her she had to get better first. We even paid the caregiver to take Mom’s dog to visit everyday and we would do it on weekends. She would get very angry with us and when she was taken to the nursing home part she became very aggressive and hit the caregiver. It has been downhill since then. This was right before Covid was increasing and the only way I and the caregiver could get in to see her was under “compassionate care.” So she has had someone visit almost every day. I told her that when the rules were relaxed that I would take her out and for a drive or visit to my house. I asked her to be patient and things would get better. When she was allowed to go out at Thanksgiving I asked her if she wanted to go for a drive and she refused saying she wanted to go home. She would yell and accuse me of wanting to get rid of her. Well, the caregiver quit after Mom hit her and she did not have the one on one attention at the nursing home. She kept trying to escape and ended up falling. She hit her head and had a brain bleed and a compression fracture. She is in worse shape now than when she went in to the facility and I am filled with guilt at having placed her there. I had noticed when she was at home that each time she fell her cognition would decline but she would refuse to be admitted anywhere and she had to be in a hospital 3 days before she could get admitted on medicaid. Since she fell at the nursing home her dementia has really gotten bad and with the compression fracture she now refuses to get out of bed due to the pain. I feel like I made the wrong decision, She has always been a very strong-willed person (it’s either her way 100% or not at all). This has all been so stressful and I keep second guessing myself even though all my family supported the decision agreeing that she couldn’t be alone. It’s just so sad to see her like this. How do I get rid of this guilt?

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Your guilt is totally unfounded. It's amazing your mother lived through the various falls and situations she found herself in while living alone at home! She's fortunate to have made it into a Skilled Nursing Facility where she can have managed care now 24/7. It's impossible to prevent her from falling, however, whether she's at home or in managed care of any kind. Elders fall ALL the time, no matter how many precautions are taken to prevent it. My mother is 95 this month with advanced dementia and living in a Memory Care AL since 2019; she has fallen a total of 90x. NINETY. It's nobody's 'fault' that she's fallen, either, nor am I the guilty party for having placed her in Assisted Living and now Memory Care either. She's got TONS of issues and is not safe to live alone at home, just as your mother is not safe to live alone at home with part time help coming in.

There are no good or perfect answers to deal with advanced old age and infirmity, THAT is what you have to reconcile with yourself. If she were to move back home, that would certainly not be an ideal situation either b/c she would STILL fall! Wherever she lives, she will continue to fall. My mother has every device in place known to man to stop her from falling, but she still falls. Partly b/c she refuses to ask for help and partly b/c her brain tells her she can walk when she cannot. So she gets up from bed and falls out of it each time. Or she tries to get up from her wheelchair and winds up on her butt. How do you prevent that? You don't. It's impossible. I can hire a sitter for her for thousands and thousands of dollars extra per month and she will STILL fall b/c nobody has eyes behind their head! Old age and infirmity = falls.

Stop feeling guilty for doing the right thing for your mother. How would you have felt had you left her at home and she fell down and wasn't found overnight and died? The guilt from that scenario would surely be worse than it is from placing her in a safe managed care environment. What you're feeling is more grief than it is guilt; grief that your dear mother is going through all of this pain & suffering, just as I am feeling about my own mother. See about getting her a hospice evaluation which gives her extra care & attention at the SNF along with comfort measures for if/when she's in a lot of pain. My mother was accepted on hospice 12/21 and it's been a very helpful service for her so far.

Wishing you the best of luck treating yourself with love & kindness
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Well, let's see...

At home she fell multiple times, broke multiple bones, she wouldn't eat, wouldn't sleep in a bed and developed terrible edema, and declined cognitively every time she was in the hospital.

At the nursing home she had proper supervision until her caregiver quit after being abused (totally understandable), and she fell and hit her head and got a compression fracture.

Tell me again why you feel guilty about moving her from home where she was eventually going to die to a place where she's being cared for and only fell because of her own actions? You say it's her way or the highway and always has been, so what difference does it make where she lives? She's going to kill herself one way or the other with her stubbornness.

One way will affect your health and everyone around her, and the other will affect only her health, plus at the nursing home she'll get fed, be supervised, and will get medications that also might calm her down.

Nope, I see nothing for you to be guilty about.
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I think basically you are looking at the wrong G word. Guilt belongs to evil-doers and criminals, who don't care about such a thing anyway, and never feel it.
What you are experiencing is grief. Grief recognizes that there is no longer any good answer to all this. Guilt assumes you to be a god, or a fairy with wands. Guilt assumes you can fix everything and you should.
Grief recognizes you aren't God; you are not omnipotent; you can't fix everything. Grief recognizes you are a human with limitations and your Mom is dying, slowly and being battered and unhappy.
There is nothing to be done but to make her as safe as you can, recognize that her depression over what she must endure in age is sad; let her grieve. Tell her you are sorry. Is this not worth grieving? Not worth tears, hers AND yours? I am so sorry for you both, but assuming the martyr's post would not change this end of life struggle.
Have you spoken with Mom about palliative care, have you considered, or has her doctor, hospice, and keeping her safe and medicated for the time she has left? There is so little we can do about aging. It is a crucible. There is no way out, and beating yourself up will not help you. I am so very sorry for all you and your Mom are having to go through.
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Earthgrammy Jan 2022
Great answer, AlvaDeer. Love the distinction between guilt and grief. I've just placed my DH in MC and, even knowing it was the right thing to do, have been overcome with sadness. Now I know to call it grief instead of guilt. Thanks for the clarity.
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You did not cause her fall. It was a negligence of the Nursing Home. Your placing her in a nursing home was the right decision. No reason for feeling guilty. Incidentally, your mother health is declining rapidly due to her aging and she could die at anytime. Nothing you could do can change her destiny. When that happens please do not blame yourself.
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lealonnie1 Jan 2022
Falls are definitely NOT 'negligence' on the part of the managed care facilities, I can attest to that! Once in a great while a managed care facility does something to create a fall for an elder, but I've never personally seen it myself but for one time; an assistant ED at an ALF my parents were living at dropped my father when she was trying to transfer him which she should not have been doing in the first place. There is only SO much they can do for an elder to prevent inevitable falls, period. To say such a thing is to not understand the nature of being very elderly and having poor balance issues and dementia issues at play!
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You followed medical advice and made sure Mum was provided with 24/7 professional care.

Mum is unable to live alone. You did not create her decline, she did not participate in activities that would allow her to stay in her home longer.
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“Guilt” never paid a bill, never gave a hug, never changed a diaper, never solved a problem.

”Guilt” is a useless, pointless reaction.

YOU didn’t cause your mother’s problems; age and deterioration from age did.

Your mom was not capable of making a lucid decision so you made one on her behalf. There are not always good decisions available. You chose what you thought, based on all the facts available to you, was the best of the choices you had.

Your guilt will not help you OR your mother. This may be the most stressful thing you ever have to do. Make decisions for your mother based on all the facts you have in accessible. Then move on.
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Know what would make you truly guilty? Not getting your mother the help she needed to stay alive and mostly well.

She needed this level of care. You did the right thing.
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So, here is the definition of "Guilt"
- having committed a breach of conduct
- the state of one who has committed an offense especially consciously
- feelings of deserving blame especially for imagined offenses or from a sense of inadequacy
- a feeling of deserving blame for offenses

The reality here is that you did nothing WRONG whatsoever. You didn't set out to hurt your mother. She aged and as we age, things happen to our minds and our bodies that we can't always control. Sometimes we are able to stay at home and live out our days. And sometimes that just doesn't work out. There is no blame. It just is not safe. As her daughter you made a conscious choice to ensure that she is now living somewhere that she has 24/7 assistance and oversight to offer the most safe environment.
People fall - it doesn't matter where they are. I'm a reasonably healthy 50 something and I cannot tell you the number of times I have fallen in my life. My adult daughters are in their 20s and have fallen any number of times - because we are just inherently clumsy and can trip on our own feet. There are no health issues that cause this, we just get ahead of ourselves half the time. Now you factor in any balance issues, gait issues, health or vision issues and falls are just a fact of life. You have 100% done the right thing by your mother.

What did you do? You assessed the situation and realized that you were not equipped to care for her in her home or yours, that you had your own health issues, that hers were more than could safely be handled with out 24/7 care and you found proper care for her. Do you know what that actually means? That you addressed her care needs....period. There are so many people that think that the only way we can address our aging adult population's care needs is by ensuring that they are able to stay in their homes. There are so many ways that they be cared for. It's not a one size fits all. Each and every care situation has to be addressed for that individual and given careful consideration as to what works for all parties. It's not just about what the individual WANTS but ultimately about what all parties involved NEED.

I get guilt. For a lot of people GUILT is a culture. Not just a word or something they feel but a way of life. But as others have indicated, in most cases, it is a waste of valuable energy and ultimately it does you no good when you have done the right thing to begin with.
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Thank you all so much for your heartfelt answers. They have been so helpful. Mom has been put in hospice care and they are making her comfortable. I am just so sad because I envisioned taking her out for a visit at my home a few days a week with her dog and being able to spend time with her without all the responsibilities that come with caregiving at home. I am angry that she could not see beyond her own wants and that she was unwilling to compromise and in that way have a better relationship with both of us (and my sisters) working together to make our time together a special bonding, it could have been so much better but she had a choice and I had given her options. However they didn’t include being able to go home. Whether that choice was due to her usual personality or the dementia not allowing her to think it through? I don’t know. I just have to tell my self that I tried and that my sister and I worked very hard to keep her in her home for as long as possible. She probably wouldn’t have lived as long as she did without our care and that of her paid caregiver. It has not been easy and some say we spoiled her too much but we did it with love and wanting her to be happy. We just couldn’t do it anymore.
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