CAREGIVER CORNER
“The Promise” and When You Can No Longer Keep It
By Jennifer Beach
Last week, I had the opportunity to work with a lovely couple, Tim and Kelly. They are in their upper 50s, recent empty nesters, and take care of Kelly’s father, who has lived with them for the past decade.
It is not as common as it once was to have an elderly parent or two move into an adult child’s home. The reasons are varied and include pressures from geography, work schedules, child-rearing, home functionality and accessibility to meet the needs of aging loved ones. Family dynamics also play a role.
Needs Change
As Kelly’s fathers’ needs continue to change and his overall health declines, Kelly and Tim are struggling because caring for Dad is becoming more difficult to manage.
His incontinence, emergency room visits, and changes in mobility are taking a toll on Kelly and Tim’s marriage, their household, work and life in general. Kelly struggles with the promise she made to her father, that she would never put him in a nursing home.
I have worked with and know many people, both professionally and personally, who have made that same promise to a parent, spouse or sibling, or have asked someone in their own life to make them “the promise.”
I have never met one person in my professional experience (or personal) who wants to go to a nursing home. We all want to remain in our own homes or live independently, or at least with the help of those we love and are comfortable with.
The reality is, unthinkable things happen in our lives: accidents, cancer, neurological disorders, strokes, and good old-fashioned aging… all of which may require a level of care that simply cannot be provided safely at home.
The guilt of breaking “the promise” intensifies the challenge for everyone.
Doing Your Best
Cheryl E. Woodson, MD, a geriatrician, family caregiver to her mother with Alzheimer’s, and author of ”To Survive Caregiving: A Daughter’s Experience, A Doctor’s Advice on Finding Hope, Help and Health,” says that you can still honor the spirit of your promise, even if you must break it.
Whether your loved one is laying on the guilt or the blame is largely self-imposed. Try to accept the situation and let it go. You can’t change their disease, condition or medical circumstance.
If their situation has progressed, requiring a higher level of care, and you are unable to meet their needs safely, it is time to honor the goal of always caring for them and doing your best. This may not mean they remain at home, as you had promised. And that is OK.
Caring for an aging adult at home is commendable, but if the situation becomes unsafe and unsustainable for both of you, accept these changes. One person trying to do the same job as an entire nursing home team can be bad for not only your loved one’s health, but also your own physical and mental well-being.
A nursing home placement can feel like a monumental failure. It isn’t. Accepting the reality of the situation and adjusting your attitude can help you realize that you are fulfilling the underlying commitment you made to your loved one. If you made “the promise,” this meant you would ensure they receive the best possible care in a comfortable setting.
If you have researched available resources and now decide a nursing home is the only viable option, then let go of the guilt. You have done all you can. You have honored the spirit of your promise and are making a difficult decision to ensure your loved one is properly cared for.
That’s exactly what being a good caregiver is all about.
