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Welcome to CareNotes. In this special section we will feature a reader's letter and provide an opportunity for an interactive exchange that will help find some answers and possible solutions to concerns. If you wish to respond to this letter, simple follow the link provided at the end of the letter and add your comments and thoughts to our CareNotes Board.

This Week's Carenote - 07/23/09

How do I get our 86 year old mother to get used to the fact that we will have to put her husband (our father)  in a nursing home, as it has become too difficult to care for him at home.  She thinks it is because we do not care, but that is so far from the truth.  It IS because we care why we are doing it.

We (the siblings) have thought long and hard about this and have had numerous discussions and came to the conclusion that this is the best thing to do.  Any suggestions would be appreciated.

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Name: Ruth L.
Location: Harrisburg PA
Date: 07/23/2009
Time: 06:53 AM


I must keep this very short today, and I'm sure you will get good advice from others. I would like to make the suggestion that often in these situations it is more easily accepted by the parents if the discussions are initiated and/or moderated by either a professional geriatric care manager (or similar professional) or even if appropriate by a good friend of the family whose opinions are held in high respect. I wish you the very best with this difficult situation, as we went through this in our family just over the past three months after five years of care for parents in their own home.

Name: Kim
Date: 07/23/2009
Time: 07:04 AM


You may want to try having a doctor or a clergy-person talk with your mother. Sometimes having someone from outside the family involved in the discussion is helpful. Also, have you included mom in the discussions? She needs to be part of this decision as well. Involve her in the process. Ask her what she fears. Have her help in the decision and where to move him. You may find that this is helpful.

Name: R. Wald
Location: Delray Beach, FL
Date: 07/23/2009
Time: 07:20 AM


Putting your father in a nursing home will shorten his life as well as your mother's. The way to go is to get aides in the house to care for him. I promised my husband that I would never put him in a nursing home and I kept my promise. I took care of my husband for 5 yrs. plus, with a very little help from aides and prolonged his life from cancer and Alzheimer's. I would do it again gladly as I miss him immensely.

Name: Lisa
Location: Wilmington,Ohio
Date: 07/23/2009
Time: 02:05 PM


So whoever said that doing the right thing would be popular. I'd assure your mother of your love, and support her, but not let her control you through her disapproval. Three against one, means she needs to be loved, not argued with.

Name: TBI Mother and Caregiver
Location: Alabama
Date: 07/23/2009
Time: 04:15 PM


It is not your fault that you must put your father in a nursing home. Deep down your mom probably knows he really does need to go into a nursing home but she also needs to put the guilt off on someone - and it is you. Having a son, with a traumatic brain injury, we kept him at home for years. Now that we are older, and he is in long term care, he is actually doing better because he is getting care that my husband and I were not trained to deal with. We have had to learn to let go of guilt and you do too. Once he is in long term care your mother will see that the care he gets is much better than any care you can get at home. God bless.

Name: David Levy
Location: Boca Raton, Florida
Date: 07/23/2009
Time: 05:24 PM


Respecting you mother's point of view is part of the dignity she deserves. However, it is very obvious that she is not the one providing care and those that are have determined it is too difficult to manage at home. One needs to examine Dad's quality-of-life as well as the caregiver's if the situation is left left "as is". The other writer's comments are valid about trying to provide an intermediary to help mom "understand." As an eldercare mediator for years trying to convince mom that you "do care", when you have been showing it with your deliberate approach to the problem. You can talk until you are "blue in the face" that is one position that is hard to overcome. Because it also forces mom to recognize that she can no longer do what she has always done - care for dad at home. If you truly believe that a facility is necessary to better accommodate what dad needs and maintain his quality of life, then move forward - waiting for approval may delay better care for dad. Depending on the facility and how active all of you (including mom) are in visiting, taking him out and being his "advocate" at all times, the nursing home may not be quite as bad as described by the writer from Delray Beach. Make sure you have all your paperwork in order to act as his Power of Attorney and Health Care Surrogate and make sure your Durable Power of Attorney has full authority to apply for Medicaid and VA benefits (if applicable) if that becomes wanted or necessary. Good luck! Respect you mother emotional well being but that alone cannot dictate the outcome.

Name: Always Best Care Senior Services of Central Connecticut, Inc.
Location: Vernon, CT
Date: 07/27/2009
Time: 01:32 PM


I have read everyone's comments and each offers it's own unique point of view that can be taken into consideration when making such a difficult decision. It is apparent that you have all struggled with making the "right" decision for your dad and that you must also consider your mom and her well being as well. There are certainly many different avenues to explore, one being in-home care by a quality caregiver. Someone who has an abundance of experience and is a retired RN or even a CNA, they can provide as little care as a few hours a day all the way up to live in care if you so choose. These types of services strive to keep family members at home where they are most comfortable and can assist in everything from transfer assists, bathing, grooming, dressing, ostomy, catheters, oxygen, managing Alzheimer's/Dementia to oncology and much more. Just make sure you do your research and assure all proper background checks are run on the individual providing the care and that they are employed by the In-home care company and not just contracted with the company. Also make sure the company you utilized is bonded and insured as well and that it covers the caregiver while they are in your home. On the flip side, if your dad has reached a stage even where in-home care would be too difficult to manage you can seek out the many assisted living communities in your area. Many have programs that could allow both your parents to move in and they too have many care programs that allow seniors to age in place until they are no longer with us. Use the internet as a valuable resource too to see which ones are available in your community, then take tours of the ones that appeal to you the most. They often allow family to bring in additional caregivers if needed to assist a family member. Be sure to discuss the careplans they have in place, the ratio of caregivers to residents, what emergency plans they have in place if something happens, if they have doctors or nurses on staff and are they 24/7. Often they are less expensive than a nursing home option and will allow your parents to remain together, something I am sure is very important to your mom. I hope this is of help to you. Best of luck as you work towards making the right decision for your and your family. You should also know that if your dad is a veteran there are funds available to help offset the costs of this type of care. To find out more about that, you can contact your local VA office and they can provide you with the guidelines and criteria for this type of assistance.


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