When a Nursing Home Must Be Considered

The decision to move an aging loved one into a nursing home may be one of the most difficult you will ever make. In fact, it is common for adult children to promise themselves they will never subject a parent to “that kind of place.” They may be sincere, but that kind of promise is based on unpredictable circumstances. Life, especially with the elderly, is fluid and changing. Promises that include the word never or always are unrealistic. Not one of us knows what the future will bring. So give yourself grace in making the decision for a nursing home. Heartsearching goes with the territory, but don’t torment yourself with guilt. Start the decision-making process by asking these questions:

1. Are you finding it difficult to continue hands-on care for your loved one?
2. Do you feel emotionally drained or chronically tired?
3. Does your elder need rehabilitation or specialized supervision?

Caring for an aging parent or spouse is tough work. As an elderly person requires more and more care, the tired caregiver often scolds himself for not loving more, for not working harder, and for not having more energy. Yet it is difficult to give the type of constant loving care that many elders need. At times, an aging person can make your job even harder by being irritable, demanding, or angry. If you do not get enough rest and help, you yourself might feel angry, depressed, anxious, and resentful. It is helpful to discuss your situation with a friend or in a support group for caregivers. Besides having the comfort of a listening ear, you might come up with some practical answers to your elder’s specific situation. You also might find new ways to cope with your weaknesses and limitations.

Acknowledge your limitations.

Caregiver burnout is one of the main reasons a family eventually places an elderly loved one in a 24-hour-aday nursing facility. While the average caregiver provides care for 18 hours per week, one in five provides “constant care,” or at least 40 hours per week caring for an elderly loved one.National Alliance for Caregiving and the American Association of Retired Persons, Family Caregiving in the U.S.; Findings from a National Survey (1997),21. More than seven in ten caregivers are women, although 27 percent of caregivers are men. Because many caregivers also work outside the home ‚Äî an estimated 14.4 million full- and part-time workers balance caregiving and job responsibilities Metropolitan Life Insurance Compnay, The Met Life Study of Employer Costs for Working Caregivers (Wesport, CT: MetLife Mature Market Group, June 1997). ‚Äî perpetual weariness is a common problem. Many are discovering they cannot do it all. Some have to reduce their hours at work or quit a job, which also reduces their income during key wage-earning years. Caregivers grow weary of being on call all the time. Unless they can find someone to help them, they tend to neglect their own lives, their health, their marriages, and their children in order to care for the ailing elder. Caregivers often feel isolated and overextended. A 1997 survey by the National Alliance for Caregiving found that one in three caregivers who provide care for at least 40 hours a week says that no one else helps. As caregivers struggle to survive a difficult situation, they may not recognize their own changing needs. Those without a support system are more prone to emotional strain and physical and mental problems (such as depression, sleeplessness, back pain, and other health conditions) and are less apt to wade through the complex health-care and social-service systems for help. If you have been trying to go it alone in caring for an elderly loved one, remember that burnout is a very real possibility. It is important to acknowledge the impact caregiving is having on you and to get support and good counsel about available services and resources. You need the help of friends, relatives, siblings, your church, and local communitybased organizations to assist you. If your aging loved one needs roundthe-clock specialized care and is not satisfied with home and community-based services, it may be time to discuss the possibility of nursing-home placement. When it is time for your aging loved one to move into a nursing home, there are some things you can do to make the transition easier. For example, have your elder take her most cherished possessions with her. (Be careful of theft.) This will help her remain connected with her past. If she is associated with a church, ask the pastor or a close friend to greet her at the nursing home when she arrives. Once she is settled in, encourage your elder to get involved in the various activities planned at the facility. A well-run facility will have a variety of activities to meet the many needs of the elderly. Perhaps you can attend with her at the beginning. Let her know how important it is for her to remain active and alert if she is to live out her life with dignity and vigor. Try to stay aware of how your loved one is eating, feeling, and doing once the move takes place. Are appropriate therapies and medications being provided? Discuss the facility’s rules for taking your loved one out to dinner, church, or other activities. As you get to know the staff, build a positive relationship so that when problems come up, a solid foundation is laid for the best care possible under the circumstances. Bring treats and flowers for them. Send notes of thanks when they go out of their way to help. Participate in family-care conferences. If you must investigate mishaps, try to understand all sides. It will be important to establish realistic expectations about visits with your aging loved one. Plan for times with other family members and friends as well as personal times when you can visit alone. When are the best times to come by, based on your elder’s schedule and yours? Are drop-in visits welcomed? What amount of time is about right for you to stay? It may take a little time to work out how frequently you should visit and what works best.

Your Changed Role as a Caregiver

You may feel overwhelmed by the task ahead of you. There are so many decisions to be made, so many people to consult. But remember that there is wisdom in many counselors. Seek wise counsel and pray to receive wisdom. God gives wisdom generously to those who ask for it. If you must do something you had hoped would never be necessary, such as placing your loved one in a long-term-care facility, it does not mean you are abandoning him. It means your role has changed and the challenges will be different. Pray about each step and ask, How might I make my loved one more comfortable from this new perspective? Look for the life-giving elements in each step forward, even when it seems like a backward step. God’s grace shows up as you ask for it.