Placing a Parent in a Nursing Home: How to Make It Easier
Nobody wants to be faced with the challenge of placing a parent in a nursing home. After all, it's hard knowing that your mom or dad needs a high level of round-the-clock care, something that you may not be able (or qualified) to provide on your own. This situation often comes with conflicted emotions like guilt, regret, and a sense of relief. How do you remain sensitive to your parent's feelings while moving ahead with what you know must be done?
As a first step, it helps to acknowledge the fact that putting a loved one in a nursing home is a fairly common challenge. Each year, millions of other people like you face this dilemma. In fact, more than one in three Americans over the age of 65 will probably require nursing home care at some point.1 That means you aren't alone in dealing with this issue. It also means that a lot of resources are available to guide and support you.
This article will help you learn when a parent needs assisted living or nursing home care, how to get a parent into a nursing home, and why it's important to be kind to yourself throughout the process. A lot of the following information also applies if you're faced with the situation of putting your spouse in a nursing home. By understanding what's involved, you and your loved one may have an easier time going through the process.
Should I Put My Parents in a Nursing Home? (When Is It Time? What Are the Signs?)
In some cases, these questions are easy to answer. For example, some people are forced into long-term residential care by a sudden injury or the unexpected onset of a debilitating medical illness. Their conditions make it impossible (or too costly) for their loved ones to provide the 24/7 care they need at home, even if it's just for a temporary period of time.
But knowing when to put mom in a nursing home isn't always so straightforward. That's because many seniors have chronic health conditions that impact their functional abilities more slowly over time, making it more difficult to recognize the point when long-term caregiving in a residential facility is necessary. In those cases, it's essential to pay attention to various physical, mental, and behavioral signs. Parents need assisted living or residential nursing care when they pose a danger to themselves or others, when they can't function independently, or when their current caregivers can no longer provide the level of day-to-day support that's required.
In reality, a lot of families end up waiting too long—delaying the decision until something tragic happens that forces the issue. By that point, it is often too late to explore all the options in search of the best possible caregiving arrangement. Action may have to be taken immediately, which amplifies the stress on everyone involved. That's why right now is a great time to be asking these questions—before an accident or sudden medical event makes the decision for you.
Of course, it's also essential for family caregivers to take their own well-being into account. Adult children of sick, disabled, or terminally ill seniors frequently have other major responsibilities such as young kids and full-time jobs. As their parents' conditions deteriorate, family caregivers can find it increasingly difficult to juggle caregiving duties with everything else, which can lead to burnout, health problems, financial troubles, or relationship conflicts.
So, when is it time to put your parent in a nursing home? You may want to seriously consider assisted living or nursing home care if you recognize any combination of the following signs:
Many family caregivers have trouble figuring out the best way to deal with parents who have Alzheimer's disease or other forms of dementia. When is it time for a nursing home in that type of situation? Generally speaking, the signs are pretty much the same as those already listed. If your parent has dementia and needs care that requires skills you don't have, then it's probably time for long-term residential care. If your own health is declining as a result of your caregiving, or if you need more assistance and can't get it, then it is probably time. And if your parent is displaying hard-to-handle behaviors that pose a real danger to himself or herself (or others), then it is definitely time. Sooner or later, most Americans who have dementia are placed in nursing homes.2
Planning Ahead, Convincing Your Parent, and Working With Your Siblings
It pays to be proactive. The more research and planning you do now, the more positive the outcome is likely to be in the future. By planning well ahead of time, you'll be better prepared if an emergency occurs that requires you to make quick decisions. When it comes to putting a parent in a nursing home, decision-making shouldn't feel rushed. The best outcomes are usually the result of advanced collaboration between parents and all of their adult children. Here's how to develop your family plan:
Dealing With Nursing Home Guilt and Other Difficult Emotions
How do you put someone in a nursing home when you feel overcome with guilt, shame, anxiety, or a sense of loss? It's a question faced by many family caregivers. Guilt is incredibly common in this situation. It's natural to feel like you're letting your parent down, especially if you've been criticized or berated by your aging father or elderly mother. Guilt trip or no guilt trip, you may feel extra regret if you've made a promise that now must be broken. And, paradoxically, your guilt may be fueled by positive feelings, such as relief that you'll have more time for yourself or that your mom or dad will finally be in a safe place and receiving appropriate care. The whole process can feel like an emotional rollercoaster with confusing loops, uncomfortable turns, terrifying drops, and unexpected highs. Some people feel these emotions even when their parents are cooperative and enthusiastic.
But regardless of how common or normal these emotions are, they can also be harmful. They can zap you of energy, make you feel isolated, increase your stress, and make it hard to think clearly. In some people, they can even lead to depression. When you suffer from caregiver guilt, feelings can come on strong and last for a long time—unless you take healthy steps to cope with them. Here are some tips for dealing with guilt over nursing home placement:
Making the Transition to a Nursing Home Go as Smoothly as Possible
When the time finally comes to move your parent into long-term residential care, you may have a lot of intense emotions, such as fear, doubt, excitement, and guilt. After all, it will probably also be a highly emotional time for your mom or dad. Your parent may feel sad, angry, scared, or confused. He or she may lash out with harsh words or give you the silent treatment. So it's important to prepare yourself and your parent for what may be a stressful few days. The following tips can help you make the best of this challenging situation:
Providing Ongoing Love, Care, and Support
As time goes on, your parent will probably feel more settled and at-home in the care facility. Both of you may begin to perceive the situation in a more positive light. That's especially likely if you and your siblings stay in touch with your parent, making each interaction as meaningful as possible. How often you call or visit should depend on how well your mom or dad has adjusted. Work with the care staff to determine how much family interaction may be beneficial. For some nursing home residents, daily calls or visits work well. For others, it may be more appropriate to have weekly or biweekly interactions.
Do whatever you can to make sure your parent remains comfortable. For example, add personal touches to your mom or dad's room, such as family photos, cherished keepsakes, or art from grandchildren. Or bring in some of your parent's favorite treats. All of those things will help you stay visible in the minds of your parent and his or her caregivers. It's also a good idea to show your gratitude when you observe those caregivers making an effort to provide great care. Don't be afraid to say thank you or send them small gifts as tokens of your appreciation.
Maintaining good communication with the facility's caregivers will be a major part of supporting your parent. But be prepared for some potential obstacles. Some of the issues that can hinder communication between families and professional caregivers include:
Most professional caregivers are remarkable people. If you show them respect and acknowledge the good work they do, they will generally respond in kind. But it's always important to stay vigilant, watching for any signs of elder abuse or neglect. If at any point you observe a decline in conditions at the care facility or suspect abuse, don't hesitate to contact the region's long-term care ombudsman. Or if you need additional help in overseeing your parent's care, consider hiring a professional seniors' advocate.
Helpful Books and Other Resources
Putting a parent in a nursing home is clearly something that requires a lot of planning, communication, collaboration, and inner reflection. So give yourself permission to explore all the different angles of this subject, and consider a variety of recommendations from seasoned experts. You may be able to take advantage of personalized assistance from a professional senior care advisor or geriatric care manager in your area. And here are some good books that are worth checking out:
- 1 Family Caregiver Alliance, "Selected Long-Term Care Statistics," website last visited on December 20, 2017.
- 2 International Psychogeriatrics, "Moving in: adjustment of people living with dementia going into a nursing home and their families," website last visited on December 20, 2017.
- Canadian Journal on Aging, "Predictors of Nursing Home Placement from Assisted Living Settings in Canada," website last visited on December 20, 2017.
- Death Studies, "The Experience of High Levels of Grief in Caregivers of Persons with Alzheimer's Disease and Related Dementia," website last visited on March 11, 2019.
- Health Communication, "We're on the Same Side: Improving Communication Between Nursing Home and Family," website last visited on March 11, 2019.
- Journal of Clinical Nursing, "Being a close family member of a person with dementia living in a nursing home," website last visited on December 20, 2017.
- The Gerontologist, "Caregivers' Reasons for Nursing Home Placement: Clues for Improving Discussions With Families Prior to the Transition," website last visited on December 20, 2017.