Nursing Home Discussions Are Important
As the population of older Americans swells, the nursing home decision becomes an inevitable part of aging. It impacts not only the elderly, but also the caregivers.
Promise you won’t put me away. It is hard to say no to that request. But it often is even harder to honor it. The author presents some very different conversations in families as they struggle to find the balance between home care and nursing home placement.
For many, the idea of being sent to a nursing home implies abandonment. Older Americans remember the poorhouse, where the old and infirm were hidden away to die. Even though these facilities are quite different from the stereotypical ones of the past, they can still seem institutional where daily life is often rigidly regulated, robbing residents of autonomy, and the familiar faces and spaces of a person’s life are gone. These practices, often necessary to care for many individuals at once, make the decision every more difficult often leading to guilt, anxiety, and family division.
A Real Story: Caring At Home
Shari Sullivan, 55, swore to care for both her husband, who had Alzheimer’s and her mother, who is 85 and lives with her.
“My vows were, ‘For richer or for poorer, in sickness and in health,” said Sullivan, an accountant who lives in Woodbridge, Va. “The vows don’t stop just because he got sick.” Also, she believed that living apart from their young daughter would have accelerated his decline. “It would have just crushed him.”
With other family members helping, she was able to manage for five years. Then a fall sent her husband to the hospital; he died six weeks later from complications. Her mother still lives with her, with home health care covered by long-term care insurance.
A Real Story: Nursing Home Placement
For Sarah Harris, a defining moment came three years after her husband’s diagnosis with Alzheimer’s. She called home one day from her job as a preschool teacher to tell him his sandwich was in the refrigerator. He did not answer. The answering machine picked up, with her voice on it, confusing him. He later told her, “I could hear you, but I couldn’t find you.”
With two children at home, she realized she could no longer keep him there safely. But that didn’t make it any easier. Because it wasn’t just Ernie she’d made the promise to. “I was making the promise to myself. I felt like I was letting myself down — I should be able to do this. It broke my heart. It was one of the worst days of my life, the day I put him in a nursing home.”
As agonizing as it was, Harris’s decision to put her husband in a facility helped her know he was safe and allowed her to take better care of her children. Her husband died 18 months later. She now runs a support group for family members of people with younger onset Alzheimer’s.
Initiate The Nursing Home Discussion
Although difficult, like many elder law issues such as end of life choices, wills, and advance directives, the seriousness of the decision begs conversation. And, before the elderly family member becomes incapacitated. Ask the questions to determine the fears of the your loved one so you may address each fear, present options, and make a decision you can stand by.