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Promising to keep a parent out of a LTC facility?

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Have you ever promised your parent or loved one that you'd never put them in a long-term care facility, such as assisted living or a nursing home?  A long time ago, I made that promise to my mind and have since had to take it back.  I watched how my aunts dealt (poorly) with my grandmother whose care exceeded their ability to give it in their own homes.  It was heartbreaking! 

Has anyone dealt with breaking this promise?  How did you approach the subject?

 


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Hi Missy,

A friend of mine was talking just last night and facing this situation with her mom who has dementia. She feels disloyal, but isn't sure her mom remembers the promise she wouldn't do this.

I think in this situation you need to keep repeating to yourself that there's a "greater good" than a verbal agreement. And this is your grandmother's well being.

Some things trump honesty in life --- health, safety and well being.

I wonder if anyone out there has had to use legal measures to force their parent or loved one into a facility?

Now this would be tough. But it happens. Any (painful, I'm sure) tales along these lines?


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Listen.........It just doesn't matter anymore what you promised in the past!  That was then & this is now! My mother always said......"I NEVER want to go to a nursing home." Who ever said they DID want to(My question mark key is broken) Even if she does recall saying that (& does she...q.m.)....the fact is that now she needs it! No matter how sad it is (and it is VERY sad).....you need to do the right thing for her care & your mental health. Of course, putting her in a facility opens a whole new GIANT can of worms......it's still what you need to do.  Do not feel guilty!!!!!! We are all doing the best we can in a sad, hard situation. Hope this helps!


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About the legal issues..........My sister & I got power of attorney, health care p.o.a. &. directives......everything we need to manage Mom's life......since she is not able to anymore. We did not have to do anything legal to move her to an ALF.......she wasn't in any shape to make her own decisions by then......but SINCE then....our legal powers have helped greatly........making decisions...paying for them....etc. .......if your parent is still "with it"...it is MUCH harder for them to agree to give up control of their money matters, driving, etc.....................but, it still needs to happen for their own good. After my Dad died of cancer, my Mom pretty much just gave up & didn't have any fight left in her to object much......which made it easier for us. Hope this helped!


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I agree it's not an easy decision but a necessary one.  My mother-in-law moved in with us 13 years ago, she was 80.  She is 93 now and in an assisted living facility for the past year..  When we saw signs of confusion and at risk for hurting herself, we started looking.  It is a lot easier to look when you can think clearly, then when it "has" to be done.  Go visit facilities that are close to your home, stop in at all hours, even in the middle of the night.  Some facilities have residence that can go outside and sit, visit with them for a while, they are a good source of information.  Get to know some of the aides, remember even though they will be living there, if you are not confortable, then they won't be either.  A suggestion was made that we tell her the doctor insisted she live in an assisted living because of her safety and the fact that the family could no longer provide the level care needed.  But also assure them that because they won't be living at home, that you are still close and will visit them.  The facility Grammy is in was the best decision we made.  Sure she was mad at first; but she got over it once she started talking with the other ladies.  I pick her up occassionaly and take her to the mall or park to walk around.  Again, it's hard, but there is only so much a family can do at home, and it's for their safety especially once they are up all night and wondering.  Work with the facility, on suggestions on how to handle different situations that come up, they are used to dealing with it on a daily basis, and are a good support for the family.  Best wishes to anyone who has to make these decisions, but know that in a long run, it's the best thing to do.


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 My 86 yr old mom has been living with us for over 7 years.  Before moving in with us, she was planning to move to a retirement community, because she didn't want to be a burden on her kids. Now she doesn't remember that, and believes that we should take care of her for life.  The first years were great, but this last year or so I've started having problems.  I feel like I have no privacy, I avoid spending unnecessary time with her and I'm dealing with clinical depression.  My husband (bless him) is fine with her being here as long as I can be her "daughter" and not her "caretaker".  However, hiring and overseeing caretakers brings on a whole new barrel of problems when mom & I don't agree on what care she needs.  I had hoped that over time Mom would see that moving to assisted living situation would be best, but although she has done some temporary stays while we travel, she absolutely does not want to move.  Do I just need to get an attitude adjustment, or tell mom I need her to move?


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Hi Susie,

I wonder if something like adult day care would work for your mom.  That would give you a set number of hours a day that mom would be out of your hair.  And I say that with the utmost respect for you both.  But I know with my children (completely different, I know) if I don't get time to just hear my thoughts and lay on the couch I go nuts after awhile!  I need that time, even if it's just for an hour or two. 


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The above are all right, they won't remember your promise and even though they are getting very forgetful, they still want to be indepent.  I would find a place you are confortable with and make the move.   Talk about your concerns with the people that work there, they will be your best support from the start and through out the time your Mom is there.   Decorate her room like she was at home, put lots of old pictures.  Be sure to put chairs for visitors, that helps a lot also.  Best wishes to you, it's a big relieve to have someone else helping care for them.  You will still be a big part of her care, but it's nice to have help and have the comfort that they are in a safe place with people that really do care for them.


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Been there...done that.  My 90 yr old mom has dementia..... 

You have to do the best you can..both for you and your mom.  My Mother said she wanted to live in her house as long as she could..  At age 90, she feel, the doctors said she could not leave alone, when she went into rehab, it was awful, she refused to get out of the car, etc.   She adjusted in a short period, now she is in assisted living.  She is okay..not necessaryily thrilled ...says she wante to live in her home a long as she could......we tell her she did and now this is what we have to do.

I agree with chap1716..make her room homely, with her stuff.

reread RENA - she is right, that was then - this is now

good luck...do NOT fell guilty


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Mom always made me promise never to put her in a 'home'. Five weeks ago I broke that promise and she is now living in a memory care assisted living facility. Sometimes I feel guilty about this but everyone has told me that I made the right decision. Mom has dementia and can no longer care for herself. I was trying to work full time and care for her at night and I did it for 3 years but as her needs increased I could no longer do it. It's a tough decision to hand over the torch. And once you do, caregiving doesn't stop, it just changes.


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I am in a situation now with my mom. She has terminal colon cancer. She came to live with my husband and I on June 2 2008 when the doctors and she decided on hospice. I am her 24/7 caregiver by myself other then when the cna comes to bath her 3 times a week. We have never been close as mother / daughter should be but I felt like it was my duty as her daughter to take care of her  in my home the last 6 months of her life. But we are now in the 8 month. The hospice group tell me she can be here for a couple of years with all the good care that I give her, but I see myself going down hill. She can't get out of bed so she is dependant on me for everything. I am really worn out and depressed due to all the past issues that have resurvaced from my childhood that was never resolved between her and I. We, the hospice social worker, my mom and I have started to talk about a nursing home. I feel so guilty and like I have failed if once she goes to a nursing home. How can I overcome all these emotions that I feel day to day? I see alot of the issues are for people that have dementia, but my moms mind is all there. I need advice and opinions.


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RE:  wkcsouthward4 --    Main mistake I made when my mom moved in 8 years ago was not planning and agreeing on an "exit strategy".  You can't change that now, and your mom may stick around for a couple more years, or be gone next week.  Regardless, your first responsibility is to your husband and your health.  If your health and well-being is being adversely affected, you cannot be giving her the best care possible.  Her needs are great and what she deserves is to have those needs met in the best possible way.  You are no longer the one who can best do that, so it is time to see that she does have the best care possible--by moving her to a place where that can happen.

Once you are no longer her caretaker, and are free to be her daughter, it will be much easier to deal with (or ignore) past issues and let her enjoy the love & caring of a daughter.  I found towards the end (before I moved my mom) that my only contact with her was caretaking, because if she didn't need something I was a far away as possible for my own sanity.  We rarely just enjoyed time together--even though I gave her tons of my time.  Make sense?  Now that she is in assisted living and has other caretakers, I am enjoying being her daughter and doing other things for her.  She is still not thrilled to no longer be living in my home, but she is thrilled with the good times we spend together now.

PS   I wrote 3 months ago in a quandry about needing my mom to move, but her not wanting to.  One day when I tried to explain to her that I was overwhelmed with being a wife, mother, grandmother, caretaker, daughter, business owner, homemaker....she told me she needed to be at the top of that list.  The light went on and I realized her needs need to come first, I just am no longer the one who can do that.  She moved within the month.


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Thank you SusieG for you responding to me.  My mom and I have decided for her to go to a nursing home. She leaves tomorrow. The hospice social worker is setting everything up for her transport. We are really, really sad about it all because we have been together 24/7 for 10 months now. I know this is the right thing for my mom and myself since it is geting harder physical, mentally and emotionally for me and for my mom too for her to see me have to do it all by myself without any of my siblings help. She can tell it is taking alot out of me and she is really tired of the 4 walls everyday since I can't lift her out of bed to put her in wheelchair. I just pray that it will all work out for my mom and she will be able to make some friends and see and talk to alot more people than she has had which was just me and my hubby. I have been really questioning myself over and over if I should send her to a nursing home but my body tells me that it is time. It has got worse on me to do the daily tasks for her since she is bedridden. I do thank everyone for putting their thoughts and concerns on this website about there own situations! It has helped me get through alot of days and hours. Now I will just have to try to get rid of the guilty and failure feelings I have, any help with that would be great too!


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Sometimes promises are very easy to make. But as our parents and grandparents age....much harder to keep.

And sometimes....we need them to realize that they have lived their lives, and we (the kids, grandkids) have lives we need to live also. 

 


 


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I made the same promise to my mother who is very angry at me because she could no longer live at home, and would not consider assisted living until it was too late.  I sometimes feel guilty because the nursing home was the only option we had, but then I remind myself that while she wants to be home that home was dangerous for her with frequent falls and calls to 911 and myself.  My mom being safe is the main issue, my onlt regret is that she was not part of the decision making process because she has a lot of denial about her ability to take care of herself.

I wish that my mom could have lived out her life independently but I agree that being a good adult daughter, at least for me is knowing my mom is safe, and that is what lets me sleep at night.


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My mother-in-law has always  said "I don't want to be a burden. Put me in a care home when I need it." A year ago last December we talked with about the fact she was no longer safe to stay in her own home. We told her that she could live with us as long as she could do her self care - Get out of bed to the bath room, bathe with supervision, come to the table to eat with us or get her prepared lunch from fridge while we were at work . Three days later she called and told us that she was going to stay put. We went along with that and in January she fell. After rehab we took her to our house and cleared out hers. We have had her for a year and she now gets up to the potty chair (we have to empty it several times a day), and turns to sit in her wheel chair, and manages to get into her lift chair. We have to wheel her to the table. Run every time she calls. She doen't even get her own drinks of water. We retired to care for her, because now that the time has come for a care home she feels that it is our duty to care for her needs and whims. She has even said that if we put her in a LTC she will just lay her head on her pillow and die. She loves to pull the guilt thing at every corner. Just when I think I can't take any more I think "Who is going to make sure she gets her Yorurt and graham crackers in the middle of the night. Who is going to be sure that she gets a balanced diet (she wasn't in rehab) of things she will eat. Or I'll pick up a book or magazine article by a person that "was so priviledeged to be able to take care of a parent in their last days."  I feel that I'm just an uncaring person.


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You know, the older we get, the more child-like we get....and your mother-in-law is manipulating you like a crafty (and spoiled) 5 yr old.  I think if my mother said that if I didn't do what she wanted, she would just lay her head on her pillow and die, I'd say  "That's your choice love.  I would sure miss you."

You are not uncaring.  The light went on for me (after having my mother in my home for 8 yrs) when I realized that her needs were important and needed to be first priority---and I couldn't make her first priority when I also had a husband, and children, and grandchildren and a business and a home to take care of.  The only way her needs could be top priority, as they should be, was for her to receive consistent care in an assissted living residence.  She's been there for 3 months now and is doing great.  It took her about a month to relax and settle in--which I understand is very common.  My mom would still rather live with us, but she knows that I moved her so she could have the best care possible.

 


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Thanks Susie Q, for your encouragement.

My sister asked me if I had handed her a pillow. And my sister took care of her in laws for several years so understands somewhat. But hers were never as manipulative as this one.

My psychologist daughter says, "Just remember, Mom, you are taking care of a 2 year old with tantrums. You know that she has always been this way when she didn't get her way."

Maybe I'm just selfish, but this is not the retirement that I had dreamed up to spend some uninterrupted time with my husband, build a house on our land, and finally have some time to do things I want to do. Mom just can't live in a travel trailer with us while we build.


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If you're selfish for wanting the retirement time you spent so long working towards, then so are all the rest of us. 

You know, when I was on the other side (before I got the gumption to tell mom I'd made a decision about changing our living arrangement), I let the "selfish" devil taunt me--and also the one about how after I've put all this love and time and effort into her care, she was going to hate me (while my siblings would slide....).  But the fact is, all of that has nothing to do with what is in the best interest of your mom.  If you are no longer able to meet her needs in your home, including ensuring her safety, then your responsibility is to be sure those needs are met in the best way possible. 

I couldn't even meet my mom's need for food and water.  She was losing weight because I wasn't there to put food in her three times a day, and the last 3 times we went to Urgent Care or the ER was ultimately because she was dehydrated.  That's basic and it wasn't getting taken care of in my home.

I also realized (with the help of my sister) that in Mom's last years (or months), I wanted to enjoy her as a daughter--not as an overburdened caretaker who took care of what had to be done and then got the heck away because I needed a break so badly. 

Since I moved mom to assisted care, we have enjoyed just spending time together.  Yes, I still have many things I must take care of for her, but without the additional burden of physical care, those tasks become easy.  I can spend time ensuring that she's well taken care of, and then just relax with her.  In addition, she has become so much more alert and enjoyable to talk to, even as her health is failing.  Rather than the isolation she had at our home, she has people to eat meals with.  Aides who come to her room multiple times daily and converse with her.  The interaction with others has helped bring her "out of herself".  She laughs easier and a sister that lives far away says she feels like she's talking with the mom of 10 years ago when they talk on the phone. 

It sounds like you have good counsel all around you.  I'm thinking you should start listening to what your sister and daughter tell you.


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Hello

I made the promise never to put my mother in a nursing home. Actually my mother told me to just take her out and shoot her instead of a nursing home.


It’s been a long road since then. My mother began significant mental problems 15 years ago, then she believed she had bugs inside of her and would scratch herself until she bled. She bug bombed her house several times while she was inside it. She slept in the bathtub. And she washed with kerosene a few times. Her skin is scared on all parts of her body where she could reach. This went on many years.


My oldest sister gave her a cat at one point. My mother was unable to care for it properly and the cat had constant diarrhea. So the chore to clean up after it fell to us. Finally it became too much and I took the cat to the pound.


My mother also developed paranoia, and believed my middle sister was trying to steal her money. It was actually my middle sister who was helping the most around that time.

My mother owns about 2 acres which requires significant time to keep up in the summer.

My mother was also diagnosed with Alzheimer’s about 10 years ago.

My mother fell and broke her hip and knee two years ago and her ability to walk was very limited. For most of the last 5 years my sisters and I have been caring for her in her home. We set up a schedule and one of us would be out every day. After she broke her hip and knee, we started going out twice a day to look after her.

A year and a half ago my middle sister took a yearlong assignment to Baghdad, so all the care for my mother fell to my oldest sister and I. I travel for my work and are gone for half the month. And my oldest sister who is retired has told me, “I did not retire to take care of Mom.” To make matters worse, my oldest sister dumped on my wife who was helping and now my wife does not help out. This became too much and we hired home healthcare people to come in a few days a week.
This worked for a while.

My middle sister returned from Baghdad, and my mother continued to deteriorate. She fell again, but did not break anything. We don’t know how long she was on the floor. She can no longer use the phone. She would not know how to use a medical alert device. She was forgetting where her bathroom was and was found several times having urinated or defecated herself. Her vision is very poor; we have been told it is a result of her brain deteriorating, so glasses do not help.
So last December, my middle sister felt she would be better off in an assisted living facility. My oldest sister felt Mom should stay at home since that what she wanted and money also was involved ( my oldest sister does not want to spend any of my mother’s money ). So I was in the middle, the deciding vote.

To make matters worse, my oldest sister quit talking to my middle sister and myself, nothing like family discord during difficult times.

I sat down and made lists of reasons to put my mother in assisted living, and reasons to keep her home. I came up with two pages of reason to put her in assisted living and one reason to keep her home, she wanted it.

So with horrible guilt I admitted her to an assisted living home, that specializes in dementia care on February 16. I felt awful, one of the worst days of my life.

I did not see her for another 10 days, the owners of the home said it would be better not to come over too soon so she could adjust. After 10 days I visited her. She cried on my shoulder, like a lost child who’s finally found by their parent. She asked to go home, and I lied to her and told her house needed repaired. I was another horrible day.

Three days later I visited again and the scene was repeated.

After a month she seemed to be adjusting, and my overwhelming guilt began to slightly diminish. She even had a boyfriend.

At the six week point, I was feeling Ok about the decision, and I went to visit and she was not there. The staff told me she had been taken to the doctor.

My mother was now in horrible pain and was hospitalized 2 days later. She has been in the hospital since. We have been through multiple diagnoses; the latest is she has a compression fracture in her spine. She is still hospitalized now four weeks later.

She has rapidly deteriorated further, both physically and mentally. She is now completely incontinent. She cannot walk or get out of bed independently. She is hallucinating and cannot feed herself.

She will certainly need a nursing facility assuming she makes it out of the hospital.

And I feel guilty, depressed, and like I have done my mother in by ignoring her wishes.

My point to all this, I don’t know. I guess I needed somewhere to tell my story.

 

Thanks for letting me share this.

Mark M

 


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Oh gosh Mark!  I'm so sorry to hear about your mom and the decisions you feel guilty about making for her.  While they were hard, from you've told us, they were right.  Your mom was harmful to herself living in her home.  And it sounds like after he last round of health issues, it would have been totally impossible without round-the-clock care.  In a nursing home, she can get what she needs and is safe. 

Does the nursing home have a social worker or other person there you can talk to about making her residence there as pleasant as possible?  Maybe you can also keep a good contact with her caregivers about how she's feeling, what she's saying to them, how she's acting and suggestions on how to keep her happy.  I really get the impression that the staff care about the residents and genuinely want to have a good relationship with the family.  

We're here for you.  Definitely post whenever you need to chat. 


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After reading several of these posts, I am reminded how little our society values our elders. Of course, there are plenty of situations where it is a medical necessity to enroll a parent in assisted living or nursing homes. However, I am concerned that so few people feel a sense of responsibility to the parents who loved and raised them. Didn't our parents love and raise us? Weren't they constantly making sacfifices for us? At a time in their lives when our parents need us the most-they feel scared, vulnerable, lost, and alone-it seems in vogue to find someone else to take care of our parents. What kind of child doesn't want to care for their aging parent because it will interfere with their retirement? Just a sad commentary on a selfish generation.


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 Anonymous....  You seem to believe you have wisdom to share.  Please tell us your caregiving experience.

 


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 Mark-  If my child broke his arm, I would take him to an orthopedic doctor, not my sister.  Your mom has serious physical and mental frailties that are best addressed by medical personnel that have the expertise to care for her and guide you and your sisters as you love her through this time the best you can.  


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Hi Anonymous,

It looks like what you posted shows up on this thread several times.  I deleted them all but the first.  I'm betting you received several "Your post has been deleted" emails from our system.  Sorry about that!  I just got rid of the duplicates.

Now regarding your post...  You're right.  It is discouraging when you see someone disregard their parent because they don't want to be bothered, so to speak.  Though I believe that's definitely the exception to the rule.  I don't think anyone takes putting their parent in a long term care facility lightly.  And perhaps when they say something like "I didn't retire to take care of Mom" what they're really saying is, "I'm afraid of how different things are.  I don't want things to change.  I want them stay as they were when we were all a little better off."  I don't think that emotion is selfish or wrong.  And I don't think it's a sentiment of devaluing our elders.  What we do with it, though, is another story.

Family dynamics are tricky.  And sadly, some people truly don't want to be bothered for one reason or another.  I guess I just try to not be quick to judge because you just never know what someone's deal is.  It may not be as simple as "I don't want too."  You know?


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