Dear Family Advisor

Transitioning Mom's Care: How to Make a Smooth Shift Emotionally and Physically

Last updated: Jan 17, 2012

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I'm afraid I won't be able to continue being my mother's full-time caregiver. She's in her mid-80s and lives with me in my small house. She has mild dementia and other health problems, and she's a hoarder. I fear that if I move her to another living arrangement, such as a nearby condo nearby or even a care facility, she'll really go downhill. She's terrified of living alone and wouldn't go willingly to a facility. But I also feel as if it's come to a "her or me" situation.

I work full-time, but her care, physically and emotionally, is increasingly all-consuming. In the past few years I've lost friendships and even dating relationships because she's so jealous and petty.

Now that I have a health crisis of my own (I've been diagnosed with lupus), I feel that I have to start taking better care of myself -- and I don't even know how to begin. I'm exhausted and worried all the time, to the point of almost being too paralyzed to make any decisions.

First, let me state how wise you are for realizing what you can and can't do as a caregiver, daughter, and woman. Caring for your own health and life is paramount at this point. You're to be commended for keeping all this in perspective while still caring for your mother as best as you can.

Before you do anything, sit down and make a plan -- not only for the level of care she requires now but for what she may need in the future. She might be hiding some of her physical and cognitive issues. Further, health and mental decline isn't always slow and steady. She may trickle or plummet. It's hard to say; you have to be ready for anything.

Given her age and declining health and condition, I'd lean toward incorporating her longer-term care into whatever decision you make. Moving her into a condo might not last long, and it would add costs in terms of in-home health care, housekeeping, and so on. And she may simply be unable to live on her own. You need to look at her finances, her insurance, what Medicare can offer, what your community has nearby -- all the possibilities that could help her in the state she's in now, plus the state she could be in five years from now.

Go ahead and talk about possibilities such as assisted living (although if she has a memory disorder and hoards, she might already be past what many assisted living facilities can offer in terms of support). You might also consider live-in care, home health aides, Meals on Wheels, community and volunteer care, and help from your siblings or other relatives. There are many ways for her to receive assistance from someone other than you -- and she could develop friendships and supportive relationships with peers or even health aides, depending on where she's living.

It will take a good bit of your time and effort to research all this and then to implement the necessary changes for your mother's life. And you'll need to realize that some changes won't work out and will need to be adjusted. But this effort will pay off. It will also give you the opportunity to think about your own future. Double-dip and begin to create your own long-term plan.

While you're researching all of this, see if there are local adult day services where your mom can spend some time one or more days a week. She may be busier and happier with more social contact with the outside world. And you can get some needed rest and "alone time" while you make plans. Or, even if you're at work while she's away, you'll know you'll come home to a tidier house and a happier living companion.

Your statement that you're "exhausted and worried all the time" tells me that you're deep in caregiver burnout. I implore you to take action. It's not going to be easy to begin to put yourself first -- to eat well, take your medication, get enough sleep, and begin to reconnect with lost friendships and other relationships. Your body is asking for help. Don't ignore it or tell yourself to be last on the list.

As hard as it is to say out loud, your mother is in her mid-80s. I hope that she's had a good life, with family, friends, and adventures big and small. You deserve the same. Do what you can to manage your mother's care with love, kindness, and consideration -- and with healthy boundaries. Carve out the time now to invest even more in your own life. That's not being selfish. That's being responsible for the gift of life that you've been given.

Reclaim your life and your home. Believe that the more you do to bring balance and wholeness to your own life, the more you'll be able to benefit your mom as well.