How do you tell a loved one that she needs to move into a nursing home before she gets hurt?

1 answer | Last updated: Oct 01, 2016
A fellow caregiver asked...

How do you tell your elderly, almost blind and depressed Mom that she needs to move into an assisted living or nursing home before she gets hurt. My brother is graciously do what he can, but she is driving both he and his wife nuts. I'm writing this from Germany and she lives in Maryland.

Expert Answers

Kay Paggi, GCM, LPC, CGC, MA, is in private practice as a geriatric care manager and is on the advisory board for the Emeritus Program at Richland College. She has worked with seniors for nearly 20 years as a licensed professional counselor, certified gerontological counselor, and certified geriatric care manager.

Talking with an aging parent about their need for ongoing care can be a challenge. The ideal way method is to approach the elder in the same way you would a valued friend, your peer. If your friend is blind and depressed and needs care that cannot be supplied long term by family and friends, how would you begin a discussion?

It's easy for an adult child to fall into old childish habits or deferring to parental wishes, and being fearful of guilt if you don't comply or of emotional distance if you cannot accede to unreasonable demands. It is time for you to cast off childish ways and approach your parent as an adult, your peer.

Being a parent does not entitle a person to a blank check for attention in later life from their children. Would you expect this from your children?

Initial the discussion with a gentle probe to see if your mother understands the extent of her disabilities. Discuss what she has lost - and what she has retained, and maybe bring up some of the bonuses associated with aging: grandchildren, no alarm clock, no 5:00 traffic, senior discounts, and so on. Then another gentle probe to see if she realizes the burden she is placing on her children by assuming they will provide daily care on an ongoing, open ended basis. She may not be aware of the costs of her care, not only financial but emotional and in terms of energy and time.

Ask her what she thinks the best solution might be. Try to brainstorm and come up with several alternatives. You need to do some homework by finding out what the criteria for living in an assisted living community are, and the cost. It's pointless to have her suggest assisted living if she cannot afford it or if she is too frail. You can do this online, or by calling various communities, or by contacting a Professional Geriatric Care Manager ( Or your brother can take on this task because he is local.

If she cannot go to assisted living, then know the price and location of nursing communities or personal care homes, and gently steer her in that direction when you are brainstorming care solutions. Do not be deterred by tears. If your friend started crying or yelling or threatening while you were talking about solving her care issues, how would you react? Instead of becoming guilty (the adult child's automatic reaction), you might wonder why they are doing this, since you are trying to help your friend with your friend's problem. You might even leave and come back later. These are all acceptable options for adult children.

The issue is a family problem, not solely the elder's. The solution must be what works for the family as a whole, not simply want the elder wants or even what you wish you could provide. Remember that you have gorwn up, and the once all-powerful parent is now a PEER, and speak and act accordingly.