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My husband and I need to move, but with Mom's Alzheimer's it seems impossible; is it wrong to put her in a nursing home?

Barbsdesk asked...

Mom is 89. Alzheimer's diagnosis 5 yrs ago - but no 'typical' progression of the disease. She definitely has dementia, and alternates between period of sleeping for days and then screaming/yelling/tearing off her clothes/throwing things AT THE TOP OF HER LUNGS with short breaks to nap for days or weeks at a time. (No meds have ever done anything to quiet her, and we have tried several). Mom is in good health other than the dementia, but only leaves her bed with my assistance to toilet, though she is incontinent. She has no interest/desire/capability to do anything - and never has. Before Alzheimer's, Mom was a hermit - no friends, no visits with family she could avoid, no socializing or church. She sat on the couch and watched CSPAN or the Weather Channel 24/7 for some 20 yrs before her illness. I have had Mom with me for 2 yrs. Prior to moving her 1000 miles to live with me, my oldest daughter cared for her in her home of 60+ yrs. I was finally to able to rescue my daughter from this when she became pregnant. My problem: My husband has been laid off nearly a year, but now an excellent opportunity (fingers crossed) is in the offing, one requiring us to move out of state. Here we own our home and Mom has a lower floor in-law suite, allowing us to 'get away' to the top floor. We will not be able to afford such a situation when we move, and will be forced to rent an apartment. But how are we supposed to do that? We can't. Unless our neighbors are deaf, they will hear Mom's outbursts 24/7, and of course, so will we. And even if we were to find a situation where the neighbors couldn't hear her, that would still leave us having to endure it. I love my Mom. I promised her I would care for her at home, and that I would keep her home in the family. Friends say it is time to just put her in a nursing home. But if I were to do that, provided I could find one that would take her, she would lose every dime she has AND lose her home. of course if she fell and broke a hip or had a stroke this would be out of my hands - but to do it voluntarily? Isn't that morally/ethically wrong? Also, I fear if I made this move, my daughter, who also made promises to her grandmother regarding her home and her care, would never forgive me. I don't know what to do.

Expert Answer

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.

I do not have a foolproof crystal ball that predicts future care needs of the people I love. I suspect you do not, either. Therefore any "promises" you made to keep mom home with you "no matter what" are irrational. Irrational vows, made in ignorance, are non-enforceable. Period.

Let's start over. A mature promise would be, "I promise to take the best possible care of you." And because you are a person with your own care needs, including an income, you must provide the best solution for everyone involved, not just your mother.

Your mother seems to have a pre-existing personality disorder which kept her from taking care of herself. You were probably raised to take take of mother, and to put her desires above your own needs. It may be incredibly difficult for you now to rearrange your life priorities, but that is what you must do in order to make the best decisions for everyone in your family.

Your mother needs to go into a nursing home. There are professionals in these facilities who are paid to deal with her outbursts. This is not punishment, and you are certainly not shirking your responsibilities to her. On the contrary you are making a difficult adult decision about what is best for everyone, not only your mother.

If your husband gets the new job, investigate nursing homes in the town where you will move. Talk to the admissions people, explain your mother's situation, and find the ones who will accept her. Make moving her part of your relocation plans. In the long run, your mother will get better care, much better than you can provide for her in your home.

AND, you will modeling for your daughter the kind of responsible adult decision making that you expect her to provide for you if you become unable to make god decisions about your own care.