Should I consider placing Mom in an Alzheimer's care unit to preserve my own health?

A fellow caregiver asked...

I promised my Mother many years ago that I would never place her in a nursing home. My Mother is getting worse with Alzheimer's, I am so worn out physically, and really even more emotionally. I myself have health issues. Should I consider Mom being placed in some kind of care facility, and how would I approached this with her. This is the most difficult decision I have ever had, and it's all on my shoulders, all alone. I love her so, and all I can think of is how I promised her those many years ago. I'm just so, so tired.

Expert Answer

Kenneth Robbins, M.D., is a senior medical editor of He is board certified in psychiatry and internal medicine, has a master's in public health from the University of Michigan, and is a clinical professor of psychiatry at the University of Wisconsin-Madison. His current clinical practice focuses primarily on geriatrics. He has written and contributed to many articles and is frequently invited to speak on psychiatric topics, such as psychiatry and the law, depression, anxiety, dementia, and suicide risk and prevention.

I certainly understand your struggle, and you clearly meant what you said when you promised your mom to never place her in a nursing home. However, what you were really promising is that you would be there for your mom and only do what you believed would be in her best interest. In the end, that is the best thing we can do for our parents. One never knows what life is going to bring. In the abstract we would all say we don't want to end up in a nursing home, but nursing homes exist for a very good reason and many loving families end up having to put relatives in nursing homes because that is the best place for them to be. I might add in your case, it may be your mom belongs in an assisted living facility, rather than a nursing home, so you may fulfill your promise after all.

The decision about when is the right time to move a parent with Alzheimer's to a care facility is always challenging, but keep in mind you are not looking at putting your mom in a warehouse. As someone's dementia progresses, it is important they are in a safe place in which they have care when they need it 24 hours a day, and where they can continue to be active, both physically and mentally. It requires real skill to know how to continue to keep people with dementia active, without asking so much they feel stressed. At some point it is simply not possible to provide all this yourself, and if you allow your guilt to get in the way of making the best decision for your mom, you are doing her (and yourself) a disservice. If you take the time to carefully look over the various facilities that can help your mom and find a caring place with a staff who have the training to help her, you have done everything you can do for her. It is important to keep in mind that if you wait too long, her memory will be so impaired that the facility will never become familiar and she will never feel at home there. Once she is there, you can spend as much time as you like with her, but as her son rather than her caretaker. This may also help her to not feel guilty about having to trouble you to get her needs met. If your guilt continues to wear you down, I would strongly suggest a few sessions with a mental health professional to talk it through.