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Caregiver Guilt and Long-Term Care homes: Sometimes Promises are not for keeping

Posted Feb 12th, 2016 in Long-Term Care, Safety, Tips, Dementia

Caregiver Guilt and Long-Term Care homes: Sometimes Promises are not for keeping

So a promise was made years ago when a loved senior was well, that family would abide by a sacred vow, and facilitate their stay at home forever. With the best of intentions, and the lack of a crystal ball, all agree that this will be the course of action, no matter what...then flash forward several years.

Suddenly a deterioration in physical and emotional health has left the elder in need of significant care, and incapable of making decisions. The end result is a deterioration of relationships, because no agreement can be made as to the next course of action.

Often when talking with families about Long-Term Care Homes, there is an overwhelming expression of guilt that this choice has broken a sacred bond...never to seek assistance in the form of a nursing home.

Perhaps there are cultural influences in place, where families steeped in tradition have groomed and fostered certain values among their children, where duties prevail, and care must continue in the home.

Potentially, there is an overwhelming sense of guilt, that orchestrating a parent's move to a home is the ultimate betrayal, a thankless expression for what may have been years of self sacrifice for their betterment.

At times there are historical references to negative outcomes, when acquaintances or other family members entered Long-Term care, and those remain the perceived benchmark of all homes.

I do believe in a perfect world we would all age gracefully, healthily, and independently in our own homes with mild to moderate supports.  Staying in a familiar place surrounded by things that evoke memories, allow for privacy, and foster as much independence as possible, would be ideal. Unfortunately this dream of the ultimate retirement is not always a reality.

Individuals may require a high level of physical care, have complex medical needs, advanced issues with memory, and without 24 hour assistance and monitoring, may prove to be at risk from a health, and safety perspective.

Sometimes in order to avoid LTC intervention, families bandage solutions spending as much time as possible with the elder,  including professional care supports, and electronic monitoring aids.  Where problems arise is when there are gaps in supervision and care, especially if an elder lives alone.

Sometimes families  cope, living with a false sense of security that once tucked into bed, mom or dad will sleep safely until their visit the next morning. This is an accident waiting to happen.

Although promises may have been made to a loved one, to never seek external care, this may prove to be an eventual impossibility. 
  • There are no guarantees that the health and physical/emotional needs of a loved one may exceed what is manageable without professional care
  • The Caregiver may find that their personal and emotional health has been placed at risk, because they do not have the supports, or wellbeing to cope with care requirements
  • The Caregiver may face difficulties managing other facets in their lives: child/grandchild care, work responsibilities, relationship breakdowns etc. because they are no longer able to equally invest their personal time

In my career, I have seen many caregivers, bandaging solutions to keep what they see as a sacred vow to care for an elder at home indefinitely. As a result, I have also seen gaps in elder care and safety concerns, caregiver burnout, family dynamics, and emotional meltdowns fraught with guilt, anger and frustration.  Not to say that the journey of caring for a frail loved one at home is impossible, but there needs to be a well thought out plan of care, support systems, and provisions in place for caregiver respite.

If Long-Term care may be a future requirement, think about the possibility and do the research long before the need arises. Review the homes carefully, go on tours and make comparisons.  If you use my mobile apps there is a built in resource manual that will prompt the user to assess what priorities are essential for future choices. (Examples)

  • Does the home need to be near family members relating to transportation issues?
  • Is there a cultural link in a certain location that makes the home more familiar and comforting?
  • Are there friends living in a residence where bonds could continue?
  • What is the emotional feel of the home and the appearance of the residents?

Planning well in advance of need is important because there could be long wait lists, which can impact eventual choice.  You can always change your mind when a bed arises, but think carefully first.

At times as the assigned decision maker (Power of Attorney:Health), we are required to make tough decisions when an elder is incapable of exercising insight and judgement into their well being and care.  Choices need to be made to support safety and mitigate risk. If keeping a promise to maintain an elder in their own home is detrimental to their well being, and exceeds the capabilities of all human and financial resources, then cooler heads may need to prevail.

Sometimes caring means recognizing personal limitations, accepting help, and relinquishing the sole responsibility of providing 24 hour supervision.  Continuing to be an avid advocate, visitor, support system, and loving presence is a gift in itself.  Because we are human, some promises are not made for keeping, and possibly should never have been made in the first place.


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