Deciding on putting your parent or parents into a nursing home can be a stressful experience. Finding out how to deal with the situation can make all the difference to you and to your parent. Prepare yourself, present your concerns, and deal with the situation with the help of others, and you can make the transition as painless as possible.
Preparing yourself includes having as much information as you can, so you know what you are talking about, what is optional and what is non-negotiable. You want to have the support of others, so get input from siblings, the other parent, or appropriate family members. You can also enlist the aid of healthcare professionals, or for some, even a trusted clergy member can be helpful. Then decide who should be included in the actual discussion. You need to consider how your parent will react if all five children are present or if it’s best if only one or two are there. This may not be the best time for the confrontational sibling to lead the discussion. Finally, in preparing, acknowledge your own feelings without judging your anxiety, anger or sadness.
Starting with “Mom, we’ve been really worried about you living by yourself. The doctor told us that you haven’t been taking your medications regularly and you aren’t eating properly. In addition, the stove has been on the last several times we’ve visited” is much better than blurting out, “Mom we can’t deal with this anymore, you just have to go to a nursing home.” You may get a variety of responses ranging from anger to denial. Gently point out the facts that support your concerns. Give your parent time to digest what you’ve said.
No matter what your parent’s response is, acknowledge it. “I know that you think you can take care of yourself and you’re angry with me for suggesting otherwise.” or “This must be really scary for you. I’m scared too!, and this is something we are all going to have to deal with together.” Most people want to feel understood, as well as have their thoughts and feelings acknowledged. You might not be able to let your parents do what they want, but you can at least empathize with them, letting them know you understand. For some, the loss of independence is key; for others, seeing a nursing home as one step closer to death is the issue, while some may fear the isolation and loneliness ahead if they have to go to nursing home. Listen patiently to identify the issues and respond in a genuine and caring way.
Your father may be angry and adamant that he doesn’t need a nursing home. Your mother may say she’s just fine and likes things the way they are, give you a smile, and then change the subject. In either case, just repeat what they said, and ask some questions that will help lead them to the conclusion that what is going on isn’t working. “Mom, didn’t you say that you fell last week? We worry about you. You called last week in the middle of the night when you thought it was morning. Being by yourself isn't good for you, is it?
When your parent continues to resist, remember it is hard for them to lose control. Few people actually want to go to a nursing home, so it is understandable if they refuse to see this as in their best interest. Continue to acknowledge them and add that you see things differently. “We know that you want to stay in the house and take care of yourself, but it’s no longer safe. We can’t let you stay here when it’s dangerous, we have to move you to a nursing home. We know this is hard for you,” or “when you are in the nursing home, we’ll know you are being taken care of, and we will visit you there, bring you home for holidays (when this is possible), like we do now. We have to do what’s safe.” Even if you sound like a broken record, remain direct, firm, while showing care and understanding.
It is OK to consider how having your parent in a nursing home will affect you. In fact being aware of and accepting your own feelings and needs will keep them from coming out at inappropriate times and in inappropriate ways. Being aware of your own anger may prevent you from lashing out at your parent. It is also important to consider a nursing home near you, making it easier for you, but harder for her friends to visit. This doesn’t mean you should get what you want. It means it’s OK to weigh in on what you need.
This is not a role-reversal, even if it feels like it. You are not parenting your parents. You are caring for them. Give them whatever choices are appropriate. Ask them what chair they want to bring, the recliner or the club chair? For some things, ask yourself “Is this worth arguing about?” Some things are, some are not. You might not think it’s worth it to bring her favorite ring, but it may be important to your Mom, then it’s not worth arguing about.
It might be easier for you to make all the decisions, but when you can, give your parent whatever dignity and respect you can. They are losing a lot as it is.
Recognize that moving a parent to a nursing home is difficult for all involved. It is a major change for them, for you and your family. Everyone’s feelings count. It is stressful and emotionally draining and there is often a trickle down effect. Your own children know when you are stressed or upset. They have antennae! So take care of yourself, and be honest with your family at age appropriate levels about what is going on. Don’t be afraid to ask for help and don’t be a hero. When everyone can acknowledge the difficulties of the situation and work together, it makes it a lot easier.
It is hard for most people to get yelled at by their parents, it doesn’t feel good, it brings up old issues and feelings. you can end up feeling guilty, resentful and ashamed. However, it is important not to take their reasonable response to a difficult situation personally. Let them vent, as long as it is not abusive. Acknowledge how angry they are and perhaps even join them in their outrage. Recognize that while they may be taking their anger out on you, they are angry about losing control. They are just trying to kill the messenger. Avoid taking it to heart.
There are resources available in many communities, so take advantage of them. You can use a geriatric specialist to help you with nursing home decisions and your family discussions. If you find that the stress is overwhelming, you can seek individual therapy, or you can offer therapy to your parents. You don’t have to go it alone. This is an ongoing process and sometimes what initially seems manageable tumbles out of control. Take a step back, regroup and look for assistance.
Responding to the needs of aging parents is a difficult and emotional process for everyone. Adult children need to communicate clearly and directly with the parent while being respectful and caring. Acknowledging feelings, while explaining that it is time for the parent to move to a nursing home, requires patience and understanding. It is important to be aware of your own feelings as well as your parent’s, otherwise anger can show up as an unwanted visitor to a family discussion. Taking care rather than control helps your parent maintain some dignity. When the elderly can make some of their own decisions, they feel more independent. A move to a nursing home will make many parents angry. Accept that it is part of the deal and has nothing to do with you. Acknowledge the stress of all the changes that surround the decision to move a parent to a nursing home. Do what you can to ease the transition, including paying attention to your own needs.
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