A man contacted me a few months ago to ask me when it would be okay to put his father into a long-term care home.
His dad was in his early eighties and still living independently. His dad’s younger wife had recently moved to an assisted living facility and the son thought it would be a good idea to have his dad move in with his wife. He was concerned about his dad’s safety especially when he was driving to visit his wife, but nothing had happened yet to cause concern. The father was opposed to the idea of moving.
Trying to decide when someone is ready for a nursing home is not easy to decide because there are many factors to take into consideration.
- Are you or they incapable of meeting their basic needs at home?
- Are they a danger to themselves or others?
- Are they desperately lonely most of the time?
- Do they have the financial means to move to a long-term care community?
Sometimes the answer is obvious, like when a person needs round the clock care; they might need the assistance and safety that a long-term care home can provide. Other people are fine to stay in their home with just a little bit of help.
In the case of the man who called me, his dad had no dementia nor mental impairment; he was in good physical health, too. I told the caller that it didn’t appear to be his decision to make at this point. His dad sounded to be fully capable of deciding whether he wanted to move in with his wife in assisted living or to remain independent. I suggested he could take his dad on a tour of assisted living and talk to him about the pros of living in a community setting. But ultimately, his father would have to make the choice. It would be unfair of the son to try to enforce his ideas on his dad. Attempts to force his dad to move could also permanently damage their relationship.
Sometimes the decision to move an aging parent into long-term care is obvious because the person needs more than the family or home care can provide.
A friend’s father has been declining for some time now. Although he was vehemently opposed to moving out of his own home, he would not allow caregivers to help him at home. Meanwhile he was falling and unable to care for his own basic needs. Reluctantly, he moved to an assisted living community at his children’s urging, though it was still his decision. As it turned out, my friend’s dad found he was happy in his new community and was able to get the help he needed 24 hours a day.
In many cases, it is clear to the adult children that their parents are declining rapidly and they cannot handle the demand. They do not feel equipped to adequately meet the parents’ needs at home. A reader recently wrote that she and her husband moved their mother to a nursing home because the woman appeared to be in constant pain, pain that they could not relieve. The mother in-law has advanced dementia and is unable to make any decisions concerning herself or to communicate her needs. The nursing home that they found is able to better control her pain. In this type of situation, a nursing home may be the best option for quality of life, so it is only right that the children make the call to move an aging parent out of their own home.
Making decisions for aging parents often falls into a gray zone because adult children must decide if making choices on behalf of their parents is even appropriate.
Aging parents are not small children who are incapable of providing input; they are adults in their own right and many of them can make their own decisions about their care and living arrangements. They should be encouraged to participate in these choices whenever possible. When an aging parent is completely incapable of making decisions, then the adult child must step up and make the call. This scenario can be an incredible burden as the children try to guess what their parents would want them to do. But to make a choice on behalf of a parent who is able to make decisions, and then to witness that parent’s long-term unhappiness with that choice, would be a perfect recipe for long-term guilt for the child. Adult children have enough triggers for feeling guilty as their parents age and pass on; why would they choose to create a new reason to feel guilty? If parents are able to safely age in their homes, let them. I think you will be glad you did. If the time comes for you to make the decision that they need a long-term care community, they will be glad you did.