How Family Caregivers Can Deal With Guilt Over Placing a Family Member in a Nursing Home

Every family caregiver wants to do what is right for their family member. All fear future self-recriminations and regrets. How can they make what they believe to be prudent decisions today that they won’t kick themselves about tomorrow? Here are some ideas.

Weigh all the options

The media sometimes report nursing home horror stories of neglect and abuse. Residents’ clothes and other possessions occasionally disappear, presumably taken by other residents or staff. And individuals can fall in facilities just as they do while still in their homes.

But when it comes to safety, those with marked cognitive or balance issues are probably better off in a nursing home with experienced staff and built-in barrier-free hallways, well-placed grab bars and other environmental supports rather than in their multistory, cluttered houses. In short, nursing homes offer older adults and caregivers better odds.

I knew that if my mother remained in her apartment, she would almost definitely keep falling and getting hurt. Today, years after her death, I take some solace in knowing that she never fell or went back to the hospital after making her big move.

Factor in additional social stimulation

Too many older adults spend their last years alone in their apartments watching TV most of the day. Even if their family caregivers live with them or frequently visit, those older adults are usually socially isolated, a significant risk factor for developing physical and/or mental health problems.

Facilities offer greater opportunity for group activities, communal meals and other ways of rubbing elbows with others. Increased social stimulation has clear salutary effects.

During my years as a psychologist, more than a few psychotherapy clients have told me that their parents with dementia seemed dull and inert while at home but much more alert, engaged and conversant in nursing homes. My mother made friends and attended religious services and concerts in the company of others at her nursing home.

View caregiving decisions broadly

Family resources, such as money, time and energy, are typically finite. Helping an older adult remain in their home and not go to a facility when they need intensive care often requires diverting some resources away from other family members and their needs, as well as the caregiver’s needs.

All major caregiving decisions should be considered in the larger family context. If the caregiver cuts back or quits work because they need to take care of an older adult in their home, then what other family financial obligations will be compromised? If the caregiver devotes more time and energy to the older adult, then which family members get less?

Ratchet down the guilt

It is not possible to eliminate all guilt about placing a family member in a nursing home or assisted living facility. To this day, eight years after my mother entered hers, I still feel twinges of self-criticism and discomfort. But I reason to myself, we were in a no-win situation.

Given my mother’s independent personality, she was not likely to take much joy in living in a nursing home, despite the friends she made there and activities she attended. But if she had remained in her apartment, fallen and suffered even more serious injures than broken bones, I am not sure I could have ever forgiven myself.

Caregivers face many no-win situations in which someone they care about is going to feel short-changed or hurt by decisions that must be made. Because caregivers are caring people, they are going to feel guilty about it. And that is normal.

But they must keep saying to themselves, with sincerity, “I tried my hardest and did the best I knew how.”