People Criticize Me for Placing My Mother in a Nursing Home. They’re Wrong

People’s perceptions of nursing homes, though, can be off-the-charts extreme. “The doctor said my father needs the 24-hour supervision of a nursing home, but I won’t put him in one of those snake pits,” I heard a caregiving son say years ago. A former patient referred to his county’s nursing home as “the elephants’ graveyard” — the place where you are sent to die.

In my opinion, their viewpoints use too broad a brush to paint too dire a picture. The simple logic behind them seems to be: Nursing homes are always bad. Caring for someone in their home is always good. Ignore all considerations about the care receiver’s specific needs and the caregiver’s limitations. Exceptions will not be tolerated.

Caregiver self-criticism

Caregivers’ self-doubts and self-criticism are the other main reasons they become defensive when confronted about placing a family member in a nursing home. Hearing others dis their care choices adds credence to their worst unspoken fears about themselves.

Many wonder: Am I shirking my duties as a loving family member? Or even: Am I dumping the person who has become an unwanted burden? They may even believe that they are betraying the care receiver, especially if they once promised to never put them in a nursing home. The guilt they feel about violating that sacred oath and forever banishing their family member can be overwhelming.

Matching services to needs

The most effective caregiving plans, by contrast, aren’t guided by strong personal opinions but instead strive to match the services utilized with the care receiver’s needs. If the care receiver is at risk of falling, you may obtain a walker, install grab bars in the bathroom and take them to physical therapy. If they can no longer shower, groom and feed themselves, you may hire a personal care aide to assist them.

Suppose they need 24/7 care because of physical debility, marked confusion with disruptive behaviors or the need for frequent medical monitoring. In that case, you might consider a nursing home, with its round-the-clock nursing and support staff, as the most appropriate and safe environment for them.

Embracing a teachable moment

More from Barry Jacobs

I Deserve to Be Appreciated as a Caregiver, Not Treated Like a Villain
My Mom Is Dying, and I Am Overwhelmed
Uses and abuses of caregiver silence
Pros and cons of receiving pay as a caregiver
Strength, challenges of immigrant caregivers

 

So how should you deal with those who bad-mouth nursing homes and, by extension, you? It’s tempting to respond tartly, “What do you know about nursing homes?” Such a retort may temporarily shut down the other person but not change their mind or improve their judgment of you. (They’ll probably see you more critically.) A better course is to embrace what educators call the “teachable moment.”

It is a matter of taking the opening that the critic has provided to share information about nursing homes that they may not know, as well as your more positive perceptions of what you believe to be an essential option for frail care receivers. Rather than getting defensive, answer them in a friendly and disarming way: “I’m so glad you brought that up. Many people have negative views of nursing homes. I probably did too in the past. But I don’t any longer. Mom’s experience has totally changed my mind.”

With this endorsement of nursing home care that is based on your family’s direct experience, you have hopefully opened their minds to question their knee-jerk assumptions. You can then go ahead and make the following points:

• As a structured living community with regular activities, including congregate meals and music hours, nursing homes offer more social stimulation than care receivers typically receive at home, where they may be parked alone in front of the TV all day. Research has shown that increased social stimulation is better for maintaining the quality of their thinking skills and overall morale. It is no wonder that you report your mother is happier.
• Constant monitoring of nursing home residents by nursing aides who are backed up by registered nurses and medical directors — typically physicians who specialize in geriatrics — generally means that care receivers have fewer falls, bed sores and medical emergencies. That may also explain why your mom is healthier.
• Because nursing home staffers provide any necessary hands-on care, such as dressing the care receiver or brushing their teeth, family caregivers can be caring daughters and sons, not nursing aides, when they visit. They aren’t shirking their duties; their primary duty was and is to make sure the care receiver receives adequate care. And they haven’t stopped being caregivers; they have taken on a different caregiving role.

You have made the right choice for your mother. It was the right choice for my mother too. During her last year in her apartment, she fell frequently and was hospitalized three times for broken bones. She simply wasn’t safe any longer living as she had. Arranging for her to move into a nursing home — where she never fell again nor returned to the hospital — was the most loving thing I could do for her as her son and primary caregiver. Eight years after her death, I still have no regrets.