“I’ll never put my mother in a home.”
I’ve heard these words many times over the years. My biggest challenge is always to keep silent, or to carefully ask a few gentle questions. Spoken with conviction and often a sanctimonious air, the words don’t usually invite dialogue. Those eight words hold hidden messages and although not all of them may be intended, some definitely are.
In some cultures, it’s considered dishonourable to not care for your elder in your home, and anyone who chooses a different route could be shunned by their relatives and their culture. Disapproval and anger may result. I understand that. I’m not referring to cultural differences, but the unspoken message in those words:
“If you put your elder in care, you are abandoning them. You’re not a good son/daughter.”
“My choice is better and more caring than yours.”
“Caring for an elder at home is always the best choice.”
Whatever conclusion a care partner reaches when looking at care for their elder, you can bet agonizing hours went into the decision.
Let’s stop judging each other.
When Home Care Is Best
Home care has the benefit of the familiar. The elder can stay in surroundings and with people who are well-known. This works best when plenty of family, friends and other supports are available for the primary care partner. It’s helpful to have both respite care, such as a program or regular classes that the elder attends every week, and care that comes in. Help with bathing and other routines keep the tasks from becoming overwhelming. From the care partner’s perspective, there must be plenty of support in various forms.
The danger of isolation
From the elder’s perspective, they must not be isolated. This is one of the greatest hazards of home care. Often care partners still need to make a living, families are busy and the elder has no opportunity to spend time with their peers. Mobility and other health issues may make it difficult to get out, even with help. Their world shrinks and what was supposed to be the best possible choice becomes a prison.
The challenge of palliative care
When they reach a palliative state, care can become more difficult. Palliative doesn’t necessarily mean end-of-life, but a steady, downward spiral brings its own challenges. Doctor’s appointments, specialists, treatments–how are these accomplished? Bringing in nursing care is exorbitantly expensive. As the bills and the worries mount the burden on the care partner can be overwhelming.
When Community Care Is Best
By community care, I mean living in a community, in a situation where medical help is always present. This might be long-term care or a private care home. In this situation, medical support is always available, and your elder has the benefits of a community where they can connect with others of their generation.
I can’t stress how important this is. Rather than being abandoned, as is often implied, elders form new relationships and interests. Book clubs, memoir writing, exercise classes, day trips–life is full!
Some long-term-care facilities leave a lot to be desired. Of course, you will investigate and choose the best one available, but the care partner can and should still be active. Advocate for care that is person-centred. Be there often to provide not only companionship but alternative activities. Get to know the professional care partners and join in with whatever is happening.
My dad chose to move from the home he had always known and the community he lived in for all his adult life. He moved in with my sister hundreds of miles away in Manitoba. Although it was his choice, it wasn’t the best one. He never saw his friends or many of his family again. I was only able to visit him once a year. My sister worked full-time, and although her family reached out to him, he was isolated. As his dementia and care needs increased, it became evident that this wasn’t working. A new care home opened a few miles away, and he was one of the first residents. My sister visited often, and when I came, I entered into the life of the home and helped peel potatoes for dinner! He was a favourite among the staff, and when he died in his sleep about a year later, everyone missed him.
The message is clear. Care needs are complex. Sometimes decisions needs to change. Many factors go into the final conclusion.
When it comes to those eight words, think first, and don’t judge.
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