I have dealt with many couples over the years but few tug my heart strings more than those who call Home Helpers as a last resort because they are overwhelmed and they promised their loved one to never put them in a nursing home. These situations break my heart when the loved one clearly needs more care than the caregiver can manage and it is taking its toll on the caregiver’s physical and mental health.
Just recently I learned of a situation in which a caregiver cared to the point of pneumonia and a double stroke. He was bound and determined to keep his wife at home because they had promised each other they would; now his wife is in a long-term care facility, and he is looking at a lengthy hospital/rehab stay. Neither one is where they want to be or where they promised each other they would be, but this is their new reality.
My first experience with this phenomenon was observing my mother care for my father. I was in the Navy and came home on leave to find my mom physically frail and emotionally drained trying to take care of my father who was suffering from several different medical conditions. We finally convinced her that Dad wouldn’t want her to get sick because of him. It took a lot of frank conversation, and I’m not sure she ever got over the guilt, but in the end she agreed to place him in a long-term care facility.
There are a few things to keep in mind if you or your parents have made promises to each other regarding care:
It’s okay to promise as long as you have a guilt-free escape clause contingent upon the safety and health of all parties.
If your loved one is at home but needs care, it’s okay to ask for help from family, friends, or a professional home care agency such as Home Helpers. The goal is to protect the health of the primary family caregiver, whether that is the spouse or child, so that they will be better equipped mentally and physically to advocate for their loved one as long as possible.
The time to have these critical conversations is before any cognitive or physical decline. While you are at it, call an elder law or estate planning attorney to complete your advance directives. It’s never a good idea to assume that your loved ones know what you want to happen in a medical crisis or at the end of life.
Let your family know your decisions, the reasoning behind your decisions if there is any confusion or disagreement, and where your written advance directives are located. In times of emotional crisis people seldom think clearly, and you want to ensure your or your loved ones’ wishes are carried out. Personally, I believe it is a precious gift to your loved ones to take the decision-making guilt off their shoulders.
Be very careful of who you appoint to make decisions for you when you are incapacitated or as executor of your estate. Sometimes the logical choice isn’t the best choice. I’ve seen the eldest child chosen based solely on birth order when the wisest choice would have been another child, and a spouse chosen when they clearly aren’t physically, emotionally, or mentally capable.
If your situation changes for whatever reason, and there are many (death, divorce, medical condition), you should revisit your promises, decisions, advance directives, and have another conversation with your loved one(s). You can change your mind, your documents, and have as many conversations as you want.
If you need some help broaching the subject of advance directives and last wishes, I highly recommend My Gift of Grace, A Conversation Game for Living and Dying Well designed by The Action Mill, which can be found at mygiftofgrace.com. It poses some interesting questions in a non-threatening way that really make you think. You can also reach out to me for some other ideas; I’m happy to help brainstorm ways in which to start the conversation about advance directives and the benefits of asking for help when caring for your loved one.
Home Helpers of Londonderry