A few years ago, I promised my mother, whom I love dearly, not to put her in a nursing home. How do we get her to see the need for assisted living?

You made what I call “The Noble Promise” to your mother years ago when things were different, and better. At the risk of your own health and well-being, including using your own finances, you’re trying to make an impossible situation work because of the promise you made to her.

No one does cartwheels and handsprings down the middle of the street and celebrates having to place a loved one in a facility. But you and your hubby are now doing the work of 3 shifts of caregivers in a nursing home. You are bankrupting yourselves and putting your own health in danger. I know for a fact that chronic UTIs are extremely difficult to handle. I have a gouge-mark scar on my arm from my mother when she had them and became combative.

When we take our parents to live with us, on some level we believe things will go back to the way they were when we were younger and growing up with healthy parents. Unfortunately, that doesn’t turn out to be so. Our parents are now people we don’t even recognize. They are angry, mean, unhealthy, unreasonable and make unfair comments that cut us to the quick. Even so, it’s difficult to make ourselves understand what must be done and be ok with it.

Because there is property involved and also a sibling, you need to get an Elder Law Attorney on board. Hopefully you have POA. Write your sister a letter and send it registered so you’re sure she got it. Explain what you’ve decided to do. Express to her that if she disagrees, you are more than willing to turn over Mom’s care to her. Have the attorney help you navigate through what you need to do to file for Medicaid.

Good luck. Keep us posted.

Good morning,

Unfortunately, I don’t think you can get them to realize the toll it takes on their adult children. I think most of them are like what you hear about drowning victims who can’t see that their rescuer is there to help them, so they latch on in desperation and endanger them both!

We never made a promise to our parents, we just rolled up our sleeves and became the Assisted Living Facility when they started to have problems in their early 70’s. Then as time passed, my siblings and I, along with paid professionals, became the nursing home. We fully intended to do this until they both passed away in their own home, but it became too difficult as their needs increased and we began to break down mentally and physically.

They are now both in a nursing home together. My father could somewhat see the toll this was taking on us, but my mother never did. My father was and still is very appreciative of the care he received from us and all the things we do now to advocate for him and when we come to visit. My mother, on the other hand, behaves as if it is her just due, as if she were royalty, and we her faithful minions. Every so often she will express anger toward us that we did not keep up the status quo of keeping her and my father in their home.

I do not know your mother’s limitations, but she may be past the stage of Assisted Living and may be eligible for a nursing home. Get a Needs Assessment done through her doctor.

It is hard, but you may have to reasses the “Promise”, as “Circumstances Alter Cases”. We never dreamed that there would come a time that we would not have the full time care of our parents. It was very hard to hand their care over to a facility, and over a year later, we are still getting used to it. We are still loving children who visit frequently and advocate for them.

My husband has made the same promise to his mother and now with his own health problems and advancing age, he is starting to see that even with the best of intentions this is a promise he should never have made. We are both RNs too. This makes it even more difficult since our careers have literally been made caring for others in the same situation.
The reality is we can only do what we can do. Her time at home being independent has come to an end. Of course she’s mad as hell about it! Who wouldn’t be? The only person she can be angry with is the two of you. It is a selfish~ self preservation time in her life, so she is being selfish. All she can see and handle is her own needs. It doesn’t matter that her care is putting your health and happiness at risk.
No one wants to accept that there care needs are a burden on others even when it clearly is.
You will both have to accept that she is going to give you both the biggest guilt trip of your lives. Accept it. It will most likely pass as she settles into her new surroundings.
I have a patient now that is as happy as anything until her daughter comes to visit her. Then she is crying and miserable, she tells her horrible things to guilt her. When I told her daughter I was surprised and how happy and involved she is here when there not here, she was shocked. Shocked and relieved to some degree. Her mother had convinced her she was a crying miserable mess 24/7 since she placed her with us which could not be further from the truth.
What to do about the anger and guilt? You’ll have to be very strong and resolute knowing you have made the only safe and sound choices for all involved. Let her vent her anger but don’t leave there with guilt over what you had no other choice about.
I have already lived with my MIL for two years and then could no longer deal with it and she is currently though temporarily living alone in her condo again. This nearly broke up my marriage. Yet she still says she was happiest living with me. To which I have nothing to say to her. My husband still feels guilty. She’ll be 86 soon and I know the time for her to live alone is drawing to a close. At that time we will have another huge decision to make. We are very divided on this.
Once the two of you say the pros and cons and make your decision you cannot waiver in it. I truly believe everything turns out the way it is supposed to in life.
She absolutely will be fine in AL or a nursing home so long as you stay involved and choose the best one. The prettiest places aren’t always the best. The one where you get to know her caregivers and visit her frequently is the best. She needs to know you still care and you’re doing what you feel is best for her.
Trying to explain your own health issues and concerns in giving her care is rarely effective. Though you can try to explain this to her don’t dwell on that aspect.
Shes only thinking of herself. Reassure her you are too and this what you both know is best for her.

Enshope, your Mom's generation when they hear the words "nursing home" they immediately think of the County asylum where their older relatives sometimes had to go. Sadly the older relatives were placed with people of all ages who had serious mental issues so the facilities were hellish. No wonder elderly parents cry at the thought of moving.

I was a senior citizen myself, so I couldn't do everything my 90+ parents had thought I could do. I no longer was that 20 or 30 year old, even though in my parent's mind they thought I still was. That is why you rarely see any Staff at a senior facility who is in their 60's or 70's. It takes a huge toll on a senior caregiver [and many younger ones].

If you can, take your Mom to preview a couple of places that you know would take your Mom if she uses Medicaid later down the road, being self-pay first really helps. Use a "theraputic fib" to your Mom by saying a friend of yours is moving their parent to senior housing and what better way to get an honest opinion then to have your Mom preview the place :)

when my mother had to go to AL after living with me, I found a facility that had IL, AL, MC, and SNF..she was in AL for almost a year when she had to move to SNF. She didn’t have to go to a new facility. So try and look for a facility that has more than AL.

It is not unusual at all for a parent to see us as the horrible child and the enemy who "threw them away"...my dad's words...when the health declines so much they need nursing care. It sounds to me like an assisted living facility may not accept your mom in her current state of health. But you can contact and tour several and meet with the directors of each to see if they will. However even if they do eventually she may need to move to a NH for 24 hr skilled care.
I know I was like you, taken aback when my dad yelled at me for his placement without any consideration of all I’d done for him the previous 4 years. It hurts!
You made a promis in good faith not realizing what would then become impossible. It’s like promising to stay together when we marry but sometimes we break that and have to divorce. We often don’t know what is down the road. I’m sorry for you but you know it’s in her best interest to move her for both her and your safety. Hard as it is you must. I always have to tell myself that dad had a darn good life for 95 and his last few years in a NH doesn’t overshadow that. You deserve a life too

This is one promise I wish people wouldn't make. We can't see into the future and know what kind of illnesses or disabilities await us. My brother made the same promise to my mother and he did not live up to it. I'm not blaming him because none of us had any idea she would have dementia, but I know he feels guilty that she's in assisted living and she feels he broke a promise to her. I will never ask this of my children for that reason.

Thank you for asking this question as I, along with many others, are struggling with this issue. I never promised my Mom that she wouldn't go to a nursing home but all the other reactions she's had are very similar to your Mom's when we talk about AL. I've tried not to take it personally when I get the cold shoulder or hear that she tells people she wouldn't treat a dog the way she's being treated. I think you'd have to be heartless not to feel awful, especially when you've been the one taking care of most of her needs. What I've come to realize, though, is that we get the brunt of the anger because we are the ones who are there the most, therefore, are the face of what is happening to them. Like you, my brothers and I have tried to have in-home help for 12 hours a day but that is so expensive, she will be out of money soon. We've tried to explain the cost to her but she shuts down and doesn't seem to understand it - or she is convinced she will die before she runs out of money. I'm not sure about that but I am sure she's been adamant that she won't go to AL. Just recently, we had an assessment done in her home (and that was important) by an AL facility which has a continuum of care. This went much better than another time when we brought her to a facility for a tour and assessment. This time, they took the approach that her doctor felt it was necessary for her to be someplace where her new medications could be monitored because she was having some trouble with them. They approached it like it was going to be respite with the hope that she would like it after she got there and end up staying. The reality is that if she hates it, we'd need to come up with another solution anyway. Right now we are in the application phase and she hasn't moved in yet so I don't know what the ending will be to this story. But, she seemed to accept this approach and didn't just shut down.

What I've come to realize is that, after 8 years of care giving, I've done just about all I can do. I also have a husband and children who would like me to be around more and I need to stop cancelling plans because Mom needs something or doesn't feel well. Do I feel awful about that? Oh yeah! But, I've been feeling awful anyway so it's time to try something different.

I do wish you the best possible outcome - even if it's not a perfect one. Just know that any decisions you make are out of love for your Mom and what you feel is the best for her (and you). She probably won't see it that way, at least initially, but when you're at the point of saying "this just isn't working anymore", it's time for a different solution.

I really wish you had asked for advice before getting a reverse mortgage on your home. They are rarely a good solution to a financial problem.

You made a promise to Mum based on the Situation at the time. Now the situation has changed and your promise is void.

Your mother is being selfish. You have met her needs for 10 years and she does not want anything to change. But her needs have gotten far greater than your ability to meet them.

Enlist the help of her doctor, perhaps ask him to write an RX for 24/7 care in a facility. Once she spends down her $50,000 and the funds from selling her condo, she can apply for Medicare.

Good luck.

You do what I did. I pointed out to my father all of the ways that it was unsafe for him to live on his own and how he had become unable to manage his own affairs. We then went and took a tour of three different assisted living facilities, "for future reference," so that he would be able to make the choice. He gradually got used to the idea, and went willingly not too long thereafter.

You have gone above and beyond the call of duty. For her safety and your own mental health, she needs to be placed in a facility even over her objections. Do not allow her to emotionally manipulate you.