How to deal with elderly parent that can no longer care for themselves but asks you to promise not to put them in assisted living?

I'm just musing here after reading some wonderful responses...my parents never asked for the promise not to put them in a nursing home. I promised myself I wouldn't. My husband and I built a tiny house for them on our property, about 100 feet from our front door. We moved them out here in November 2015. Alzheimer's took my mother seven months later. At about the same time, dad was diagnosed with congestive heart failure. He's still hanging on, but failing rapidly. It's about time to call in hospice, I'm thinking. I have experience with several of our local nursing homes (because of mom) and I wouldn't put my dog in there. Too many chiefs, and not enough Indians. They're terribly understaffed as far as nursing care goes, and therefore they hire anyone with a license, whether they are fit to care for people or not. So I will keep dad with us until the end, but I am certainly not saying everything is rosy. I have had to work through the process where you rediscover your parent as a person, not as a parent, and they may be the sort of person you wouldn't normally like much. Dad has a habit of criticizing my cooking, my hobbies (yes, I insist on retaining my hobbies), my grandchildren, etc. He does this with a "ha ha I'm just joking" laugh, but I know what's going on. He also will not tell me if something is physically bothering him until it has reached the stage where a trip to the emergency room is necessary, then when he tells the doctors that his symptoms have been developing for several days, they look at me like, "What sort of caregiver are you, anyway?" Guys, he doesn't TELL me! I get it...in his youth, sons were what mattered, if you wanted to keep the farm going and provide for your family. Daughters were there to support the males, and that was it. Well, he has a son, who lives in another state, does his own thing, and only calls once in awhile. It's been several years since I've seen him. But he is plainly the Golden Child to my dad. All this causes resentment, not to mention the strain on the rest of my family due to loss of wife/mother/grandmother time. But enough free associating. One of the things I hear is "they took care of me when I was a kid, now it's my turn to take care of them". Oh, yeah? 1) They made a choice to have kids. With that choice came the knowledge that they had to take care of them. I don't feel like I owe them restitution for a choice they freely made. 2) They were a whole lot younger than most of us caregivers are now! They were in better health, had a lot more energy, and weren't necessarily on fixed incomes when we were kids! Even with these thoughts bouncing around in my head, I'll take care of dad until he dies, mainly because I promised myself I would, and a promise isn't made if something is going to be easy, right? I'm going to use a word you don't hear much anymore..."honor". I feel my honor is at stake, here, and I would be letting myself down if I didn't honor my promise. No, it isn't easy. Yes, circumstances change. But as long as I'm able to hang in there, I will. I hope all us caregivers can find the fortitude to do what we have to do. Let go of the guilt...you don't owe that to your parents. Peace to you all.

Parents who ask for this promise have NO idea what they are asking their children to endure. We went through a lot in dealing with my local in-laws. A lot. Daily on the phone with social workers, taking time off to take them to medical appts, transitioning them out of driving, ER visits, daily errands, meals, house in foreclosure, no money to provide for their daily needs, Parkinsons, short term memory loss, denial, dementia, cc debt collection, Medicaid... My own mother (who lives next door to me) watched all this transpire and the stress it put my entire through for a solid 1-1/2 years non-stop. My fiercely independent Mom used to flippantly say stuff like, "I'm never going into a Nursing Home with all those OLD people!" and "If I ever get like *that* just take me out back and shoot me!" After she saw what resistance, denial and bad planning looked like in my in-laws, she NEVER said any of that again. On her own she went and visited facilities, has tried out hearing aids, is reducing her driving, etc. We have discussed keeping my mom in her home as long as it is safe for her and not taxing on us (since we are not retired and run a business). If any of our parents ever gave care to LOs with dementia/ALZ they would NEVER try to extract the promise of never putting them in a NH. I also liked a response below who suggested to promise never to abandon our LOs. So Ilkain, DO NOT make that promise to your parent, no matter how they respond or what they say to you. NYDIL gave a great response. Please heed it.

My father is 83 with vascular dementia. Let me tell you he is the most difficult man you will ever meet. I have carers who come in to help him bath and to help him with a few things. He is rude to them doesn't listen to me. I'm 44 and i live with him but I have my own space in the house so i dont share anything with him. It makes no difference what you say or do he wont listen. He fights every step of the way. He wont have a shower, is a hoarder and his vascular dementia is getting worse. He wont accept he needs help and he doesn't want to go into a care home. He said he wants to live in his own house and die in his own house. He said if i ever put him into care he will kill himself. He is dead against going into care. He is becoming more and more impossible. So argumentative at his age is not good. I am surprised he is still alive. I have wished him dead because its a struggle especially when he refuses to listen or accept help which I am paying for.

By recognizing that they are asking you out of fear, obligation and guilt that, in different amounts, are nonetheless the primary ingredients for all unreasonable requests.

Fear: drill down to what the actual fear is. "Assisted living" is not a real fear. It's a catch-all for something else such as having to leave their home. What you can do is, instead of giving into the fear by making a promise over which you have zero control over keeping, help your parent figure out what renovations can be made in their home to help them age in place. A raised toilet, grab bars, a shower chair help reduce accidents in the bathroom, which remains the #1 room in the house where accidents happen.

Obligation: whether your parent admits it or not, they expect a commitment from you in their old age. And some parents have high expectations! Be clear with your parent that you cannot make any promises - you are not marrying them - and that you will help them however you can including figuring out what's best and helping them make reasonable decisions. As soon as their expectations become unreasonable, all bets are off and you must do what keeps them safe whether they like it or not.

Guilt: guilt is for when you do something wrong but parents often lay guilt trips on their children when they want to control the child. It's a tool of manipulation. Rather than be honest with themselves and their children that aging is not for the faint of heart, they resort to guilt, which is lazy and dishonest but nonetheless can be very effective in getting them what they want which is CONTROL. And in old age, one loses control over many things.

Help your parent by being forthright and honest. Tell your parent what you can and cannot do and how you can and cannot help. If you are married, that discussion happens first with your spouse before ever reaching your parent's ears.

Always be vigilant about establishing and enforcing healthy boundaries.

Finally, in my opinion no one should take on the monumental task of caregiving for anyone without having the authority to do so i.e. durable power of attorney both medical and financial. That may involve a family meeting about who gets what powers and why.

I missed they are having difficulty. See is the parent qualifies for in-home assistance. My mom ability-wise qualifies for NH, but we found a Medicaid program to come to her in IL.

"Mom, let's just take care of today. Hopefully we won't have to ever discuss AL. "

That's a promise nobody should be asked to keep

Ahh---the old piecrust promise--easy to make, easy to break.

IMO, nobody should extract from their children the promise that they will always house them and care for them. People are living longer and longer..I have not made this promise to my DH and he has not expected it of me. We have not asked our kids either.

I have no statistics to back me up, only what I have seen--sick elderly parents moving in with their kids and in a few months or years, everybody is mad at everybody else.

My own family is fractured beyond belief--we will never heal from the choice to keep mother in with brother's family. It's been a sick and twisted relationship and has affected a LOT of people. I am currently 'grey rock' with my mother, don't speak to her or even really think about her as she has been so nasty during my bout with cancer (which isn't even over).

Having said that--I have seen families where the extension of g-parents has added pleasantly to the overall dynamic. They are unusual, but it can happen.

May I just say that I tried to fulfill that promise and it just about killed me, emotionally and physically. Nearly 15 years of my life that I can’t ever get back. Regrets? Yeah, and more than a few.

Please learn from my ignorance. I truly did not realize what I was signing up for. Everyone has different circumstances so it truly isn’t fair to compare each other. Emotions can get the best of us if we lead with our hearts.

We can’t see the future. No one can. There are no guarantees in life. The only constant is change. The changes became overwhelming for me.

It effects the caregiver the most but spills over to husbands and children too. Of course, the elder is effected as well.

For what it’s worth, I would not ever be a primary caregiver again. It destroyed the mother/daughter relationship and now I grieve for what could have been.

You may want to consider not putting yourself in the same situation as I did.

It’s a very isolated life. You will no longer be free to socialize with friends. You will miss privacy with your spouse and children.

I tried. I failed. I’d like to think that I succeeded in some areas. I think if all involved were to be completely honest they would have to say that I wasn’t a complete failure even though they did their best to make me believe that I was. It’s horrible how those of us who have done the most, sacrificed everything, set ourselves up for the worst betrayal.

I have cried a river. It’s okay. I had to release the pain. I have much to be thankful for in spite of everything. I have to remind myself of that because otherwise I could allow myself to go into a very dark place. As it is I suffer from bouts of depression.

Cherokee, Sorry to hear that. That must be extremely difficult. My aunt has a similar thing, always taking care of someone. 

Is your husband going to memory care? Whatever you do, i hope things work out for the best.

After seeing how dementia took over my husbands mother then eventually his father, my husband understood how hard it was on the kids. Meanwhile I was taking over the care of my mom because she refused help from anyone other than myself and her granddaughter. Being on call 24/7 started to get to us and her constantly falling didn't help. Her PC said one more fall or one more threat of suicide and you will be admitted to a NH or skilled nursing facility. A few days latter, I got the usual call, she was in the floor and had crawled from outside to the inside, cleaned up, fell again and I needed to come get her to take to the ER. She had a dislocated shoulder and fractured wrist on the other hand. They set the shoulder, splinted the hand and she pulled the shoulder out again two more times in about 3 hours. They were going to send her home with me but, I told them NO WAY!! I didn't have a bed available for her and she would take off walking the 6 miles back to her house. I insisted the contact her PC and they finally did. She admitted her to the hospital until after Christmas and helped us find a nursing facility to take her. She lived there for 3 years, The last year was in a memory unity where she refused to participate in anything and constantly asked to go home. She managed to climb out a window and over a 10' wrought iron fence and 4 adults had to fight her back in. She fell in July, 2018 and had a head trama injury. Never recovered from it. She passed in Dec. 2018.

Having 3 parents go thru so much pain and being on call constantly even after she was admitted to the NH, left us drained and wary of our own mortality so, we preplanned our final arrangements and paid for them and instructed our 2 children that they were NOT to try to care for us if/when the time came but, they were to put us in a NH or AL. Which ever one the dr suggested. This released them from any responsibility and left them able to live their lives, not ours.

Unfortunately for me, my husband was diagnosed last December with severe stress, anxiety, depression and dementia that was leading to Alzheimers. So now, I have that to look forward to. I didn't get any rest between moms passing and my husbands illness starting.

I agree with saying I won’t abandon you instead of a promise to keep them at home. When I was very young I promised Mom I wouldn’t but in the end it had to be. It was for 6 weeks before she eventually was hospitalized and passed. Thankfully She understood when it finally happened. With my Dad who is 94 and a Veteran, I have already discussed that if he can no longer be independent, we have a wonderful Veterans facility nearby. I was upfront and honest with him. Thankfully he is on board.

Wow!! Lots of great responses here to marinate with for awhile. I would  definitely NOT make any promises to NOT move a Loved One (LO) into a facility if and when needed; I would Promise to love them, support them and always be there for them (in whatever form you can be) and I would Promise to make sure they have the best care possible. Beyond that I would be careful making promises, even if you have a crystal ball... I mean let's face it... The world is not always a nice place in these times and like it or not; stuff happens that's completely out of all our control on a regular basis. 
I'm sorry but, you didn't mention if your elderly parent has any cognitive issues or illnesses (i.e. Dementia ALZ or other) just that they were no longer able to care for themselves.  I firmly believe from my own personal experience with my mom (who's now in the end-stages of dementia ALZ) and with all the people that live at her Memory Care Facility (MCF) and all the seminars, reading and researching I've done since moms diagnosis; that anybody with these types of illnesses will undoubtedly need professional around the clock 24/7 care at some point no matter how hard you try and avoid it. Unless you are a trained caregiver and even then I believe you will need outside help in order to stay healthy to be there to care for your LO. I'm not suggesting everybody should put their LO's somewhere if the have Dementia/Cognitive Impairments (that's a personal decision) but , I do however, think in most situations involving these types of patients; the patients will need to be in a facility of some sort at some point. The day my mom was diagnosed, the Dr. said she couldn't be left alone for more than a few hours at a time; I moved in with her that day and I would drop her at my brothers for a few hours a day 4 days a week. After a year, we moved her to my brothers house, where we implemented Adult Day Care Camp a 2-3 days a week (4 hour increments) into her schedule and I would care for mom 3 to 4 days a week at my house and stay overnight when they were out of town or busy with the kids. We had a CareGiver (CG) come in 1x a week as well. However, this summer (after 16 mos at my brothers house) it became painfully obvious to my brother and I that we needed to find mom a Memory Care Facility as she was starting to need more and more assistance than we could (even as a group) possibly give her. We were starting to feel as if we were fighting a losing battle in caring for her, no matter how hard we tried, we are just not equipped to be her 24/7 caregiver and nor would she want that. It is definitely different for everyone and my hats off to those that have been able to care for their LO at home until the end. We however, needed the help and we find comfort in knowing she is in the best, safest place possible where all her needs can be met. Good luck with your LO llKain. May you find peace on your journey!

I promised my father that I would become President of the USA..didn't happen...oh well.

That is pure manipulation on their part don't fall for it, forget about the promises, do what is best for all..not just them.

Emotional blackmail is not a good thing. We all tend to make promises during good times...........it's easy to say Sure Mom, I Will NEVER Put You in Assisted Living, No Problem! Then when the poop hits the fan, all promises fly right out the window in favor of doing The Right Thing. Not to mention, the vast majority of them wind up LIKING Assisted Living just fine. They get to sit around complaining all day with other people their own age, kvetching about the horrrrrible food, the small portions, etc. They get to gossip all day long, too, about things that are none of their business, like Did You See Mildred Going Into Bob's ROOM Last Night? OMG That Little Hussy!!! They get to watch Boring Movies together, like Westerns that Nobody Wants to Watch Except the Men. They get to indulge in Happy Hour every Friday and all get tipsy. They get to ride the mini bus on outings to restaurants, events, plays, all sorts of things they'll find boring and irritating, which gives them even MORE fodder for the complaining mill later on at dinner! Yay!

Go tour some local Assisted Living Facilities yourself. Speak with the RESIDENTS and the STAFF. Ask them how THEY like living and working there. That will determine which place is best for your parent. I also suggest you select a privately owned AL rather than a Corporate owned one..........the privately owned places are MUCH better and easier to deal with the management/billing/nursing, etc. Corporate owned facilities have one thing in mind: the bottom line numbers.

Best of luck!

This “promise” should never be requested, never anticipated, never listened to, and never honored.

Your profile doesn't indicate what condition the elderly parent has. For me, if an ailing senior, who is disabled to the point they can't care for themselves, seeks a promise that like....that tells me that they are not using proper judgment or able to think clearly, because, anyone knows that they would likely need help under those circumstances. Unless, they are very financially secure and can afford around the clock care inside their home, then, I'd consider the request unreasonable. Cogent thinking seniors say, you never know when you might have to go into AL or a NH. If my LO said that, I'd likely say, we're going to make sure you are well cared for, wherever that might be and then make arrangements for their care, based on the options that are available.

Also suggest you visit the facilities yourself 1st. Choose ones with respite care so mom / dad can have a "trial run". (But be advised the place will be on best behavior to get you to sign with them. ) I made the mistake of taking mom with me and she fell in love with a place that wasn't suitable for her needs. And tell them let's let the doctor decide where you need to be.

My Dad also doesn't want to go to an AL facility. He said his grandfather went to a nursing home and a short time later passed away from boredom.

He has this idea that its a prison.
I feel bad for him. I see these videos of AL facilities and the people socializing and doing things. He sits at home and is bored. I try to give him things to occupy him, while I do my own thing.
And when he feels okay, i take him places like a store or restaurant or bank, etc.
I was thinking about taking him to an activity center, so he can socialise with his peer group. Sometimes, he's not ready to go out somewhere until 3 though.
Maybe eventually I can introduce AL. It will definitely take a miracle and a lot of prayer to convince him

I would not promise to never put them in a facility. You don't know what the future holds.

My dad used to try and manipulate me into promising to take care of him when he got old. I said ,"I promise to find a good home for you."

I don't do manipulation from my family. It is hateful in my opinion and it is never okay to obligate someone to do the unknown at any and all expenses to them, that is not what a loving parent does.

Statistically 40% of caregivers die before the person they are caring for, who asks someone to put their life at that kind of risk so they don't have to do anything they don't want?

My husband made this promise to his mother and I have told him that it is not one he can keep.  If there comes a time when their needs outweigh your capabilities and resources, there is not a choice.
Another answer stated exactly what I would say, "I promise not to abandon you".  That is the best answer you can give and an honest one.

You let them know just how selfish that is, to ask you to make such a promise. And then you refuse to make such a promise. If you make any promise, it should be that you will make sure your loved one's needs are met.

Do not promise anything. Tell parent that, like said, that they are getting more and more dependent on others. There will come a time when you just can no longer care for them. If you are a Senior, u may want to tell parent that you too are getting older and with that there are things you just can't physically without hurting yourself.

I answered honestly: "I cannot promise you will never have to move into AL/NH because I cannot see the future. I can promise you as long as we can manage it, I will do my best to keep you at home or maybe in my home. To stay at home, you will need to accept help from people we hire to help. If you need 24/7 medical care or transfers I cannot provide at home then we will have no choice. I can promise if placement is necessary we will pick a good one and I will visit often and make sure you have good care."

A lot of our seniors think AL/MC is just like being stuck in a small shared hospital room instead of an independent space where people come in to help as needed and they can join others in the dining or common room for company and activities. It doesn't help that several NHs (at least in our area) have been established in former hospital buildings. Some brochures on local ALs or a couple of visits might reduce resistance to at least considering AL.

" Why do you ask that, Dad?"

I think you need to get at the root of his fear.

"I promise I wont abandon you".