Ageing is a natural part of life and it will (hopefully) happen to all of us at some point. When we do age, it’s often those closest to us – our spouse, children and close relatives – who need to drive a lot of the decisions around our aged care needs.
For those in the decision-making position, this process almost always goes hand-in-hand with guilt. You may worry if you’re making the right decision, maybe you’ve said to Mum or Dad ‘I’ll always look after you’ or you know they have told you that they never want to go into an aged care home.
While these feelings are natural and very common, they are not always necessary. Most families I find are doing the right thing by their parents or spouse in helping them to access aged care accommodation– it’s just hard to see that sometimes and the feeling of guilt can be overwhelming.
It’s easy to promise someone you love that you will always look after them, particularly if they have expressed concern about going into an aged care home or are healthy when you make that promise. The most common unrealistic promise I hear is the ‘I promised mum I’d never move her into aged care’ type.
Rod* came to me with this problem when his mother had a fall and the hospital told the family she could not return home. Often hospitals will advise this when they know it would be dangerous for the elderly person to live at home alone. Rod insisted that we find a way for his mum to stay at home because he ‘wanted her to be independent’. I had to explain to him that at this point, saying that he wanted mum to stay in her own home because he wanted her to be independent was like me saying I wanted to win the lottery. Yes, it would be nice – but we need to be realistic about the situation.
The reality was it would be irresponsible and cruel for Rod to let his mother to continue to live at home. Her condition meant it was clinically and practically impossible for her to live alone. She needed outside or addition support to remain as independent as possible. It’s confronting, but it’s what a lot of children who are helping their parents with aged care need to hear.
Then there’s the realisation that adult children are often not in a position to care 24/7 for their elderly parent. Perhaps mum or dad have many care needs that require 24/7 care – something you simply cannot provide. You may have a job, your own family to care of or you may live interstate and it’s not practical to move yourself or your parent.
I find that the vast majority of families who are choosing to place a loved one in an aged care home, do so because it is truly the best decision for their loved one. If you know within your heart you have made the best decision out of all the options, then it’s important to not feel guilty about the choice you’ve made.
Other feelings such as grief may arise, which is perfectly normal, but you don’t need to burden yourself with guilt when you know you chose what was best for your loved one. I also passionately believe that we often assume that staying in your home for as long as possible is the best thing for everyone, which brings me to my next point.
I’ll never forget when Tom* came to me to arrange apartment accommodation for his mum. He insisted the most important thing was that the apartment had a decent kitchen so his mum could bake cakes, which she loved doing. I made sure to present a few options with great kitchens and we went to inspect them.
Once Tom’s mum saw the kitchen, the first thing she said was: “What’s this for? I don’t want a kitchen – I never want to bake another cake in my life! Someone can do it for me from now on.” Needless to say, this promptly ended the tour and we had to go back to the drawing board to find out what Tom’s mum really wanted.
It’s very common for adult children to have a perception of what their parents want, but they’re often recalling what they remember from their childhoods or what their parents liked to do when they were well or a lot younger. Your mother may have always loved baking cakes and living at home, but that was when she was well.
She may have also enjoyed living at home when she had friends, cooked delicious meals and wasn’t scared of the postman. I frequently meet elderly people who are eating nothing but toast every day and are too scared to open their front door. I often ask their children, would you like to live like that?
We also forget that that one of the biggest negative impacts on health is loneliness. In fact, the federal government committed prior to the election an additional $10 million to expand the Community Visitors Scheme for aged care and home care residents. This program matches volunteers with an elderly person to build a friendship with them, either in their own home or an aged care facility. We know there are so many physical and mental health benefits from regular social interaction that occur in communal living. In fact, social isolation is one of the leading causes of health decline in our later years.
Your parents may very well be happy at home, particularly if they have a strong social network or a neighbour that pops in every second day or so, but that is not the reality for many. We must consider how many of our most vulnerable members of our society are home alone day after day.
To find out how your parent is really coping at home, you could ask them:
You may also want to check what food is in the cupboard, if the house clean, has the bed being made etc.
One of the factors that impacts the guilt people feel, is the fear that if something goes wrong in an aged care home – whether your loved one isn’t happy there or you worry about the quality of care – that they don’t have the ability to change the situation.
The language the aged care industry uses doesn’t help either, with many describing an aged care bed as a ‘permanent bed’. However, permanent doesn’t mean you can’t leave or it’s a prison, just that it’s permanent in the same way buying a house is permanent. It’s your home for as long as you want it to be, but unlike a house, in an aged care facility you’re able to leave with seven days’ notice and with no cost to you (again, unlike committing to a mortgage!).
If at any point you feel an aged care home is not suitable for your family member, you can move them into a different residence if you’re not happy. This article goes into more detail about what you can do if you suspect something is not right at an aged care home.
It’s vital to remember that aged care is voluntary. It should be your choice. The difficulty is, when many elderly people are asked: “Do you want to move into aged care?” the answer is invariably: “No.” Also, this is not a really fair question to ask someone when there really is no other alternative. A better question is: “Would you like to have a look at a few options that you may want to consider if you need to move?” We find this often is received by a positive response.
Even when you are happy with an aged care home, families often take residents out for a few hours, a day or overnight, especially for family events or holidays. Independent residents can also come and go as they please, provided that the nursing staff are aware they are leaving and for how long so they don’t worry.
I also remind the people I see if their parent has to or wants to move into aged care it means they will be receiving a lot of ongoing help for their daily living needs, such as medication management, meals, cleaning etc. There’s also the social interaction they receive through organised entertainment and activities that aged care homes can provide.
Remember – aged care is about care and quality of life.
Many clients I work with experience a lot of grief and guilt when placing a loved one in aged care. While this is normal, I know from experience that families will always choose what they know is the best option. Whether that means home care, independent living or a residential aged care home, everyone is different so it is important to focus on what is right for you and your family.
*Names have been changed to protect privacy.
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