“I will never…” This is one of the most common phrases family members utter to their aging loved ones.
I will never…put you in a nursing home.
I will never…let strangers take care of you.
I will never…move you out of your home.
Family members take such promises seriously. But it’s important that family members make peace with the fact that they may not be able to keep these promises indefinitely.
When promises like these are made, the caregiver typically doesn’t know what he or she is truly agreeing to. The family member had every intention to keep this promise but circumstances change.
Maybe your Mom’s dementia is so advanced that she is wandering out of the house each day, putting herself at risk. Since you can’t have your eyes on her at all times, 24/7 supervision at an assisted living may need to be considered. Maybe helping your husband bathe after his stroke is becoming too physically demanding for you. In this case, perhaps a home care agency can help. You may resist taking these options into account because of the earlier vow you made to your loved one.
The truth is, elder care is complex, exhausting and just too much responsibility for one caregiver. It makes sense for a spouse or adult child to reframe “The Promise.” If you haven’t made “The Promise” to an older loved one in your life, resist. Don’t do it. Instead say, “I will make sure you have the best care I can afford.” Or, “I will keep you at home as long as it is safe for everyone involved.”
If your loved one does not have memory loss, explain why you are changing courses: what have the consequences been to your life by keeping “The Promise?” For example, you may explain to your Dad that because you are spending so much time helping out at his house, you have been late to work five times in the last month. Then you can discuss options such as hiring home care, a housekeeper or arranging to have meals delivered. Frequently older loved ones will not be happy with changes they did not initiate but the caregiver must set such boundaries to avoid burnout.
If you have already made “The Promise” and your loved one has cognitive impairment, you may not be able to have a conversation where you can reason with him or her and discuss how the circumstances have changed. Let yourself off the hook. Talk to a geriatric care manager, a psychotherapist, your spiritual advisor or a supportive friend to deal with your guilt. Give yourself permission to reframe your earlier pledge.
Most people, especially older adults, want to remain at home without assistance for the rest of their lives. In an effort to make this dream come true, caregivers struggle with negative emotional, spiritual and physical consequences of trying to honor their loved ones’ wishes at any cost. While it is admirable for caregivers to respect their loved ones’ preferences, it is critical to understand that “The Promise” cannot and should not be upheld in many care situations. In order to be healthy themselves and provide the best care for their loved ones, caregivers must make peace with the fact that keeping “The Promise” is often unattainable.