Judd Matsunaga, Esq.
As the U.S. population ages, the number of people needing Long-Term Support and Services (LTSS) will rise. On average, 52 percent of seniors (65+) will develop a severe disability that will require LTSS at some point. The average duration of need, over a lifetime, is about two years (source: AARP Public Policy Institute, Fact Sheet, March 2017).
But, moving your spouse or parent into an assisted living or nursing home is one of the hardest decisions you’ll have to make in your life. Even when you know relocating your parents to a senior living community is the right thing to do for their safety and health, guilty feelings may arise.
This is particularly important to the Japanese culture, where guilt and shame are such dominant emotions. Sometimes, the same action may give rise to feelings of both shame and guilt. Shame, however, reflects how we feel about ourselves and the guilt involves an awareness that our actions have injured someone else. In other words, shame relates to self, guilt to others.
So many caregivers feel guilty about moving their parent, spouse, relative or close friend to assisted living, a nursing home or memory care. Unfortunately, guilt is a part of caregiving, particularly when you have to make a decision that you know is against the wishes of your loved one. You may have made your parents promises not to put them in a nursing home.
“Many seniors unrealistically believe they can take care of themselves for the rest of their lives,” said Stella Henry, R.N., author of “The Eldercare Handbook.” But when caring for someone at home becomes dangerous or nearly impossible, it often becomes absolutely necessary to move them to a place where they’ll be safe and get the care they need.
“Once in a nursing home, our pain is often escalated by our loved ones begging and pleading to be taken home. Each visit can become a nightmare of pain and suffering for you both. Emotions range from feeling inadequate to feeling overly responsible,” said Dr. Stephan Quentzel, a psychiatrist in New York affiliated with Mount Sinai Beth Israel Hospital (source: Psychology Today, May 2, 2017).
Unfortunately, the reality is that even if this is the best decision for their health and for yours, the guilt and sadness can still be overwhelming. It hurts when you have negative thoughts and feelings about a decision you were forced to make. Your heart will need some time to catch up with what you know in your head.
Borrowing a line from O’Reilly (played by Charles Bronson) in “The Magnificent Seven” (1960), this type of guilt “is like a big rock that weighs a ton. It bends and it twists them until finally it buries them under the ground. And there’s nobody says they have to do this. They do it because they love you, and because they want to. I have never had this kind of courage.”
We don’t want that. So, while you’re adjusting to the changes, the experts say it’s helpful for you to understand what’s causing the guilt, which can help you accept the decision to place your loved one and reduce the guilt and emotional stress. Here are three ways to cope found on the website APlaceforMom.com (https://www.aplaceformom.com/planning-and-advice/articles/parents-senior-living-guilt):
1. Focus on the Small Victories
Did your parents enjoy a meal or activity in their new home? Do you sleep better knowing they’re less likely to fall in their new surroundings? When guilt creeps in, remind yourself of the benefits of their new home, experts say. “Small victories include excellent palliative care, creating meaningful activities, even keeping our parents together for as long as possible.”
2. Accept Some Uncertainty
Being put in the position to make critical arrangements for others is often hugely stressful. When the task concerns relocating your parents to an assisted living community or nursing home — a decision with enormous financial and lifestyle consequences — the anxiety and second-guessing can be even higher. Remember why you made the choices you did, but know that some uncertainty will remain about how things might turn out.
3. Give It Time
As with any change, there will be an adjustment period — for children and for their aging parents. It will likely take time for your parents’ relocation to senior living to bear fruit. Strike up a conversation with family members visiting their loved ones and ask them how they dealt with the change. Enjoy meaningful moments with your loved one and restorative time doing what you like to do during this transition period.
For most of us, the guilt we feel is unjustified. We have to remember that even though we feel guilty, it does not mean that we are. Recognizing the enormity of the tasks in front of us, all we can do is to try our best. We cannot possibly do it all, even though we may try. We feel over-responsible, out of control and helpless at the same time.
The result is experiencing caregiver burnout and resentment. Even if we could do it all, we would still find something to feel guilty about. It just goes with the territory. We all make promises with the best of intentions, but events and situations change, and we cannot keep our word. We feel we have failed. We berate and blame ourselves for all those things we “should have” or “could have” done.
What many family caregivers don’t realize is that you will still be part of their caregiving team. Your loved one will still need you as their advocate. Accept this newly defined caregiver role and the benefits it provides. A reputable nursing home will provide your Mom or Dad with the care and engagement that they require. That’s a winning situation for both sides, so put aside the guilt and shame.
Judd Matsunaga is the founding attorney of Elder Law Services of California, a law firm that specializes in Medi-Cal Planning, Estate Planning and Probate. He can be contacted at (310) 348-2995 or judd@elderlawcalifornia.com. The opinions expressed in this article are the author’s own and do not necessarily reflect the view of the Pacific Citizen or constitute legal or tax advice and should not be treated as such.
