The Nursing Home Decision: Families Adjusting by Miriam Zucker, ACSW
"Sleepless questions in the small hours: Have I done right? Why did I act just as I did? Over and over again the same steps, the same words: Never the answer."
-Dag Hammarskjold, Markings
Throughout the life cycle, there are separations that highlight our transitions from one juncture to the next. First days of school, the departure for college, a new job in a distant town, all force us to deal with the pull of home and the desire to push ahead. However, the separation that is experienced with the placement of a spouse or parent in a nursing home holds little sense of this pioneering spirit. Instead, we are left with feelings of ambivalence, failure and guilt. We are enmeshed in this web. Was such a decision really necessary, we ask? Could we have waited a little longer? We mercilessly interrogate ourselves in a court of the mind that offers no freedom and finds no innocence. Then, in the early morning hours, when loneliness seems unrelenting, we sentence ourselves to a life of pain and guilt.
For the spouse who is dealing with the placement of a husband or wife, it is a feeling of loneliness that is most agonizing. Time that was once devoted to caring for a wife now stretches before us. While visits to the nursing home are frequent, it is that time after returning from the nursing home that seems so empty. "The days are all right," one gentleman commented to me, "I visit my wife each day, bring her some ice cream, take her for a walk. But then go I home" he wept, "and I think about what she used to do at home. It will never be the same." If we are indeed mourning the passing of lives together under one roof, how do we deal with the separation that, as one person put it, "is an end that is really not an end?" I listened to one such woman who recently came to my office. She had placed her husband in a nursing home some two years ago. "People tell me to get on with my life," she said with outrage. "Tell me how to do that," she begged. "They make it sound like he's dead. It's easy for them to say because they don't see him everyday. They never see him," she sobbed in frustration.
For adult children who have had to make the decision to place a parent, it is often the sense of guilt that pervades. We have broken the unspoken promise to return the caring. Furthermore, as one middle aged child commented, "I have taken the last bit of dignity away from my mother...her home of forty-two years." For others, there is a sense of anger at all we have done for Mom over these years. We are relieved that we no longer must carry the burden of caring. Her demands were always great, we remind ourselves, but the gratitude was never to be found. Nonetheless, the hardiest among us return from a visit to the nursing home wrenched by the words, "Take me home. When will you take me home?" We know the answer as we desperately try to rid ourselves of the guilt and manipulation that our parents still impart on us.
How do we vindicate ourselves of this self-imposed sentence of guilt? It is a labor indeed! Initially, we must accept, as one author stated, that the move into a nursing home represents the lesser of two evils. It is here that a spouse or parent can receive the kind of care that he or she needs at this point. If we can accept our decision in this light, then we can view our guilt as something we can control. Mom and Dad can dish it out, but this is not the time to be a good child and take what is given. Remember what almost happened to Hansel and Gretel!
The loneliness that accompanies nursing home placement can also be reversed. This time it's community service that will ease the sentence. Take an active role in the nursing home. Helping hands can help a hurting heart. Beyond this, good friends and family can play a crucial part. Recognizing that this situation walks a fine line, discover how much and what type of activities feel good. Finally, take just a bit of the love that you have given so unconditionally to your spouse and bestow that gift upon yourself. Recall the happiness it has brought and can still bring.