15. What happens if my mother gets too sick to stay at home? She is terrified of ending up in an institution and has asked me to promise that I won’t “put her” in a nursing home. It is hard for me to figure out what to say.
If you are over 40, chances are you’ve had a similar conversation with someone you love. It might come up if you see a segment about nursing homes while watching the evening news. “Promise you’ll never send me to a nursing home,” your mother says. This request usually reflects what most of us want: to stay in our own homes, to maintain independence, to turn to family and friends for help.
Sometimes, however, parents really do want their adult children to make a promise. Think carefully before doing so. According to the Centers for Medicare and Medicaid Services, “Quality of care means doing the right thing, at the right time, in the right way, for the right person, and having the best possible results.” Agreeing that you will not “put someone” in a nursing home may close the door to the right care option for your family. It requires you to know that no matter what happens you will be able to care for your parent. The fact is that for some illnesses, and for some people, professional health care in a long-term care facility is the only reasonable choice.
When faced with a parent who is truly ill or frail, long-distance caregivers may find that some promises hamper their ability to do what is necessary, either for their own health, or for their parent’s. Many people discover too late that the promises they made (“Of course you will be able to die at home.”) cannot be kept.
Try to focus your commitments on what you know here and now. If asked to make a promise, you could say something like, “Dad, I will make sure you have the best care we can arrange. You can count on me to try and do what’s best for everyone. I can’t think of a situation where I’d walk out on you.” Base your promises and decisions on a realistic assessment of the current situation or diagnosis, and realize that you may need to revisit your agreement. Your father’s situation might change. Your situation might change. You truly do not know what will happen in the future—disease and illness can lead to enormous changes. And, of course, it’s not only your parent’s health that changes—your own health may alter over time, too.
If you’ve already made a promise to a parent, remember you can bring the subject up again; you can change your answer to something more specific, something you feel you can undertake. As hard as that conversation might be, it may be better than risking the guilt of a promise not kept.
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