So many times, my clients are faced with a very difficult decision: when is the right time to transition a loved one suffering from some form of dementia from their home into a care facility? Sometimes they are so overwhelmed, paralyzed in fear or guilt that they are unable to make the decision and end up waiting too long until they have no options left other than a nursing home. Don’t wait—there are numerous and wonderful options available for you and your loved one. There is a better way.

For those of you who are curious about what is available in an elder care facility, I prefer the term care residence; this term speaks more appropriately of the setting, style and care plan that is offered in so many places today. These care residences range from a three to fourperson residence, up to as many as 80-person residences, sometimes more. If you are imagining an institutional setting, think again! Their styles vary in luxury and accommodations. These care residences range in styles, some are like a private home and others are more like a luxury hotel with private suites, minus a stove.

Their meals are provided three times a day in a formal dining room and snacks are typically offered twice a day but are available at any time. There is plenty of friendly and compassionate staff, aides and in most cases nurses to assist at any time, day or night. These care residences are designed to take the pressure and worry off of the family members and/or caregivers making sure all your loved ones’ needs are met and ensuring them a greater quality of life. Your loved one will make new friends who are in similar stages of life, finding comfort and companionship. There is social interaction available at all times, yet if your loved one prefers solitude they can find it in the comfort of their own suite. Care packages, including but not limited to medication management, are designed based on each resident’s specific care needs.

Here is a typical question from an anonymous and overwhelmed caregiver:

Q: I promised my mother many years ago that I would never place her in a nursing home. My mother is getting worse with Alzheimer’s; I am so worn out physically, and really even more emotionally. I myself have health issues. Should I consider Mom being placed in some kind of care facility, and how would I approach this with her? This is the most difficult decision I have ever had, and it’s all on my shoulders, all alone. I love her so, and all I can think of is how I promised her those many years ago. I’m just so, so tired.

Answer, by Kenneth Robbins MD: 

I certainly understand your struggle, and you clearly meant what you said when you promised your mom to never place her in a nursing home. However, what you were really promising is that you would be there for your mom and only do what you believed would be in her best interest. In the end, that is the best thing we can do for our parents. One never knows what life is going to bring. In the abstract we would all say we don’t want to end up in a nursing home, but nursing homes exist for a very good reason and many loving families end up having to put relatives in nursing homes because that is the best place for them to be. I might add in your case, it may be your mom belongs in an assisted living facility, rather than a nursing home, so you may fulfill your promise after all.

The decision about the right time to move a parent with Alzheimer’s to a care facility is always challenging, but keep in mind you are not looking at putting your mom in a warehouse. As someone’s dementia progresses, it is important they are in a safe place in which they have care when they need it 24 hours a day, and where they can continue to be active, both physically and mentally.

At some point it is simply not possible to provide all this yourself, and if you allow your guilt to get in the way of making the best decision for your mom, you are doing her (and yourself) a disservice. If you take the time to carefully look over the various facilities that can help your mom and find a caring place with a staff who have the training to help her, you have done everything you can do for her. It is important to keep in mind that if you wait too long, her memory will be so impaired that the facility will never become familiar and she will never feel at home there. Once she is there, you can spend as much time as you like with her, but as her son rather than her caretaker. This may also help her to not feel guilty about having to trouble you to get her needs met. If your guilt continues to wear you down, I would strongly suggest a few sessions with a mental health professional to talk it through.

So take a deep breath, know you are not alone in feeling the distress, guilt and anxiety and reach out for guidance and assistance.