Placement or Home Care?

by Betty Weiss

People often ask how will they know when it's time to place an Alzheimer's loved one. There is no 'set' time. Placement will not improve the patient's condition. The disease will progress at its determined pace whether in the home or in a facility, if cared for by a family member or a staff of professionals. Many caregivers are like new mothers, believing that 'no one can take care of my baby/my Mom as well as I can'. They think placement will make Mom worse, it'll kill her. Unless it is a snake pit of a facility and no one is making regular visits, that's not likely to happen.

Few understand how daunting it is to take care of someone all alone with Alzheimer's. The only reason for placing an Alzheimer's patient is when you cannot get enough in-home help and there is no one in the family healthy enough, young enough, well enough, strong enough, willing enough to continue unrelenting 24/7 caregiving, doing the work of a professional staff all alone for years with no end in sight. Fifteen percent will die before their contemporaries; far too many die before the patient they are caring for; forty-three percent will fall into a clinical depression that can linger for years, even after the loved one dies; and elderly caregivers with their own chronic illness have a sixty-three percent higher mortality rate than their non-caregiving peers. Placement is really to save caregivers because their well-being is every bit as important as that of the patient but is too often put on the back burner. Further, it can crack a marriage wide open and take parents away from their primary task of being there for their children. So, it's a dilemma few want to face.

Placement is most often harder on the caregiver than the loved one. Normally, a patient will adjust within a month or so, but the caregiver can't get over the guilt, visits all day every day and talks about bringing Mom or hubby back home. They worry about the promise made to never place Mom in a home, the marriage vows they really want to keep. It's a good guess that most Alzheimer's patients in a care facility had a loving caregiver who never-ever meant to stop being the one and only true home caregiver. But the hard facts of life are that life, itself, intrudes on all our plans. We take a vow when we're twenty to cherish in sickness and in health, but fifty years later that young, healthy, strong, confidant bride is a great-grandmother with her own aging problems. Or you promised your Mom that you'd never put her in a nursing home, but now you have one child in college, a couple still in high school; increasing rifts in your marriage and your own health is neglected because you just don't have time for everything.

Some indications that a caregiver needs significant additional assistance and might consider placement: Not sleeping; crying uncontrollably; not getting things done; anger at and hitting your loved one; relationships with others deteriorating; increased drinking, smoking, use of drugs; poor appetite or uncontrolled eating; retreating into yourself; thinking no one else can adequately care for your loved one and refusing help; always feeling sorrow, guilt or hopelessness; patient's health is declining and needs constant medical care; your own health is deteriorating; feeling like you're living in limbo; you keep thinking of getting just a little break; the idea of a care facility is not as unacceptable as it was in the beginning; doctors and other medical personnel are recommending placement to you. Certainly, caregivers need to make their own choice between placement and continued home care. But a vow to take care of someone does not mean you have to do it all alone at home 24/7 for years until you drop. It still fulfills your pledge if you get help in the home, turn to family and friends, and maybe it means placement. Placement is not abandonment, it doesn't mean failure; it's accepting reality. Your loved one will still require your active care participation--it's not a free ride.
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About the Author

One of hundreds of articles about topics of interest to seniors that are posted on Today's Senior Magazine. This article was submitted by Betty Weiss and published in our May 2006 Edition.

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