Dear Imprudence: Can I Stick My Aging Parent In A Nursing Home Yet?

I always love when I can do a ‘doing it right’ edition of Dear Imprudence, and this week we’ve got a doozy from the live chat with Prudence:

Everywhere, USA: My older siblings financially support and care for my sick elderly parent. My parent is admittedly happy as they do not want to live out their days in a nursing home. I live five hours away and get home only two or three times a year and do not earn enough of an income to help. While I appreciate my siblings’ efforts, I disagree with the diet my parent is fed, which is not healthy and caters to my parent’s every wish and whim. I also think that a nursing home is better equipped to care for my parent. This has created a divide in our once-close family. What can I do to narrow this divide?

Emily Yoffe: You can pitch in or shut up. If you’re a five-hour car ride away, you can come on long weekends and prepare the kind of healthy food you think your parent should be eating. Since you contribute nothing financially and rarely visit, and the other siblings have taken on the burden of caring for your ailing parent, and making him or her happy—as you acknowledge—be grateful they have relieved you of this burden. Stop complaining, start acknowledging the sacrifices your siblings are making, and do more so that when it’s all over, your siblings don’t forever resent you.

Let’s see. Everywhere lives five hours away from Aging Parent, doesn’t contribute financially, and doesn’t provide any other support. We don’t know what the circumstances are behind this; it sounds like Everywhere may work at a not so great job that pays poorly and doesn’t provide a lot of time off for coordinating trips home, so it’s good that Everywhere’s siblings are capable of providing care, since Everywhere cannot. This person ‘appreciates’ the ‘efforts’ of the siblings who are acting as care providers to prevent Aging Parent from being instutionalised, but disapproves…of what they are feeding Aging Parent. Because Aging Parent is being fed the food ou likes.

Solution? Stick Parent in a nursing home, of course! Because clearly community-based care from family members is inferior and wrong. Obviously Aging Parent has no established friendships or relationships in the community that might be disrupted by being forced into an institution. And it’s clear that ‘force’ would be involved here because it’s pretty strongly indicated that Parent is very happy to be at home, with family members. I wonder who will be paying for that nursing home, since Everywhere claims to not be earning enough income to help; nursing homes are rather expensive.

This sounds like a divide Everywhere has created, and that’s why I was glad that Prudie came back swinging. Although I could have done without Prudie’s referring to Aging Parent as a ‘burden’ and caring for a family member as a ‘sacrifice,’ the rest of this advice is right on point. Everywhere does indeed need to either start getting involved in caregiving, or zip it.

It doesn’t sound like Aging Parent is disabled, but this type of dynamic occurs both with people with disabilities and older adults. Family members chomping at the bit to pack them off to an institution so that they will stop being a bother. This a narrative that’s also supported and reinforced by the society we live in; look at this letter, where the person tries to claim that a nursing home is ‘better equipped’ to provide care than Aging Parent’s own family. I’m really glad that Prudie pushed back hard on this, because my jaw actually dropped when I was reading the question.

About s.e. smith

s.e. smith is a recalcitrant, grumpy person with disabilities who enjoys riling people up, talking about language, tearing apart poor science reporting, and chasing cats around the house with squeaky mice in hand. Ou personal website can be found at this ain't livin'.

11 thoughts on “Dear Imprudence: Can I Stick My Aging Parent In A Nursing Home Yet?

  1. You’d think anyone who’d ever been in a school cafeteria or admitted to a hospital would understand that institutional food services aren’t anything like meals at home. Whether cooked at home or take-out, doesn’t matter. A simple cheese sandwich eaten at home with people we love (and who love us) will always be *miles* better than a tray of nutritionist-approved food eaten alone among strangers.

  2. This really irks me because I’m reminded of my grandfather. My aunt cared for him and in his last months, he looked like someone you’d expect to see in a documentary about concentration camps or starving people in Africa. This was not because he was eating unhealthy food or because my aunt didn’t care. It was because my grandfather just didn’t want to eat more than two slices of bread per day at best. Unless it was cake or something that he really liked to eat.

    Frankly, unhealthy food is still better than no food, and if it makes them happy, why not? When anyone in the family talked about not wanting to eat unhealthy/potentially dangerous food (I had a rather paranoid episode due to the BSE scare), my grandfather replied: “I’m in my 80s, how much damage can it possibly do?” That was his choice and we respected it.

    Maybe it’s related to the fact that many people thing living healthy is more important than being happy – maybe because they think of being healthy as a prerequisite for being happy. The healthy = happy construct is annoyingly persistent.

  3. I feel lucky that my parents have decided that when they get older, they want to move into a retirement community that is capable of increasing levels of care if they need more help as they age. My sister is not emotionally very stable, and I am both physically disabled and bipolar, and I do not want my parents to suffer if we aren’t able to give them the level of care a person ought to have.

    But a big part of why I like that decision is because it IS their decision. They want to move somewhere that has a lot of social activities so that they’ll be able to forge new friendships among the people in their new community. If my parents wanted to live with us, well, I guess we’d have to find a way to make it work.

    After my grandfather died, we had to deal with making care decisions that were counter to my grandmother’s wishes. She wanted to live out her life in their house, but her alzheimer’s was bad enough that she needed a 24 hour caretaker and she was emotionally abusive to the family members who tried to take up that position, and because of the way she treated people, she could not stay at an adult day care center. In the end, we were left with an unpalatable choice – leave her a frequent hazard to herself (she’d walk and get lost, forget who she lived with or where she lived, leave stove burners and ovens on, that sort of thing) or move her into a small senior care center against her wishes.

    I do not think she was any more unhappy in the center than she had been anywhere else; at that point, she lived my grandfather’s death several years before as the most recent memory she had, and so a constantly raw, new wound. I do not know if we made the right decision. I am not sure there WAS a right decision. The only thing I can say for certain is that trying to be caretakers for her was exhausting, and even in as large a family as we have, we got badly burned out and hurt.

    We tried to make her happy, but her wishes exceeded our capability to fulfill them. It was incredibly painful. My grandmother was very dear to us all.

    ~Kali

  4. ***look at this letter, where the person tries to claim that a nursing home is ‘better equipped’ to provide care than Aging Parent’s own family.***

    That part really took me by surprise. Especially in this person’s situation, where multiple older siblings (which also suggests potential spouses and children, a network of people) prefer to care for their parent themselves.

    There’s no indication of abuse or neglect or even “they’re poisoning him against me!” The sole problem is that the diet is “not healthy,” but Letter Writer doesn’t bother to say exactly how unhealthy, or in what way.

    I think the real problem comes down to the part about “caters to my parent’s every wish and whim.” They’re caring for an older person and doing their best to let that older person make hir own decisions, and the letter writer wants to rule with a sterner hand. I could spend hours exploring that idea and the psychology behind it.

    I’m glad that this letter writer’s parent is with family, and that hir wishes are being respected. And I’m glad that the letter writer was told to get over it and contribute.

  5. The part about “catering to the parent’s wishes and whims” reminds me of a comment I saw elsewhere, on a post about how all the fatties are going to die young, by a woman whose 80-year-old mother is fat! And eats whatever she likes! And won’t listen to her daughter! Seriously, the woman is 80. She’s already surpassed the average lifespan, is active and able to live independently (according to the daughter) and the problem is that she eats “bad” food? Nutrition police and fat police are everywhere – not to mention infantilising of the elderly.

  6. Dear Everywhere:

    You can 1.) shut up and 2.) apologize to your family, because you have been a giant jerk. The diet of your elderly parents is not your concern when you are not there to help prepare food and provide care for them, and when your parent/s and the care providers have not asked for your input.

    If you want to be involved, ASK your siblings what you can do, don’t make bizarre demands outside of the current care plan that would make your parent/s miserable.

  7. I disagree with the diet my parent is fed, which is not healthy and caters to my parent’s every wish and whim

    WHAT IS THAT I DON’T EVEN. BECAUSE GOD FORBID AN ADULT GETS TO DECIDE WHAT THEY EAT. I MEAN, IT’S ONLY THEIR FREAKING BODY.

  8. My grandmother was cared for at home. WHile all children and their families who don’t live in another country tried to visit as regularly as possible, the majority of the work was being done by my uncle and his wife. They hired proffessional help that my gran qualified for, but they were the main family carers. And I will forever be gratefull that they took such good care of her, allowing her to end her life in her home, surrounded by things and people she knew and loved.

    Someone who created a lot of stink about my uncle’s family supposedly not doing a good enough job? My aunt from the states, who only visited two or three times over last five years. And I don’t blame her for not being able to visit more, but I did hate the way she just assumed to know everything better and decided to attack my uncle repeatedly. I am not sure if he will ever forgive her. (And she was the one who suddely made the switch from “mommy is so much happier with me because I know the right way to spend time with her” to “there is nothing left to her. I don’t know if we should not just let her die in peace”). I am not sure if I can forgive her for that.

    My gran didn’t really like eating much in the last years. Something she liked until close to the end? Home-made chocolate truffles. And yes, we made them every time we went. Because they were something she liked to eat. Because they made her happy. Because any food eaten voluntarily is so much better than something that gets cold on the plate because no one wants to eat it.

    The thought that a child should get to dictate their parents care against their wishes when there is absolutely no need for it? And because the diet plan is not sufficently “healthy” (as if “things you like to eat” is not a valid indicator of something being good for you in some way).

    Nauseating. Thank god the parent has other children who seem to respect and care about what zie wants. If the author of the letter were the only relative, zie would probably try to have the parent sent to a nursing home by force.

  9. Indeed, this question struck me as rather rude and patronizing/dominating of the aging parent, who presumably cannot eat what ou wants because ou needs someone else to care for ou. Apart from the burden part, I liked Prudie’s response.

  10. Anyone who thinks nursing homes are a one-size-fits-all answer to the changing needs of an elderly or disabled person never had my cousin’s experience of trying to find a nursing home for our great aunt – most she investigated had major problems and would’ve been as bad in their way as the home living situation which our aunt now found untenable.

    The home our great aunt lives in now is very good in most respects, but like most instutitions, it has its limitations, which include bland food, where the choice tends to be between the hot dinner and a sandwich – and if you don’t like either then that sucks. Specially when, like my aunt, it means losing weight and becoming malnourished. We realised that she eats much better when at relatives’ houses or restaurants, where she can get stronger-flavoured stuff, and between that, relatives bringing stuff in, and the home’s cook trying out some of her recipes, my great aunt’s weight and her enjoyment of eating have increased. As someone whose health problems, and the dietary limitations they create, have often led to people saying ‘just eat healthily’ or ‘just treat food as medicine’ (ugh), I think the latter point of my aunt enjoying her food is as important as the fact she’s putting on weight.

    So the idea that someone would want to step into what sounds like a very loving situation where a family has created a mutually supportive network around the needs of an older person and been able to provide that person with stuff they enjoy eating – that someone could see all that and want to interfere…. that is a really sad thing to read. I’m sorry that the answerer uses ideas like ‘burden’ to describe caring, but glad that she otherwise lays the smackdown.

    I mean, I know of so many families where only one person bothers to help out a sick, disabled or elderly person – and often that carer has their own health and other support needs that aren’t being met within the family either – that I was really touched to hear of how the family in the example is rallying round and enabling their elderly relative to remain in their own home and community. It’s not possible in every family, but where it is, it’s something to be celebrated.

  11. There’s one circumstance where a nursing home can be “better equipped”: when the person requires actual NURSING care. If Aging Parent’s family members are not able to adequately meet hir physical needs, then sure, it’s time to either bring in professional help or turn to a care facility. However, there is zero indication from the letter that such is the case with Aging Parent.

    That’s happened in my life once before, when my father was in the final days of dying of cancer, and had developed dementia from pain medication and probable brain metastases. It’s happening to my husband’s family right now, with his very elderly grandparents — their day caretaker wasn’t able to get them to eat enough or to provide the rapidly-increasing ADL help and 24-hour assistance they require, and we don’t have any other in-home options. They’ve been in the hospital to get their physical needs met, but this morning, they were moved into a care facility. There are some positive aspects to this particular facility, to be sure; his grandmother is actually looking forward to having more people around to talk to, and to having some organized activities other than watching TV all day.

    However, that’s the silver lining of an unavoidable situation, rather than the “better” alternative to adequate in-home care.

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