Nursing home guilt, any advice?

Dear "CindyLin,"

Boy, I felt your mom's gut wrenching statement pierce my heart and it's no wonder you are obsessing over the guilt.

I'm sure it's difficult on everyone's part after rotating her between you and your sister's and now being in a nursing home with the COVID-19 lockdown. That certainly did not help with how your mom views her life in general.
Not only could you no longer care for her because she fell and broke her hip but, that realization is even more true now that her condition has worsened because of her present situation - she needs 24 hour care and you can't seem to set the appropriate boundaries I'm guessing because they weren't there to begin with. So at it's worst, you find it would be "nearly impossible" to set them now.

Since I don't have any answers, can you ask yourself if the guilt would still be there if your mom hadn't vocalized how she feels? Did it feel like she said it hoping you would feel guilty? And even though I can't tell you how to handle it, I can at least reassure you that many of us feel guilt at some point(s) when being a caregiver for our loved ones. We don't like to see what is happening to them and we want to somehow be able to "save" them from the inevitable. What would have to happen with your mom/situation for you not to feel guilty? Is the scenario perfection? If so, than you could never attain something that doesn't exist. None of our situations are perfect, we're just doing the best we can as each twist and turn occurs. I hope you can somehow ease up on yourself along with the expectations you may "think" your mom has for you as well as the expectations you have for yourself. Also, I'd be curious if your sister is struggling as much as you are with feeling guilt.

I wish you peace within your heart and I hope someone else on the forum will provide you with the suggestions/guidance you are seeking!

In your profile you write that your mother was difficult to care for BEFORE she broke her hip, due to her cranky disposition.

And now she needs 24/7 care.

You are aware, aren't you, that one person cannot do 24/7 care without break or respite? Young parents do it with newborns, but only for a short period of time. And that's when we are young. And usually there are 2 parents, and perhaps a grandma at hand.

Your mother is being unreasonable in saying that the fact she is in a nursing home means no one wants her. I hope maybe she's lost her filter due to some cognitive decline, but if this is her usually mode of operation, then she is using a technique called Fear, Obligation and Guilt (F.O.G.). Look it up. Frequently employed by folks with Narcissistic tendencies or full blown Narcissistic Personality Disorder. Nothing matters but what SHE wants.

I take it that if your mother is 90, you are no spring chicken yourself.

You have an important role to play here as your mother's advocate for her to get the best care possible. If you become ill from 24/7 caregiving, or from beating yourself up out of guilt, shes not going to have you looking out for her.

If she tries that line again, I'd say "nonsense, mom. You need far more care than can be given in a private home. We love you and THIS is what the doctors say you need". Be brisk and forthright in shutting down her self-pity.

Is her PTSD being treated by a psychiatrist? Is there depression as well? Getting my mother good psychiatric care was key in helping her remain calm and unagitated as she aged.

Guilt is for folks who've done something wrong. You haven"t.

I know feelings of guilt can feel unbearable. My mother passed away almost a year ago, I was her primary caregiver for several years before placing her in first a memory care then a nursing home despite promising her years earlier that I would never place her. Maybe guilt is a measure of love when you can't take a different course. Maybe guilt is the price for still caring when you can't meet their needs yourself. I don't know. Perhaps guilt, painful as it is, is an attempt to not accept how life has become, of staying connected to our loved ones as they go through this part of their life. I do know that forgiving ourselves is not being disloyal nor is it lack of love.
I hope you are not too hard on yourself and come to terms with the loss and take some comfort in the caring and good that you have done.

We often choose guilt so that we do not have to look at grief. It is worth grieving that we live so long that people honestly are unable to care for us in a home and still maintain their own lives and health. You might tell you Mom that honestly you DO feel guilty and inadequate, and that you are so sorry that you are not able to do what she would like, but that--in fact--you are not able to. And that you have cried over your human limitations more than she can know. Hon, I am famous for saying we are not Saints. We are human beings, flaws and full of limitations and inadequacies. If we are decent human beings we spend a good deal of our lives thinking of the many ways we have failed our parents, our siblings, our spouses and friends and children. But we do the best we can at the time with what we have to work with. Saints get shot full of arrows and killed, then we pray to them to fix everything. A bad job description, that one. It is worth grieving over, so allow yourself you grieve what life has come to with all its losses for your 90 year old Mom. We will, most of us, experience this if we live so long. It is worth grieving. But unless you are a felon, then guilt is honestly not the word for it.

When somebody falls and breaks a hip, it is usually osteoporosis and the reality is the hip broke and then they fell. It is very hard to heal broken bones when osteoporosis is that advanced and moving those people usually requires at least 2 people. So, please do not buy into the guilt your mother is trying to lay onto you. Instead, tell your mom that you love her very much. Let her know that you are unable to provide the type of care she needs and that is why she is in her new home.

First of all your mother’s statement is one many elderly use when they are moved into a nursing home. She’s not unusual in that regard.
Also realize you yourself are allowing the guilt to consume you. You can’t feel guilty unless you want to. I would suspect you are wishing you could just make her happy, but sadly that truly isn’t possible.
My dad never adapted to living in the NH the 2.5 years he was there. It made me sad that was where he had to go but I was realistic. I knew it was the only way he could get the care he needed. Are YOU being realistic?
We are not responsible for Covid, or how NH are isolating our family. My dad died during Covid from age and dementia. It was very sad, but I feel no guilt for things out of my control.
please get counseling if it is causing you this much angst.

You are doing the best for your mom. There is no way you could bring her home. Actually trying to care for her at home would probably cause her more pain. Please tell yourself that you are a good daughter and are making difficult decisions for her best care. This is a common complaint among the elderly whether they are injured or not. I have been a caregiver for my dad , who just passed, and now have my mom and a very elderly aunt. They are demanding and manipulative. Take a step back and enjoy a mini break even if its just one day. I wish you peace and joy.

First off - STOP THE GUILT TRIP ON YOURSELF. Your Mother is in the best place for her. Unless she can do part of her assistance for herself, she is where she needs to be.

My mom tried some of the same tactics with me. I just reassured her that I loved her and explained that I was the one that was unable to give her the level of care she required ( i.e., lifting, bathing, etc.). Then I changed the subject.

Mom fell on Mothers Day at her assisted living facility (totally her own doing). She stayed on this earth only six additional weeks (she was 98 years old). Covid-19 has made life for our elderly a real nightmare. Bless you for all you have done for her and take the time to celebrate her life.

Do little things that can be given to her to show how you feel - cards, notes, tiny gifts, flowers, if possible -- anything you can think of. She is lonely and feels forgotten, just who wouldn't under todays world.

Don't worry about "boundaries" at this time, just let her know you think of her often and that she is exactly where she needs to be for her care and her safety at this time.

Good luck and God bless.

Your mother's statement was awful and made to make you feel bad. Shame on her for that. By placing her in 24 hour care you are doing the most loving thing you can for her. You and your sister cannot dedicate every waking moment to your mom's care. Go back to being her daughters rather than her caregivers.

You have done your best.

Some reach the point where they need to be in a seniors residence. It is not their fault anymore than it is yours. Sometimes we have to deal with the crappy hand that has been dealt to us.

Do not allow your mother to manipulate you.

Nursing homes are far from safe, and it is not uncommon for people to go downhill after placement.

I completely understand what you are going through. Believe me when I tell you that placing her in a nursing home is the best thing you could have done.

Like you mom, mine had taken several falls, broke her hip and ended up in a nursing home. I did all I could from moving her in with me (totally interfere with family dynamics), and moved her into senior housing with on site assistance. She fought me all the way. All I heard from her was how badly I was treating her. Nothing mattered.
After she came to terms with living in a nursing home she become the social butterfly she use to be. When I would see her of course she would cry and act out but the staff would tell me that when I wasn't around she was always laughing with others etc.
My mother passed August 18, 2019. I also feel bad at times yet I know that she now being in heaven knows just how much I did love her.
Stay strong and lean on God for understanding.

Forgive me for being curious, but did your mother take care of her mother or grandparents? It seems that those who were never caregivers can be much more insistent on care than those who have never worn that cap. My mom's parents were cared for by family members who lived close by. Mom lived more than a thousand miles away and had nothing to do with her parents' care. She managed on her own quite well into her late '80's when she started needing a little assistance. One sister started with the assistance early on. Since then her needs have grown considerably and four of us do what we can. She has no concept of how much work we do nor how difficult it is for us.

I know others in the same boat. We all have the same thought: we will never do to our children what our mothers are doing to us. In every case the mother simply does not understand what she is costing her children in terms of physical and mental stress.

A number of my mother's friends have voluntarily moved into senior residences of one kind or another. The commonality? Either they have no daughters or they cared for their own mothers. In the case of those who cared for their own mothers, they have a much better perspective of what it is like.

Tell her that you want her safe and well-cared for and that her needs go beyond what you can give her. Then change the subject. Do not obsess over those guilty feelings. You did what you could until her condition required other options. When you feel a twinge of feeling sorry for her or guilt that she is not happy, write her a cheerful note on pretty stationary and mail it. Those little notes will cheer her for longer than it takes you to write them and you will have done something to counteract your own response to her unhappiness as well. Pick up some nice little things at the dollar store to include in the envelopes of those "thinking of you" notes. It is too bad that the pandemic keeps us from visiting because those visits can help both the visitor and the visited. Do your best with phone calls, Zoom, and the notes. Remember, your best is all you can do.

Let's start with a definition of guilt:

"the fact of having committed a specified or implied offense or crime."

So, have you committed an offense or crime? Nope.

She fell, which is not your fault, unless you pushed her down, but that isn't likely. So, you have no fault there and should not allow guilt to consume you for that.

She had to go to NH to get proper care. Again, you have no fault in this, it is what it is, it happened and there's really nothing you can do to change that. Very few of us would be able to provide the needed 24/7 care. You are not Superwoman or Wonder Woman, so what offense or crime has been committed? None. IF you neglected her, sure, but you/sister ensured she was taken care of, that is what counts!

Because of the virus, lock downs are in place, so you can't visit to console and assure her in person. Not your fault. Not even facility fault. Again, it is what it is, there's nothing we can do to change that, so guilt should not play a part here.

For now the best you can do is maintain contact by phone or video if that's available. Reassure her that you DO care and plan to resume visits when it is allowed. Encourage her to work with PT/OT, if this is provided, to build up her strength so she can return home. This last bit is to get her working on getting stronger. There may never be a chance to come home again, but give her hope! You never know, she might recover enough to come back, or at the very least join you and your sister for outings after lock down is over.

Send encouraging and cheerful cards, notes, little gifts, flowers. Anything to help cheer her up and ask how her progress is going. Keep encouraging her, saying you want her to work hard, get strong and come home!

Meanwhile, both you and your sister need to understand that you have done NOTHING wrong, therefore feeling guilty is a useless emotion. Pour your energy into encouraging mom (yes, she's likely going to be the piss-ant in this whole process, but tune that out!) Remind her that eventually the lock down will be reduced or removed and you can visit, maybe take her out for a bit.

My mother's facility (IL/AL/MC) has been on lock down since 3/16. Recently they began offering brief outdoor visits. I haven't yet taken them up on this, mainly because, like your mother, mom's hearing is pretty much shot, she has Mac Deg too, and has for months refused to stand/walk without major help. She also has dementia, making things more difficult. Given that we have to stay apart and wear masks, there's not much ability to have a conversation. I had asked if they have a white board we could use, but no. I was using a Boogie Board LCD tablet to write and clear what I say to facilitate when visiting before, but we can't use that if we're 6' apart!

Hard as it is, understand NONE of this is you or your sister's fault. Guilt should only hound you if you've done something wrong! Both of you have done what you could prior to the hip break to care for her, so that should be some consolation for you! You did more than I did!

Why on earth do you feel guilty. You had nothing to do with the virus and she is getting 24/7care so she is safe and being tended to. Be at peace that you did the right thing for her. If she is 90, getting worse is part of the process of life at her age. You did not cause that.

I don’t know your age but my sister and I kept my mother at home as long as we could and got caregivers BUT when she had to have some emergency surgery, she was worse than ever with the dementia which was deemed moderate by the doctors. She also was bedridden with arthritis and could not stand at that point. It got to be way too much for us. Dad was falling trying to get her up at 2:00 A.M. and they both ended up in the floor. He was 85. Even the doctors said she needed to stay in the nursing facility after her rehab. She was falling out of bed thinking she could walk and all at home. We bought motorized recliners, walkers, you name it to try to keep her at her house comfortably but Daddy mattered too. My sister had to see a chiropractor from pulling on our mother to get her up to potty chair. It was becoming a nightmare! SO, take it from those of us who have been in your shoes. Do not feel guilty because a parent will actually take you down because they still see you as a healthy adult child. They become selfish because they are desperate to NOT adjust to the situation and help you to help them. They lose their filter too so they say hateful things sometimes. Brush it off and know you are doing the right thing. They have UTIs at that age fairly often and they can be easily tested and treated in a 24/7 facility. My Dad had even bought a handicap van and 3 of us went on multiple doctors appointments when she was at home. You get the picture by now. Accept that your Mom is aging out and just talk to her via phone and when this insidious virus is over, you can visit her as often as you wish. Take care of yourself and stay in touch with the nurse’s station at the nursing home and you will feel better. You are doing the right thing. You are a good daughter. Mom will say things to dig you a little but you are wise to that if you read posts on this forum.

Imho, as you are NOT a trained medical professional, you cannot take care of your mother. You must let go of the guilt, else you fall faint and ill. Prayers sent to you.

You did not cause your Mother to get old.
Neither can you cure it.
You, your sister & your Mother all have your own life journeys to live. You can share wonderful times together but no-one has the right to expect another to give up their life journey.

A Social Worker told me that.

If your Mother needs so much help you have to give up so much of your life to live only hers, it's time to look for more help. A nursing home is just that. More help. You still love her!

She actually is in a better place than yours IF you can't properly take care of her in every way.  24 hour care means you or someone needs to be around all the time.  And of course the guilt trip is always played out when they can't have their way or IF not possible.  The caregiver MUST take care of themselves first otherwise they can't care for the patient.  I am sure most people would rather not be in a NH but when family members can no longer physically care for the patient there is not many other options.  I know with the lockdown people cannot physically visit but IF your mother has a window in her room or if the NH has a place where you can visit thru windows, that would be one option to see her.  Does she have a phone that maybe you can call her or get one of the nurses (during a NON busy time like not at lunch time or bed time) to call you and hand the phone to her so you can talk.  or by zoom (which myself haven't figured out yet, need my kids to help me with that).  But do NOT feel guilty that you cannot handle the caregiving at this point.  You apparently did plenty before which you should be proud of and I am sure she appreciated it.  Everyone has some depression due to this virus thing, but don't feel guilty that she is somewhere where she can get meals on time, her meds on time, can watch tv, be given a bath, and taken care of when needed.  Wishing you luck.....and maybe find some online counseling for your guilt.

My 101 1/2 year old mother was discharged from the hospital after 3 days treatment for UTI and delirium. I brought her home. The hospital social worker is helping me get the proper attendant care for her so I can get a break as I am her only caretacker. I don't know what state you live in but the state I live in has programs that help the elderly stay in home if they have been determined to be at a level of needing snf care. I will be getting help to bath her, feed her and give me some respite by having one stay with her every so often, also visiting nurse to check her vitals and meds. There are of course monetary limits of the care provided depending on the person's income. Much depends on income level. Check out Area Agencies on Aging in you own area. They at the very least can help head you in the right direction for your particular needs.

It must make you feel terrible to hear your mother say that "nobody wants her." She might really feel unwanted or might just be guilt-tripping you. Can you reassure her that you love her but that you are not a "good enough nurse" to take the best care of her. If she is stubborn and vindictive about it, it sounds like she's trying to make you feel guilty, but if she really feels no one wants her maybe some reassurance will be helpful.