Weighing the Options when it Comes to Care for the Elderly

Earlier this year, one of my dear elderly neighbors slipped in her garage, broke a hip, and landed in a rehab facility. She’s been there for the maximum three months; now it’s decision time for her kids.

Should they:

  • Bring her home and hope she can handle life all by herself, or
  • Transfer her to a nursing home permanently

It’s not an easy choice. On the one hand, she’s frail, never really exercised, and lives alone. On the other, she owns a one-story home, is financially comfortable, still possesses her wits, still drives, and has caring neighbors to check on her. And her kids live nearby.

How old is “too old” to look after oneself? Eighty? Ninety? I’ve known people at twenty-one who were unable to tend to themselves, either because of mental or physical disabilities or because of sheer laziness. I’ve also known people at forty who were unable (or unwilling) to look after themselves. So it doesn’t appear to come down to age.

Still, all of us eventually (if we live long enough!) are going to face this dilemma, whether for our parents or for ourselves. I wonder how many have made provisions? How many have even made their wishes known to their loved ones?

My neighbor’s kids have been fixing up their mother’s home, roofing and painting and all that. They’ve done it on the sly, coaxing the neighbors not to tell their mother because they wanted to surprise her.

I’d like to believe they did it out of the kindness of their hearts (with maybe a tiny bit of weariness over hearing their mom complain the house was “as old as she was.”) I’d like to think she’d ooh and aah when she’d walk in, marveling over the makeover and eagerly anticipating the rest of her life in a like-new dwelling.

But something tells me she won’t get to see the improvements.

You see, one of the kids confided to another neighbor that they intend to sell the house and move their mom to a nursing home.

She forgets things, they said. She might fall again, the house is too big for one woman, she needs to be around other people.


This is a woman who likes her privacy, who never really was a social butterfly, who was comfortable in her surroundings. She could afford to hire a caretaker — full or part time, live-in or not — to help out, to ensure her dignity remains intact, and to permit her to stay in her own home.

I wonder if her kids even asked her wishes or if they simply decided what was best for her (and easiest for them). Knowing my neighbor, she’d agree to anything that wouldn’t inconvenience her loved ones. She’s that selfless.

But most studies nowadays confirm that people tend to do better and live longer in their own home. Shouldn’t she be given that chance, rather than shipped off to a group facility where she’s surrounded by people lying in beds or sitting in wheelchairs, staring out windows and waiting to die?

13 thoughts on “Weighing the Options when it Comes to Care for the Elderly

  1. Unless they already have control of her finances, or intend to take her to court, it isn’t their decision. But the way it sounds, they’re not thinking of her. My God. She’s not a dog to be put in a kennel!! We just moved my Mom to a rental house that is 4 blocks from my house. Bill and I are retired so we are the kids who can be most available to help her. It has been wrenching for her, selling her house that she and Dad built. But she fell and broke a femur in two places, and although she’s recovering, she doesn’t want to live so far from help any more. We are optimistic that she’ll be independent again, but if not, you can be sure we will explore other options with her. And SHE will decide! (God willing.)

    • Lynne, y’all have tackled this decision with love and reason, the way ALL such decisions should be tackled! My heart breaks for people who don’t have family who love them enough to let them keep their dignity while accepting periodic help. The hardest thing is seeing the elderly ripped from their homes and tucked neatly away for others to tend. No, none of us wants to wipe behinds or administer insulin shots or hundreds of other thankless chores, but this is their mother, for crying out loud, and the least they could do is hire her the help she needs!

  2. I’ve seen enough of these issues that I’m going to avoid judging the kids’ decision because I don’t know what other factors may be involved in making their decision. My grandma was very vocal in her younger years that she never wanted to go to a nursing home. She would rather die. So, when the Alzheimer’s got bad enough that it wasn’t safe for her to be on her own, my parents moved her into their house. My grandma didn’t like that either and insisted that she wanted to go “home”. For three years, my parents cared for her (with support from my Aunt and Uncle.) A few weeks before my grandma died, they finally put her in hospice care – the first and only caregiving break they had in three years.

    Now, seven months after my grandma’s passing, all four of her caregivers are still feeling the effects. Their own physical and mental health has declined and their rate of aging accelerated, I believe from the all-consuming task of caring for my grandma. They wouldn’t have done it any differently, but I still worry that they won’t get back on their feet. My mom has told me that they don’t want us to go through this – she wants to go to a nursing home. I don’t know if I will be able to comply with her wishes or not.

    It does sound like your neighbor is in a better position to be able to live with part-time or full-time assistance, but there could be other reasons why the family feels this isn’t a viable option. I don’t know. If the reason is that it’s just easier, then that’s a regretable decision they will have to live with. Their own children will probably return the favor when their time comes.

    • Janna, I empathize with your parents’ dilemma — wanting to honor your grandma’s wishes but I’m sure worried about the effects on themselves and their family. It’s never an easy situation. You’d think somebody smart would have come up with something by now that would address all the circumstances but, like you say, each situation is different. My mom refuses to go to a home in her later years (after seeing her mom go into one and die an early death). At least my neighbor should have a choice, having the money to afford live-in help and having control of her wits! Thanks for sharing your experience!

  3. Certainly she should be apart of the decision process and in a perfect world her kids would do everything possible to honor her choice–including giving up some weekend and after work time. I have a friend and both her parents need help living in their own home. Substantial help–much more than your neighbor seems to need and along with her sisters they devised a plan and a schedule to make sure her parents are well cared for in their own home. We helped our neighbor stay home for as long as possible–kept an eye on him from a distance at his kids request.
    I am not naive about the worry and the care that goes into helping an elderly family member make decisions about their future. Grandparents and an elderly aunt have made me all to aware of the possible heart break and worry…but it has to be a joint decision whenever possible not one based on younger persons idea of what is “best” or ” easier”
    Your neighbors kids might find their mom is much more adamant than they ever believed possible when they try and make the decision to move her. . .

    • With people living longer today, we really should have come up with a way to make sure their Golden Years really are golden. Too many “kids” just can’t tend to elderly parents because they don’t have the training, the time, the proximity, or the patience. But if the parents have been frugal with their monetary resources and they need specialized help but want to stay in their own home, I say let them try. If that fails, the family needs to sit down and logically consider alternatives. Thanks for helping with this discussion!

  4. I just lost my mom this past February. We kept her at home until the end. She fell many times and we had an 24 hour aid, but it was still a problem with accidents. I think it was good for her to be home in one way, but I also think she would have been safer and had better success with all her many medication that we struggled to give her in a good nursing facility. It’s so hard to know just what to do. My motivation was to make my mom as comfortable as possible and for her to be as safe as possible. I miss my mom. I still have my dad and my husband and we just moved in with him so he can stay in his house. We gave up our home, he’s 85 years old. It’s not easy but it was needed. One day I’m going to be in this postion and I pray my children will keep my best interest in mind.

    • I’m so sorry about your mom, Tanya. I lost my dad nearly three years ago, but even though he had cancer, he was able to stay in his home nearly to the end. I think people do better when they’re in familiar surroundings, especially if they’re old or ill. He, too, struggled with falls, but he was adamant about not having strangers in his house to watch over him. You’re right — it is a hard decision, but it sounds as if you and your husband made the selfless choice in moving in with your dad. I’m sure he’s grateful to have you both there!

  5. He’s very happy we are here financially, help wise and companionship wise. It is quite an adjustment for me and my husband, but I love my dad and life is short…so this time is presious. I think you have to trust your instincts and do the best you can in all decissions pertaining to their care. You’ll drive yourself crazy thinking of should of could of would of. We did our best. No matter what we do somebody is going to have something to say or some advice.

    • You’re so right! All we can do with big decisions like this is seek God’s Will, then follow His leading. He knows us better than we know ourselves, and He will do what’s best for all concerned. I think you’ll both be glad for your decision — maybe not all the time and every day, but certainly in the long run!

  6. HI Debbie, Your heartwrenching post really resonated with me. You have some great discussions here about a topic we all have to face either with aging parents or with ourselves. My Mom is almost 89 and fully functional in her own home at the moment but I do know that things can change in a heartbeat and it will be a difficult decision when the times comes. I agree with Lynne that the ultimate decision should be hers as she showed us with her own Mom and the children should try to communicate their concerns about their mother’s safety with full disclosure as long as she still has her mental capacities. I do not agree that they should make a decision of that magnitude behind her back. I’m sure they are concerned about her safety but she deserves to part of the discussion and decisionmaking. On a much smaller scale, 5 years ago we were all invited to our aunts 90th birethday celebration 4 hours away inb Philadelphia. Nobody thought my Dad could make the trip due to his many medical conditions and physical frailities. When he was asked, he nodded yes, he wanted to be there. We were a little nervous and we had to make some accommodations but he went and had a wonderful time. I am so glad we let him make the final decision even though it meant small sacrifices on our part to maintain his safety. None of us wants to have decisions made about our life behind our backs. You really got me going,Deb!

    • Thanks for adding to the discussion, Kathy. It’s always great to hear first-person accounts as testimony when making big decisions. I think they’ve decided to sell my neighbor’s home, though. To hear them tell it, she wants to go into a nursing home. I just don’t know because I wasn’t privy to that conversation. Still, it saddens me because that’s the only home I’ve ever associated with her, and she seemed so happy in it. I know now you’re all glad you honored your dad’s wishes about traveling to your aunt’s birthday celebration — even if it wasn’t an easy trip!

  7. Pingback: Waiting…Waiting… | Musings by an ND Domer's Mom

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