Have you promised your aging parents or other relatives that you will never send them to a nursing home? Don't do it. Of course no one, young or old, enjoys the prospect of that final move, and such promises are usually make with only the best intentions. But are they realistic? There's nothing like being 75 to make me consider the realities of aging.
From my reading and observations, I've concluded that this promise has the possibility of two tragic outcomes: destructive self-sacrifice for the caregiver and worse, elder abuse.
I have no children or other close relatives to make such a promise to me, nor would I accept it if offered. Yet my mother died last year in a nursing home at age 95 (no known abuse) despite her grandson's noble promise of years earlier that she'd remain at his home.
That grandson (my nephew) did his best, but as people live longer and longer, this noble promise often becomes unrealistic. Good intentions may not be enough. Despite my nephew's valiant efforts, there came a time when Mother needed constant care that he could not give. No nursing home is a palace, but she spent her final years in a good one, among caring people.
I've observed and read about too many cases of extraordinary caregiving sacrifices: marriages, families, personal health forfeited to care for an elder until his or her death, until it is too late for the caregiver to recover as well. That's sad, but there is an even worse possible scenario.
According to an April 10 Chicago Tribune article by reporter Gerry Smith, the Illinois Department of Aging found a 53 percent increase in reports of elder abuse, including physical, sexual, and emotional abuse, passive neglect, financial exploitation, willful deprevation and confinement, between 1998 and 2007. The numbers of reported cases rose from 6,213 to 9,489, and many cases are believed to remain unreported. About 80 percent of cases occur at the hands of relatives.
In one of the worst cases reported in Illinois, two sisters, aged 54 and 47, were accused of criminal neglect after their 84-year-old mother was discovered, in the home they all shared, "dehydrated, malnourished and lying on soiled sheets covered with ants." Even though she suffered from cancer and had suffered a stroke earlier, she hadn't seen a doctor in nine months.
I have no inside knowledge of that case, but I can imagine the extreme frustration of caregivers in such a situation. Did they have financial problems? Psychological problems? Of course they should have done better. Had they made "the promise"? I don't know.
Don't misunderstand. I'm not advocating sending the "old folks" to nursing homes automatically, ignoring religious or cultural instincts. Do the best you can, but face reality. No one knows what the years will bring. Noble self-sacrifice can go too far, at worst descending into intentional or unintentional elder abuse.
If you're the son or daughter, don't make that promise. If you're the elder, don't demand it.
Copyright 2008 by Marlys Marshall Styne