Releasing Guilt Over Tough Decisions

Caregiving Daughter: “Mom’s condition is beginning to worsen.”

Caregiving Son: “I know. She is requiring more and more care.”

Daughter: “I don’t think we can care for her at home any longer. She needs more care then we can offer. But I feel so guilty even considering a nursing home.”

Son: “Me too. Is it what she would want? I feel bad…”

Daughter: “We have to come to a decision soon…”

The above conversation represents a common and often inevitable crossroad that arrives along the path of caregiving. When the increasing level of caregiving responsibility becomes too difficult to handle, family members are faced with some tough life-altering decisions.

  • Is it time to place mom in a care facility?
  • What are the implications of this decision on our entire family?
  • What about the promise we made to care for dad at home?

These questions stir up complex deeply held emotions and there are no easy answers. Knowing when it is necessary to choose care outside the home is a very individual decision. When you are weighing your options, some things to consider are:

  • Are my loved one’s medical needs beyond the scope of home care?
  • Are other areas in my life being significantly neglected due to caregiving responsibilities?
  • Is my own physical and emotional well-being becoming compromised?
  • What is the long term picture of my loved one’s condition?

As signs become more apparent, the decision to place a loved one in a care facility can be an unavoidable choice for many families. Once the decision is made many family members feel mixed emotions. These emotions are natural. They spring from a place of love and caring. While every person has a unique response, they tend to fall along a common emotional range:

  1. Denial. There is a period of time when reality of a loved one’s situation is blocked out. This basic defense mechanism arises when painful emotions begin to surface and we are not ready to deal with them.
  2. Guilt. Feelings of remorse are natural as reality sets in. Guilt is frequently accompanied by self-blame and questioning. Could I be doing more? What could I have done differently?
  3. Helplessness. Often there is very little a loved one can do to change the situation – so feelings of helplessness creep in. These feelings can be overwhelming at times.
  4. Anger. Feelings of helplessness often lead to anger. Often misdirected instead of acknowledged, anger may be expressed outwardly or inwardly.
  5. Sadness. Underneath many emotions there is sadness. Sadness is a natural outgrowth of caring and love. As families deal with change, sadness becomes a form of pre-emptive grief.
  6. Relief. Along with the various degrees of difficult emotions, there is often relief – a sense of a burden beginning to lighten as primary care responsibility is transferred. Acknowledging your emotions is the first step. The following thoughts are designed to offer comfort as well as inspiration when you find yourself in the throes of emotional upheaval:
  • Give yourself permission to feel your feelings. Feelings are neither “right” nor “wrong.” They are a natural part of being human.
  • Talk to somebody about your feelings. Whether it is a trusted friend or professional therapist, talking about your feelings is necessary for emotional as well as physical health.
  • Recognize that you are doing the best that you can under difficult circumstances. Be kind and compassionate with yourself and release feelings of guilt.
  • There are many good self-help books about the subject of caregiving and transitioning a loved one into a care facility. Ask friends or colleagues to recommend a good one.
  • Surround yourself with your support system. Communication is crucial during these periods of stress and transition.
  • Use coping tools to keep stress at a minimal. While things are chaotic around you, do your best to make time for relaxation, self-care and fun.
  • Talk with your loved one openly and honestly. Give them a chance to express and process their own feelings. Use deep, attentive and nonjudgmental listening.

Nobody sets out in their life to care for a loved one and be responsible for making decisions on their behalf. But life takes unpredictable turns. Help and support is available if you remember to reach out. Each crossroad undertaken, every challenge surpassed, each hurdle crossed, contributes to the rich experience of caregiving.