When there is no good answer – Turning a difficult decision into a better quality of life

January 19, 2011 by  
Filed under For Patients & Families

Every day, caregivers are faced with painful choices. The other day, a man shared with me that he had promised his mom that he would never put her in a nursing home. But now she needed more care than he could provide. Just this week, she had started a fire in the kitchen. He didn’t want to break his promise but he couldn’t protect her from herself.

This type of situation can be so painful. We want to do the right thing, but sometimes it becomes impossible. I explained to him that even though he had made a promise, he couldn’t stand by and let his mom be in harm’s way. He hadn’t known what the future would hold when he made that promise. I explained to him that as caregivers, we have a responsibility to step in and to make sure the person is safe.

I encouraged him to do what he could to keep her at home. Perhaps he could hire more help or make the house safer. But if those options didn’t work, he had to forgive himself and do the right thing to find a good care facility. This doesn’t mean he won’t feel badly about going back on his word. This is the hard road of caregiving.

Choosing the Least Worst Option

What often helps caregivers making the tough decisions is to realize that sometimes we have to pick the “least worst option.” What does this mean? It means we don’t always get a “good answer” or a “good choice” when making a decision. The only choice may be to pick the least terrible option, because that is the best option available.

Of course, caregivers should work hard to determine if there are any better options available, asking other people for help as they research their choices. But if the only option is one that is less than optimal, we will need to make peace with the situation by doing our best to make a bad situation a little better.

Creating a Better Quality of Life

When the “best” choice isn’t available, we can still make the decision better. As you evaluate the options, think about how your decision will be experienced by the person in your care. What will it feel like to move to a new place? What will it be like to go through a medical test or procedure? How will the decision be perceived through the mind of someone with Alzheimer’s or dementia?

For the gentleman who now needs to place his mom in a memory care unit, he will need to look at the places that are available, to consider what his mom can afford and to make sure the place will meet his mom’s needs. He will also have to look at how he can make the transition easier on his mom. What can he do to make her feel safer when she moves there? How can he bring joy and comfort to her when he visits? What can he do to improve the quality of her life, even though this is not the kind of life she would have wanted? Even though his mom would never have wanted to move out of her home, her son can make each day a little better for her. This is called person-centered care—when we think about how our choices will be experienced by the individual in our care.

Have a kind and respectful day.

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One Comment on "When there is no good answer – Turning a difficult decision into a better quality of life"

  1. Mary Jarett Whisler on Wed, 17th Oct 2012 10:51 am 

    Thank you Viki, for your book and for this post about the gentleman that felt guilty about going back on his word to his mom. I bought your book at the Alzheimers Community Care conference in West Palm Beach and read it. But now I am faced with the same situation this gentleman is in…I promised my dad I would never send him to a famility but just placed him 2 weeks ago. Your book and your blog have helped me enormously although I continue to feel guilty. And I have seen such a decline in my dad that I am battling with the fact that I may have been the cause of his decline. I know he is safer but it still hurts.
    Thank you for your insights and comments…it continue to help me.

    Kind regards…

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