How Do You Know When It's Time?

clock.svg.medBeth began caring for her mom in 2002, after mother's stroke. Over the years, a few family members regularly warned Beth that she must be careful the situation doesn't become too much for her, her husband and their three children.

The warnings created huge worries for Beth. How do I know when it's too much for me?, she asked me. How do I know when it's time for my mom to go to a nursing home?

In order to understand the timing for nursing home placement, it's important to understand the other times in caregiving. Consider the following:

1. Is it time for support? When Beth first worried about nursing home placement, she had been alone in her caregiving role for seven years. She felt overwhelmed and stressed but didn't tell anyone for fear that her husband or another family member would say, "It's too much for you. It's time for nursing home placement." She finally reached out for help, finding support at and working with me to develop coping strategies to manage her experience. Beth connected daily to other family caregivers who understood her days and who shared ideas and suggestions to resolve the issues that came up. She began writing regularly in a journal and stayed connected to activities she loved, like swimming and volunteering.

2. Is it time for more help? Beth had some help, which became too little help when her mom's care needs increased. She resisted getting more help, believing she must be the one to provide care. Ultimately, she realized more help allowed her to be the one who provided care. She increased help from home health aides from just four hours per week to 20 hours. The additional help gave her a break from showering her mom, which had become a one-hour ordeal they both hated. The aides showered her mother in half the time it took Beth. Beth felt immediate relief just by eliminating the dread of shower time. And, with the extra help, Beth had more time with her children and husband, which meant she cut back on some of her guilty feelings over not having enough time for everyone.

3. Is it time for a break? A few hours every few days may make a difference. The intensity of the caregiving experience demands more time to refuel, replenish and rejuvenate. A break of an extended period of time, like a week, can help you recover from the demands of a physically and emotionally exhausting experience. Contact local assisted living and skilled nursing facilities to learn about short-term stays so you can enjoy not just a break but a vacation. You can take a trip to enjoy a change of scenery or take a staycation to catch up on your sleep. The time off from caregiving can help you continue. Be sure to also check in your community to find out if you qualify for programs which can help you take time off.

4. Is it time for additional services? A decline in her mother's health led Beth to her local Hospice organization. In addition to the aides from a local home care agency, Beth had a nurse, social worker and volunteers from Hospice helping her care for her mom. The additional insights and knowledge from professionals became a boost to Beth's confidence. She no longer wondered to herself is she's giving the right care; she simply asked the nurse and social worker how to give the right care.

When you begin to question yourself about the timing of nursing home placement, take a closer look at the amount of support, help, time off and services you have. When you can, add more. When you've reached the limit, you may decide it's time. The decision for nursing home placement will be easier when you know you did all you could for as long as possible.

For Beth, her time ended in caregiving with her mom at home, with Beth at her mom's side as she passed.

--Our three-part respite series offers suggestions to help you take a break for a few hours, a day and a week.
--Take our StayCation Challenge.
--Join one of our online support groups.
--Search for home health agencies at the National Association for Home Care and Hospice.
--We have tips to help you hire quality care.
--We have suggestions to help you choose a quality home health agency or facility.

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