When One Partner Needs to Move for Long-Term Care and the Other Doesn't
Donna Pacer, of Essex County, N.J., had been dreading the phone call that came from her father's girlfriend informing her that it was time to move her dad to an assisted living facility.
"After my mother passed away, my dad started dating Pam," says Pacer. "Her husband had passed away, too, so they commiserated on their loss together. Eventually my dad, Joe, moved into Pam's apartment in the city where they lived together for about ten years."
But Joe's health was deteriorating. He had started falling and was having memory issues.
"I knew Pam was feeling overwhelmed with my eighty-three-year-old father's health issues," she says.
And Pam's two daughters said they were concerned about their mother's well-being. Pam's first husband had been ill for quite a while, and she had spent years caring for him during his decline.
On the phone that day, Pam told Pacer she wasn't willing to be a full-time caregiver again, especially at her age. "And she didn't want to bring in a health aide to her home. Moving my dad to assisted living was the only option," says Pacer.
When one person in a couple needs more care than the other, partners and adult children face a difficult choice, explains Becky Bongiovanni, brand president for CarePatrol, a care placement agency.
"The decision to move a loved one into a care community can be agonizing, especially if you are the primary caregiver and already experiencing burnout," she says.
Broaching the Subject of Long-Term Care
Having a talk with your partner or parent about moving to a long-term care facility can be upsetting. "Your spouse or parent may deny that they need help or express anger and even begin to blame the person trying to help them," says Bongiovanni.
So, you might want to make the conversation a dialogue, rather than just telling them what they are going to do. Be compassionate and empathize with their feelings in a non-patronizing way.
"As an individual loses their independence, they will go through a grieving process and we need to allow them to transition through these stages," Bongiovanni says.
Calmly express your concerns and observations while also acknowledging your loved one's point of view.
"Be honest about the physical and emotional toll that the well partner is experiencing," says Lisa Bayer, an aging life care manager. "Explain that moving to a facility is necessary to keep the well partner healthy and make sure that the less-well partner has the care he needs."
If the loved one is suffering from cognitive impairment, it may be hard for them to fully comprehend the situation. Besides struggling with memory loss, people with dementia may lose skills related to insight, judgment, logic and reasoning.
Without these abilities, sound decision-making and perception can be compromised. "In this situation, trying to discuss care needs can be counterproductive," says Bongiovanni.
When family relationships are strained, it can be beneficial to bring in a third party, such as an aging life care manager.
Connie McKenzie, president of the Aging Life Care Association, says an objective third party can help families navigate challenging scenarios.
"The person can offer council, options and solutions and helps alleviate a sense of blame or feelings of guilt that the spouse or adult children may experience," she says.
Finding New Living Arrangements
A wide range of living options are available, including assisted living, nursing homes and memory centers. Be sure to find a place that is suited to the person's needs.
If possible, keep the person who will be moving involved in the decision-making. This can include touring and ultimately choosing the facility.
"Seeing with our own eyes helps to debunk preconceived thoughts and ideas," says Bayer.
Pacer looked at several facilities and ultimately found one close to her home that could provide her father with the type of care he required.
"Luckily, my dad had good long-term health insurance," she says. "It allowed us to afford a privately run senior living facility that could meet his needs."
After seeing how important good insurance was in smoothing the process, Pacer and her husband, who are in their 50s, bought long-term care insurance for themselves. "So we could take this burden off of our kids," she says.
Tips for the Transition
Adjusting to a new living arrangement can be challenging. The transition is not usually linear. Up and down moments should be expected, especially during the first 30 days.
"Be prepared to set boundaries," says Bongiovanni, who explains that it's normal to experience feelings of guilt or loneliness. You may have to remind yourself why you needed help with care.
"Allow your loved one to work through negative feelings. Realize you cannot change their situation, but you can be supportive of their feelings," she says.
McKenzie advises putting together a schedule for in-person or virtual visits so the family member receiving care does not feel they are being sent away and left alone.
"Also, set up easy-to-manage technology to help them stay connected to their partner, family and friends," she adds.
The partner that remains at home may also have trouble adjusting, especially if that person has spent a good deal of the day caregiving.
"While it may be difficult at first having so much more free time, the well spouse may decide to get back involved with a hobby or see friends that they have not seen in a while," says Bayer.
Pacer echoes this sentiment. "Even though Pam initiated the move, she misses my dad's company. The care facility keeps my dad busy with activities and he has made new friends," she says. "Pam seems lonely and continues to visit him weekly."
Calming the Guilt
It's understandable to feel guilty about moving a spouse or parent from the home they have grown accustomed to into a long-term care facility. This is especially true if the person had expressed not wanting to ever live in a care facility.
"We all tend to make promises to our loved ones about their future care and do not always understand what that looks like until we are dealing with it," Bongiovanni says. "If your spouse or parent could understand the amount of care required, they would not want you to bear it alone."
Couples may feel they are letting each other down when they can no longer care for one another. But caregiving can be both physically and emotionally exhausting and can prove to be a strain on the caregivers' health and well-being.
Adult children may also have these feelings of guilt.
"As upset as I was, it was at the thought of my dad moving to assisted living," says Pacer. "It was clear that Pam could not provide the care Dad needed to say safe. If she was unwilling to bring in a professional caregiver to their home, an assisted living facility was the only choice."
Although it is challenging, moving into a care facility can improve the quality of life for both partners, as well as for adult children.
Even though it was a hard decision, Pacer is confident it was the right one for her family. She explains: "The year before my dad moved, I worried every day that I would get a call from Pam that he had fallen or gotten hurt. Now I am more relaxed because I know he has twenty-four-hour care. And his new home is so close to my house. I can visit with him more often and [we can] spend more time together."
Randi Mazzella is a freelance writer specializing in a wide range of topics from parenting to pop culture to life after 50. She is a mother of three and lives in New Jersey with her husband and teenage son.