Dealing with the stress of caring for a parent in your home.
anonymous Asks ...
My wife is caring for her dad who has dementia and a lot of pain and mobility problems from 2 broken hips. My wife does not work. She has always promised her dad that he could stay with us and she would never put him in a nursing home. Since it was what she wanted and her dad was happy and I liked him a lot and we could afford it I thought it was a good idea and the right thing to do.
Her dad is 84 and he has deteriorated quite a lot in the last 2 years and caring for him is now a very physical and demanding job. He was always a stubborn individual but he was also very funny and kind but now his personality has changed and he is angry much of the time and he can't see anymore what a burden he has become.
My wife is clearly overwhelmed. She is frazzled and depressed and has gained weight and she is irritable all the time. I try to get her out of the house as often as I can but she feels guilty when she leaves for extended periods.
It is time for him to go to a nursing home. To me this is very clear. She is ruining her own health as well as the happiness of our marriage caring for a man who is not appreciative of what she is sacrificing. The problem is she feels trapped by the promise she made that she would never put him in a home and I can't make her see that it is OK and that sometimes you have to go back on your promises when the cost gets too high.
I am worried that if this goes on for years we are going to end up divorced. How can make her see that this situation is not good for anyone any more? I don't want it to come down to ultimatums but she won't listen to what I think is reasonable. I think the strain and stress of caregiving has affected her judgement and she can't even think clearly any more. What can I do?
David Shannon Says ...
It is understandable that your wife wants to keep her promise to her dad, no matter the sacrifice. At least at the present time, she is not likely to be persuaded by the idea that the cost has gotten too high. She may feel that to go back on her promise would be very costly too, in terms of guilt, reduced sense of integrity, self-worth, and self-esteem. Placing him in a nursing home would never be a happy choice, but she might be able to see eventually that it is not in his best interests to remain in the present situation. It would have to seem to her like an improvement for him, in terms of his health and happiness.
I don't know what the type or degree of his dementia, or the long term prognosis, according to his doctors. But from what you say, his personality has changed, and he is not the same person that he was when she made that promise to him. I don't think that she will want to consider that as a reason to change her commitment to keeping him at home. But as it progresses, it might be one of the factors in realizing that he would get better, or at least more specialized, care in another environment.
She is increasingly overwhelmed, depressed, and irritable. She feels guilty when you do persuade her to get out of the house and do something together. She might feel less guilty if there was someone else there with him, whom she could trust to give him good care. It could be worthwhile to investigate the availability of home health care and respite services, so that the entire burden does not fall on her shoulders. If and when the home service providers say that they are no longer able to provide the care he needs, it would be another powerful piece of evidence that the present situation is not the best for him.
Seeing a therapist for individual counseling might help her come to terms with her own limits, as well as her sense of guilt, as she considers other possible solutions. This is also causing a great strain in your marriage, to the point it might end in divorce. Marriage counseling might help you to see each other's perspectives and understand each other's feelings. It could help you communicate more clearly with each other, in a supportive and less pressurized setting, Rather than issuing ultimatums, you could both focus on the consequences of continuing as things are. You could also agree on short term goals, and make their implementation part of your relationship contract for a specified period of time, after which you would talk again about how it is working, and whether other changes need to be made.
Best wishes to both of you in this very difficult situation.