One of the hardest decisions an adult child/children must make is whether or not to place their parent(s) into a nursing home. There are feelings of guilt and failure attached to such a major decision. This is why careful analysis of this life-changing decision is important. Many decide to keep their parents at home because they feel that it is the right thing to do. However, there are some important considerations.

Many elderly loved ones want to remain at home because of the memories attached to belongings and their residence. They also have a sense of community with long-time neighbors. However, there are issues that may be of concern such as cooking, cleaning, toileting, shopping, doing laundry, and driving, as well as falls, which for frail elders could prove to be problematic.

One has to ask oneself if family members, friends, or neighbors will be available to take care of the specific thing the elder has trouble with — such as doing laundry or shopping. Also, someone must be available to accompany the elder to doctor appointments and other appointments. The elder may need assistance in maintaining the residence and paying bills timely.

If one chooses to become a caregiver, they are some dangers for the caregiver to contemplate. According to, caregiver burnout is a serious problem. It is a “state of physical, emotional, and mental exhaustion that may be accompanied by a change in attitude — from positive and caring to negative and unconcerned.”  This a result of a caregiver don’t get the help they need, or if they try to do more than they are able — either physically or financially. Guilt and inadequacy are the final result. Here are the symptoms:

  • Withdrawal from friends, family, and other loved ones
  • Loss of interest in activities previously enjoyed
  • Feeling blue, irritable, hopeless, and helpless
  • Changes in appetite, weight, or both
  • Changes in sleep patterns
  • Getting sick more often
  • Feelings of wanting to hurt yourself or the person for whom you are caring
  • Emotional and physical exhaustion
  • Irritability

Scott Eckstein was an Executive Director of an Assisted Living Facility for 20 years. He has witnessed many adult children in tears about the challenges of being a caregiver. He suggests the following:

  • Find a support group or network. You may be surprised how many are out there and how many people are in the same boat as you. Attend some meetings to receive feedback and learn coping strategies. Find the meeting that is a fit for you. Openly share your feelings and experiences with others.
  • Strongly consider speaking with someone you trust. Bottling all your tension up can lead to angry outbursts. It’s always good to hear things from an outside perspective, especially from someone not directly involved in your situation.
  • See your doctor or another professional to explore the burnout issues that are impacting you specifically.
  • If possible, vary the caregiving responsibilities. Rotate/share responsibilities with family members — demand it! It’s really okay to ask for help. You have to accept the fact that you cannot do everything yourself, otherwise you’ll end up being the one that needs to be cared for.
  • Put time into taking care of yourself emotionally and physically. Be sure to get enough sleep, maintain a healthy diet and get some sort of exercise each day.
  • Make room for “Quiet” or “Me Time”.  Meditate, get a massage, see a movie — whatever does it for you. Just do it!
  • Stay involved in hobbies or other outside interests. All work and no play…you have heard it. It applies to care giving too.
  • Acknowledge caregiving is filled with stress and anxiety. Understand the potential for burnout. As a caregiver, you need to be on-guard against succumbing to burnout. It may be cliché, but it cannot be said often enough: “The best way to be an effective caregiver is to care for the caregiver.”

Why does this require careful consideration? Studies have shown that loving caregivers can become abusers if they do not take care of themselves first in order to be effective and loving caregivers. To those who are caregivers of older loved ones, you are charged with the responsibility of  helping them maintain their quality of life.

As I always mention, please report all incidents to the proper authorities. You can also find information on the National Center on Elder Abuse’s website at

Please feel free to leave your questions or comments.


Eckstein, S. (2011). 8 tips to combat caregiver burnout. Alzheimer’s and caregiving, 2011