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Extreme Guilt: Dealing with the feelings surrounding the transition to skilled nursing care.

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When you were growing up, your parents were there to take care of you..

When you were growing up, your parents were there to take care of you. They were there when you fell off your bike, and you needed a bandage and a hug. They were there when you forgot something in Kindergarten and they brought you something you forgot or needed. And they were there when you moved from your safe, familiar elementary school environment to that ‘bigger, scarier’ middle school or high school that seemed so daunting at the time. But even though you were afraid to go through these transitions, your parents knew it was all just part of growing up — and growing older.

Now, if you’re reading this as an adult-child of an elderly loved one, chances are you may face many of the same emotions surrounding how to best care for the parent (or parents) who cared for you. Too often, we don’t plan for this life-stage transition because we want to think of our elderly parents as being as independent as they’ve always been. But just one incident, accident or illness can change everything, just like that.

Role Reversal.

Every aspect of handling our aging parents' futures can provoke tremendous emotional responses. We’re often in denial about their increased vulnerability as well as their reduced decision-making abilities. As children of seniors, we’re suddenly placed in the role of caring for our elderly parents. And this exchange of roles not only intensifies our parents' feelings of helplessness but also adds to our own confusion and guilt. Putting anyone into a new environment can be an uncomfortable and even distressing experience. Suddenly, while at their most vulnerable, we expect our parents to form new relationships, trust new professional caregivers, navigate new schedules, and acclimate to new environments. These demands will challenge them for sure, while we, as children thrust into primary decision-making roles, can only hope they're able to make the best of their new situation.

Moving Past Guilt.

According to Dr. Stephan Quentzel, Medical Director for Psychiatry at the Institute for Urban Family Health in New York City, guilty feelings are typical of adult children who are faced with relocating their elderly parents.

"There are plenty of factors that go into feeling guilty," Quentzel explains. "Emotions range from feeling inadequate to feeling overly responsible because we assume moving them into a facility declares loudly and clearly that we can't handle taking care of them."

One way to address this very common situation is to try and anticipate their possible needs and explore options before circumstances become emergent. The better our perspective, the better the outcome.

Also, try not to get trapped in the vicious cycle of doubt. We find ourselves rethinking our elder-care decision, replaying conversations, wondering if we’re doing the right thing. This second-guessing can turn the time we have left to spend with our parents into unnecessary stressful and anxious experiences.

Finally, make decisions with your parents while they are still at a place to make such decisions — like preparing a comprehensive Living Will and Power of Attorney. This can ease the approaching situation for everyone. Early planning can broaden your options, answer many of your initial questions, and clarify some of the ambiguity.

Moving our parents is never easy. Often times, we’re faced with an elder-care decision that challenges our ideals of the parent-child relationship, and the window of time we need to make these decisions forces us to make momentous choices without always having every resource available to us. But we do the best we can for them with what we have, and hopefully remember that our parents once did the same for us.

Robert W. Hurlbut President & CEO

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