If I'm Doing the Right Thing, Why Do I Feel Guilty?

You've just completed the process of admitting a family member to a long-term care facility and you're faced with the guilty feeling that you may have let that person down.  Even though you may have spent a long time trying to cope with caring for the loved one yourself and know that this is the only way to go, the negative thoughts persist.

Be assured that these emotions are not unique and you are not alone.  Nearly every family in your position experiences some degree of trauma which may include guilt, anxiety or even anger at having to take responsibility for making the placement decision.  These are understandable reactions.  And there are positive ways to deal with them.

  • Talking over your problems with other families who have been in the same situation can be helpful.  They understand your difficulties and may have good advice to offer.

  • Most facilities recognize the importance of aiding family members in making the critical transition.  "Each time you admit a resident to your facility, you are, in a manner of speaking, admitting that resident's family as well," says Suzanne Geffen Mintz of the National Family Caregivers Association.  Family members are urged to seek the counsel of the facility's social service worker to your concerns and answer your questions.

  • Avail yourself of any supports that the facility has in place to aid families, such as:  a caregivers resource center which offers books, pamphlets, newsletters and videos on a variety of subjects.

  • Perhaps there is (or you might organize) a family council run by family members as a way of addressing grievances, organizing activities and communicating with the administration.

  • Respond to invitations to contribute to your loved one's care by helping at mealtime or accompanying the resident to an activity.  It has been established that such caring participation in the person's life makes family members feel more needed and lessens the sense of frustration or guilt.

  • When appropriate, the transition may be made easier for the new resident and the family by a clergy member, who could include religious reading, hymns and poems.

  • It is very important to keep the lines of communication open with the staff of the facility.  Don't be afraid to ask questions about the facility's routine and practices.  This will insure your peace of mind about the loved one's care.  The facility's administrators want you to feel secure.  Bottled-up anxiety can cause misunderstanding and result in fewer of the family visits that are so vital to the resident.

  • Family members who live far away from the facility should be encouraged to make phone calls and send letters to the resident.  Sending audio and video cassettes is an especially good way to keep the loved one in touch.

  • Take advantage of suggestions the facility may have available to make visits more successful, such as "visiting kits," collections of subject matter for discussion on subjects like "springtime" or "music."  Perhaps you can prepare a list of things to talk about tailored to the loved one's particular interests.  Families can also utilize a variety of community resources.  For example, the Alzheimer's Association has support groups which can be helpful to you if needed.

Making the long-term care placement is not an easy move for you or your loved one.  But don't let it cause you to be unjustly critical of the facility or tough on yourself.  Especially, don't let it keep you from maintaining a close and supportive bond with the person whose interests you feel are best being served by taking this step.

(Source: The Social Work Consultation Group Letter, 3(4):2-5, Winter 1993, Brown University's Long-Term Care Quality Advisor, The Later Years.)

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