“Promise you won’t …”

The request every daughter or son dreads: “Promise you won’t put me in a nursing home.” The child in you wants to provide a soothing answer: “Of course. Never.” Best to pause and think this through first.

You can’t predict the future—your loved one’s needs or your own health and abilities. It may be that 24/7 care is exactly what your loved one eventually needs. For example, he or she may lose mobility and need to be lifted in and out of bed. Or perhaps require injections or IV medical treatment.

In the case of advanced dementia, your parent may need full-time supervision, including throughout the night. Is that something you can promise to do?

The root of such a request is typically fear: fear of being alone in an institution, of lingering in pain, of potential indignities, and of overall loss of independence.

A promise of “never” is a setup for you to feel guilty—even when you’re doing what’s best for your loved one! Instead, reassure your relative:

  • “We’re a team, and that’s our goal: to keep you at home. If it turns out you need other care, I will make sure you are safe and comfortable.”
  • “Let’s talk about your priorities and wishes when we know more about what you actually need to stay healthy and safe. I want to ensure that things go to your liking in every way that I can.”

If you’ve already made a promise, reach out to your parent. It’s not too late to talk things through. And it’s better than feeling guilty later. Choose a quiet time, perhaps shortly after a doctor’s visit. Acknowledge the potential for the unforeseen. Then restate your commitment to ensuring his or her care and comfort regardless of the circumstances.