When my diapers needed changing, when I cried all night long and kept them awake with worry when I was ill, they didn't drop me off any where.

When my mother wanted to go out and do things with her friends, or just have a day alone, she didn't because I was there and she had responsibilities and things that were much more important to her.. I was one of them.

My father did and still does get up every day at insanely early hours of the morning and trudges off to work, not because he wants to but because he has a family to support.

If it ever comes to the point where I have to decide between caring for my parents or handing them off to someone else so that I can "live my own life", I won't do it, not in a million years, I could never, would never be so infinitely selfish. They've been there for me, always, and I will always be there for them to the best of my ability. I don't care if I have to devote the majority of my time to them, it doesn't matter.. they deserve that and much much more. It will never be a burden, and if I ever start to think that it is.. well, I'll hope that someone slaps me with the hand of reality a few times.

Of course this will vary from person to person, from situation to situation, and so on, these are just my feelings on the matter. It seems inherently selfish to me when children force their parents into places they don't want to be simply because they don't want to take the time out of their precious little lives to take care of the very people that brought them into the world.

I can see people jumping all over me for this, but again, it will vary between people and everyone has a different type of relationship with their parents.

Yes: when you couldn't feed yourself, they fed you; when you couldn't control your bowels, they cleaned you; when you couldn't control yourself and broke something, they didn't throw you out.

But if you were ever sick--really, really sick, not just with the sniffles but with something more serious--they would have taken you to the doctor or the hospital...and they would have done so, I'll wager, because they loved you. They would have recognized that you had a problem that was beyond their ability to handle--a problem that required the attention of an expert, someone who had the knowledge and training to make you well again. They would not have tried to save money by handling it themselves; their decision to put you in the hospital would have been a fulfillment, not an abdication, of their responsibilities as parents.

Though it's difficult to contemplate, your parents may one day end up in the same state--they may need more care than you know how to provide. It happened to my grandfather not so long ago as my grandmother's illnesses slowly grew more and more severe. He didn't want to put her in a nursing home for all the reasons that you describe; he'd been married for 60 years, he said, and would not simply put his wife away.

My grandfather is a man of incredible patience, strength, and charity, and he held out for a long time--longer than most people would have (and perhaps longer than I would have, though I'm sixty years younger than he is). But he's not a doctor; even if he were, he could not have provided adequate care by himself for 24 hours a day, which is what my grandmother ultimately required. Eventually, her condition degenerated so much that he was driving her to the hospital almost every day...and at that point, he agreed that it was time. He held off even then--he could not bring himself to put her in right around Christmas and their anniversary--but ultimately he realized the necessity.

Yes, some people may give up too easily, but--sad as it is--there may come a time when it's necessary. It appears that you love your parents deeply, and if so, you would not want to hurt them by withholding necessary care.

I have been a certified nursing assistant for the last six years. I have worked with the elderly, with Alzheimer's suferrers, and with developmentally disabled.

There is no such thing as an "old age" home, at least not in the US. We who care for them are medical professionals, some are nurses, most are certified nursing assistants.

What we do is called LTC, or long-term care. We do not refer to the people we care for as patients, though that really is what they are. But we deliberately de-emphasize the medical image because we want the people we care for to feel our place is their home (which for most of them it is).

We call the elderly patients residents, the developmentally disabled clients.

Our clients and residents are not in our care because their families chose themselves over their loved one. They are in our care because they require medical care, which their families cannot provide. They are better off in our care.

Not all elderly live in a nursing home because not all of them need it. None of our residents/clients are in our care because their families did not want them anymore. It is not necessarily your choice either. If you cannot provide proper long term medical care for your parents, Social Services may even force you to place them in a nursing home.

By the way, we are not strangers. Nobody works in LTC because it is "just a job." We tend to be overworked and underpaid. We do it because we get attached to our residents and clients: They are like family to us.

If the day ever comes that your parents require long-term care, please do not feel you are getting rid of them so you can live comfortably. Quite the contrary, if you really love them, you will provide them with all the care they need, when they need it, even if that means placing them in a nursing home.

But hold on a sec whizkid, isn't that deception?

When you deliberately de-emphasise the medical reasons that actually brought them into the nursing home in the first place?

I have parents that are approaching the high end of their middle age, and every year I can see them getting older, and frailer, and I know that at some point they are going to need care, for that reason alone, I want them to be near me.

Life is short, and the only thing that really matters in the end is love, and believe or not the only real place you can get lasting love is family. To betray that love in the last instance by casting a member of your family away because it is hardship, well, that seems wrong.

I will provide in home care for them if it comes to it, I will live with them in my house with me and my wife and children. I want my them to know their grandparents and to know that the true expression of love is something that goes beyond daily concerns. I want every part of my family to feel loved and cherished, and although I know that LTC places do their best, they can never replace the loving, playful, and ever changing atmosphere of a growing family.

Cultural values change, and our society is becoming more and more individualist with the consequence that many people spend most of their lives being lonely. Think of like this, from a purely selfish point of view, your children pattern on you, like it or not. If you put your parents into a home at the end of their lives, then chances are you too will end up there at the end of yours.

As a concession, I must admit that there will be people who feel they cannot afford to look after those elderly members of their family while maintaining a decent quality of life. My response is one of regret. I understand, society doesn't always give each of us the ideal situation in which to maintain family life, but remember this: for at least the first 16 years of your life you were all but useless to the parents that reared you, and that now they need you, shouldn't you return their kindness?

I work for a company that produces newsletters for nursing homes and related facilities. It isn't whizkid's experience, but I type up their newsletters and activity calendars. These facilities go to great lengths to be home for their residents. It isn't a just a matter of care, but of quality of life.

The medical care is the reason for these facilities' existence, but it isn't all that they provide. The homes have a life for these elderly people that it seems unilkely they could get at home; social and physical activities for people who, in home care, would probably sit in a room all day staring at the television. They allow a measure of independence for people whose minds are fine but whose bodies have stopped working on them, who would often feel like they were being a burden on their families if they stayed at home, and who would probably not be getting the physical and occupational therapy at home that keeps their bodies functional as long as possible. They have something to do there, with other people, be it bingo, Bible study groups, or writing opinionated editorials for the facility newsletters like a couple of ladies do. They have people around them who understand their lives because they are about the same age. (Sheesh, I'm 28 and I feel out of touch with young people; I can't imagine what it must be like for people in their eighties).

And then there are the Alzheimer's disease units. My great-aunt Jean lives in a retirement facility to be near her husband Arthur who is in the Alzheimer's unit there. He doesn't recognize her too often any more. I don't think she could care for him on her own, not as physically frail as she is. It's hard enough on her emotionally; the facility takes the burden off her of getting someone whose brain is just not functioning properly to eat, keep clean, and every other thing a healthy human takes for granted. Long-term care facilities can offer snoezelen, "sensory orientation" and other activities that an untrained person would not be able to give them. (From many of articles I've typed, loved ones of Alzheimer's patients usually need a lot of guidance to hold a conversation with the patient.)

And the facilities hold support groups for home caretakers and people dealing with their their loved ones' decline. Some of the facilities also have "adult day care" services which might be an alternative for families where an elderly person can't be left alone and the breadwinner can't give up working. This is a compromise for those who have a huge problem with the idea of their loved one living in a facility.

My grandfather died in a nursing home. Yes, it would have been wonderful if a series of transient ischemic attacks and strokes hadn't affected both his body and brain so that he could have continued to live at home, down the street from my uncle. If he had to die, perhaps it would have been nice if he'd had a heart attack in his own home's bathroom and not that of a facility; even the medical care there wasn't able to save him. But that wasn't a possibility. My uncle tried to care for him at home; my grandfather became hostile to his own family as if he didn't know who they were, and getting him to take his medication was damned near impossible. There wasn't much alternative to a nursing home, and that's how it is in real life for many people.

I think we need to be looking at the bigger picture here. Whether you decide to sacrifice for your parents the way they sacriced for you (a noble sentiment, and one I applaud) or acknowledge that some people need 24 hour medical attention and sometimes a nursing home is the only way to provide it (also an excellent point, one I can't argue with) the fact remains that there are a large number of elderly and severely disabled people, yes, even in North America, with no one to adequately care for them.

I have to disagree with whizkid on this point: Old age homes do exist. I've been to them. They can be every bit as bad as the worst TV exposes have led you to believe. They are underfunded, routinely ignored by state health inspectors, the people in them have been known to literally starve to death because the overworked, underpaid and unqualified staff forget to feed them, and they do contain people who do not need 24-hour medical support, but medicare in many states won't cover home visits while it will cover nursing home care.*

I'm not saying that all nursing homes are like this. Some, like the places whizkid and Segnbora-t mention, provide quality care and life-affirming companionship. But the hell-holes do exist and they are filled with the poor, the family-less and the forgotten.

I hate to jump up on my same old soap box, but we need universal healthcare NOW. The decision of where your aging parents should live is a painful and deeply personal one, but the decision that no one in our society should be abused and that everyone should have a little human dignity is going to take a massive group effort. If you aren't willing to send your parents there, you shouldn't be willing to send anyone else there, either.


* This makes me so mad I could just spit. Medicare won't pay a nurse $20 / hour to come over to my grandmother's house once a day to give her an IV, but they will pay to put her in a home, which must cost at least hundreds per day. Of course we just paid for the nurse out of pocket, but what about people who can't afford that?

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