Never is a very long time

A statement which always makes me feel shivery is

I would never put my parents in a home.

I've heard this so many times. Mainly, from people with healthy parents who are able to help them and not in any need to aid. Sometimes, and particularly when I was at work, from people who were now faced with managing a parent with complex needs. Sometimes, they would manage somehow and sometimes, they would have to sadly, and guiltily renege on a promise.

Should Christians ever allow their parents to go into a home? Is this ever right and should we promise our older family members that we will always prevent them entering a care home?

Of course, this statement assumes that the parent can't make that decision. As children, we can't dictate where parents live if they still have the ability (capacity) to make that choice.

What are the circumstances when it can be difficult to care for someone? These fall mainly into three groups.

Relating to the older relative: These difficulties are usually around issues such as wandering, aggressive behaviour, faecal incontinence, difficulties with transfers and hoisting, very high falls risk and difficulty with feeding. Some of these issues can be overcome with appropriate medical management but some will persist despite the best of intentions.

Relating to the younger relative: These difficulties often relate to poor health. Major health problems such as needing chemotherapy, severe depression or painful arthritis would make caring challenging in the extreme. A sick spouse or child may change a manageable situation into something impractical. There is good evidence that care givers have poorer health than the rest of the population and often fail to be able to make time to visit the doctor for themselves. 

Then the combination of the frailer person and the person providing care may just not work. There may be a personality clash or there may be the risk of elder abuse. Yes, none of us are exempt from this and there are going to be times when we are tempted to shout or worse. 

The Bible talks very clearly about our responsibility to older family members.

Honour thy father and thy mother.

Exodus 20 v12

If any widow have children or nephews, let them learn first to show piety at home, and to requite their parents: for that is good and acceptable before God. 

1 Timothy 5 v4

If any man or woman that believeth have widows, let them relieve them and let not the church  be charged; that it may relieve them that are widows indeed.

2 Timothy 5 v16

So, yes, we are responsible but there is nothing that says that we necessarily have to do all the hands on caring ourselves. The wife in Proverbs 31 had servants to help with her duties and we may need help with ours. For me, at present, that means that we have carers come into the house twice a day to help. Yes, I could do everything myself but it would be difficult to manage with my other responsibilities. 

For others, that means that an relative has to go into a home. I know about this from personal experience. My Mother was loving cared for at home by my Father and care workers but latterly, her health needs dictated that she was better being looked after in a high quality care home.

Why is it damaging to promise never to put someone into a home?

• It can lead to broken promises.
• It can lead to major guilt.
• Making this promise, leads to placement in a care home happening in an emergency, often from hospital. Researching and finding a place in a high quality home most suitable for that person is difficult in this scenario. A thought out choice to go into a home means that time and care can be put into choosing and changes of care home are less likely to occur.
• Sometimes, it can mean that someone struggles to provide adequate care as the amount or type or care needed is more than one person can provide.
• It makes the assumption that once a parents is in a care home, the family is no longer involved. This need not, and should not, be the case. That would be reneging responsibility.

So please, think twice before making this statement. It isn't fair to yourself or your relative.

And yes, I have vested interests!  I currently look after my husband's Mother who lives with us. We hope that she will be able to live with us for the rest of her life but don't want to make promises we can't keep. My Mother was cared for beautifully in a Christian care home with nursing for the last years of her life. Although currently, I do not practice as a doctor, I worked as a consultant in Medicine for Older People for nine years until January 2011.

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