Placement Guilt When Moving a Loved One to a Care Facility

A support group member asked, “How do I get over the guilt?”

A few months prior she had moved her husband to a board and care facility because she could no longer care for him by herself at home. Intellectually she knew it was the best thing for both of them, but the guilt still gnawed at her.

I haven’t been a hands-on family caregiver for many years, yet I still feel guilt at times over things I could have done better for my aging parents.

One thing I learned with 100% certainty is that feelings of guilt can be controlled, and may dissipate greatly over time.  But these feelings may never go away completely.

Most family caregivers make solid decisions but then second guess themselves, which causes guilt.

How to Deal with Placement Guilt

Feeling guilt over placing a loved one in a care facility when you, their caregiver, can no longer care for them safely at home is one of the most common causes of guilt.

When placement guilt rears its head, look back and recall the living situation in your home before you placed your loved one.  Stop and answer the following questions honestly. WARNING: It’s easy to idealize your “before” life, but please don’t. Be brutally honest with yourself.

About Your Loved One:

• Were you able to care for him/her on your own 100% of the time?
• Was he/she cooperative in the care you were giving? Or were they stubborn and/or combative at times?
• Were they safe from possible falls or injury at home? Could they be left home alone safely? Would they be able to call 911 in an emergency if home alone?
• Were they accepting of paid caregivers you hired at home to help?

Here are more warning signs to look out for.

About Yourself:

• How was your physical and emotional health before placement? Was it deteriorating?
• How stressed and worried were you then?
• Did your life seem like it was spinning out of control?
• Were you able to get a good night’s sleep? Any sleep?
• Were you eating well?
• Were you able to get a break from caregiving? And was it long enough to feel relaxed and refreshed upon your return?
• Were you trying so hard to preserve your loved one’s dignity or the status quo of your family life, you were nearly killing yourself in the process?
• Did you sometimes feel you were at the end of your rope?
• Were you ashamed to admit you couldn’t care for him/her all on your own any longer?
• Did you feel like you were failing your loved one, yourself or your family?

My experience says that if you honestly answer these questions — and not paint a false, rosy picture of what your home life used to be like — you will be free of guilt feelings by the time you’ve read to this paragraph. The safety and care of your loved one, as well as your health and peace of mind, have got to be better now than your home situation was before placement — or you wouldn’t have moved him or her in the first place.

So, when those guilt feelings start creeping in, come back to this blog post, answer these questions again and remember what life really was like before you made the difficult placement decision. It may not take the sadness or loneliness away, but it should lessen the guilt quite a bit when you re-confirm the decision you made truly was best for both of you!

A way to overcome these guilty feelings is to learn, believe and repeat this affirmation: “I made the best decision I could based on the information I had at the time.”

How I Overcame My Own Guilt While Caregiving

An example from my life illustrates how I handled the guilt I felt because my father died alone.  I had hoped very much I would be at his bedside when his time came.  The exact circumstances about his death don’t really matter, just know that the guilt over this bothered me very much initially and even now, years later, comes back to haunt me on occasion.

The hospice company that cared for my parents keeps in touch with bereaved families for one year following a patient’s death, as most hospice companies do.  I received various mailings and phone calls during the year after my dad died, but never took them up on their offers of counseling, religious services, or holiday memorial events.  Just before the hospice service was ending, I decided to make an appointment with the hospice social worker for a one-on-one counseling session.

I sat there crying and told her of the tremendous guilt I felt about my dad dying alone.  I had been with him so much over the last several years of his life including the three months he was on hospice, how could that have happened?!  I was feeling like I’d let him down completely by not being there.

What I learned from her was that death is a very private experience, and that many people “choose” to die alone!  She told me how many families will be at their loved one’s bedside, and then right after they leave to either get some sleep or eat some food, the person passes away while they’re gone.  As she relayed this to me, I had to admit I remembered hearing this happening to other families I knew.

In this case, education helped me decrease my placement guilt.  And when I think about my dad dying alone and the guilt begins to resurface, I remind myself that it could have actually been what he wanted.

Practice Self-Compassion

Most family caregivers make solid decisions but then second guess themselves, which causes guilt. A way to overcome these guilty feelings is to learn, believe and repeat this affirmation a wise support group leader taught me: “I made the best decision I could based on the information I had at the time.” When you do this, your guilt will diminish.

Practice self-compassion and don’t beat yourself up over decisions you’ve made. Remember, most caregiving decisions aren’t set in stone and can be changed completely or modified in some way if need be.