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A Promise that can be Impossible to Keep

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An article posted recently on the excellent website of the Washington Post poignantly expressed the dilemma faced by more and more adult children – not to mention spouses – of aging seniors. When is it best to place Mom or Dad, or your own husband or wife, in institutional care?

Click here to read this very touching and very timely article. The title of the article says it all: it’s called simply, “Promise you’ll never put me in a nursing home.”

The article spotlights the often painful clash between a senior’s wishes and the demands of his or her physical or mental state. It talks about conversations “that are playing out increasingly between husbands and wives, children and parents, and others as the population of older Americans swells.” And there’s no doubt that America is getting older: according to the Washington Post piece, “By 2050, the number of people 85 and older is projected to triple.”

As we read the article, we could almost hear the pain in a loved one’s voice. The words may reflect actual conversations many our clients have had or will soon need to have. “Promise you won’t put me away. It is hard to say no to that request,” says the article. “But it often is even harder to honor it.”

As the article says, even if that promise is never stated it is often implied. We feel it’s our duty to care for Mom or Dad, or our infirm spouse, at home, no matter what. But over time such desires may prove unrealistic. In the words of the Post, caregivers “engage in a constant calculus: How long can you hold a job, take care of a declining loved one and stay healthy before something cracks? Where is the line between self-abnegation and self-preservation? How do you balance the best interests of the sick person and those of other family members?”

One expert quoted in the article is a geriatrician named Bill Thomas. As Dr. Thomas points out, often the real issue is not about nursing homes per se. It’s about preserving dignity and privacy, and avoiding a life of pain. Sadly, Dr. Thomas reminds us, promising to keep Mom or Dad out of institutional care may actually increase the amount of abuse and neglect they’re subjected to, because “there’s a limit to what [a family member] can do.”

In spite of the burden that caregiving places on family members and spouses, many people insist on home care even when institutional care may be the better option. “Caregiving can take a severe financial toll,” says the Washington Post, “and studies have shown higher rates of depression, physical illnesses and mortality among family caregivers. And yet the impulse to keep a loved one at home is powerful.”

The point of the article seems to be that honest conversations about institutional care are essential. We fully agree. Avoiding unplanned institutional care is one of the essential elements to a solid retirement plan, but so is avoiding becoming a burden to your loved ones. Deciding how to balance these ideas demands careful planning and unusual wisdom.

An excellent way to begin the process of preparing your retirement plan – your LifePlan, as we call it – is to attend one of our free LifePlanning Seminars. We hold these in locations throughout the region, and in a brief session we cover all five facets of a well-rounded plan. What are the best housing choices for you? How does your family figure into your retirement planning? Are your financial affairs in order? Are all your legal documents up to date and complete? How will you handle your health care needs?

If you’re ready to take the first step, click on the Upcoming Events tab on this website – then plan to join us at a LifePlanning Seminar soon. We’ll look forward to meeting you!

(originally reported at

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