Family Conflict Series: When Promises Become Impossible

According to the Alzheimer’s Association, people with Alzheimer’s disease or other forms of dementia may lose awareness of recent experiences as well as of their surroundings, experience difficulty walking, sitting, and communicating, and may eventually require around-the-clock assistance with daily personal care.

In these later stages, it can be extremely difficult for families to care for their loved ones without professional support.

One of the most heartbreaking moments families must face is when a loved one constantly reminds them of a promise made years ago that they would never be placed in a senior living community.

The emotional weight and guilt can be overwhelming for caregivers, especially when they genuinely want to honor that commitment, but recognize their loved one needs and deserves care they’re no longer able to provide.

Most families fully intended to keep their promise, but they could never have imagined the physical, mental, and emotional challenges of caring for a loved one with dementia. When this promise was made, families imagined the effects of normal aging, not the wandering, complete personality changes, or aggression that can come with dementia.

Although this situation is emotionally challenging, there are ways for family caregivers to navigate it with empathy and understanding.

Understanding Your Loved One’s Feelings

Understanding your loved one’s fears, acknowledging their emotional needs, and giving them an opportunity to express themselves can improve communication and ease the transition.

Dementia takes so much away from a person; they lose their memory, personality, and independence. Your loved one may struggle with sadness, anger, fear of the unknown, and fear of dying. To them, moving to a senior living community may feel like a final loss of independence.

In these moments, it's common for loved ones to use guilt as a way of reminding you of the promise you made. People with dementia are navigating new spaces daily. Some things are familiar, and some are not. Even if they don’t remember everything, they recall emotions and how to evoke a response from a loved one, and guilt is their way of holding onto something familiar.       

Tips for Managing Your Loved Ones’ Emotions

It can be frustrating when a loved one frequently reminds you of your promise to care for them at home as they age. However, there are effective strategies to support them throughout the dementia journey.

Acknowledge Their Feelings, but Don’t Argue

When speaking to your loved one, listen and acknowledge their feelings, even when they remind you of the promise you made. Instead of arguing or becoming defensive, respond with empathy and understanding.

Let them know you understand their feelings and that you love them and only want what's best for them. Reassure them that you're committed to their well-being and you're not walking away.

Reframe the Promise

Gently explain that your promise to take care of them and to keep them safe hasn't changed. Let them know that ensuring their safety and well-being is still your priority, and being able to do so means seeking help from professionals who are specially trained to support individuals with dementia.

Admit you’re worried about their health and well-being, and you need help. This admission and acknowledgement can change their mindset because you're validating their feelings and admitting you're no longer able to provide the care they need and deserve.

Give Your Loved One a Sense of Control

Giving your loved one a sense of control, even in small ways, can help them feel respected and valued. Discuss their preferences when choosing an assisted living or memory care community, visit them together, enjoy a meal, give them the opportunity to meet residents, and ask questions.

Before moving into the community, let them decide what clothes, furniture, accessories, and photographs to bring to decorate their room. Reassure them that you and other family members will visit often, stay involved in their care, and make it easy for them to contact you if they need help or want to see you.

Ways for Caregivers to Manage the Emotional Challenges of Dementia Caregiving

Caring for someone with dementia is a significant responsibility that stems from love and a sense of duty. However, it can be emotionally challenging to provide care, especially when you’re faced with reminders from a loved one that you promised to keep them at home.

That’s why It’s important for caregivers to prioritize their physical, mental, and emotional well-being.

Don’t Take Things Personally

Individuals with dementia don’t see the changes that are happening to them. They believe they’re fully capable of driving, cooking, and taking care of themselves, even though they are not.

It’s important not to take their frequent reminders or outbursts personally, even when they express anger or frustration. People with dementia struggle to process information, balance their emotions, and make sound judgments.

Let Go of the Guilt

Unfortunately, guilt is a part of caregiving, especially when a promise clashes with reality. As a caregiver, your resources and abilities are limited. You’re balancing a career, a family, and maybe your own health issues, all while trying to provide safe, quality care. Choosing professional care isn’t a betrayal of your loved one; it’s an act of love and responsibility. Your responsibility is to ensure they receive compassionate, safe, and high-quality care.

If your loved one could fully comprehend the emotional and physical toll caregiving was taking on your health, they would have never held you to the long-ago promise.

Give yourself grace. Making the decision to move your loved one to a memory care community doesn’t mean you don’t love them; it means you're making decisions that they can no longer make for themselves.

Focus on the Benefits of Memory Care Communities

Memory care is a specialized, long-term care option designed to meet the unique needs of individuals with Alzheimer’s disease, other forms of dementia, or cognitive changes.

Benefits of memory care include:

• Support and memory care resources for families
• Additional safety precautions to prevent wandering
• 24-hour care and supervision by professionally trained staff
• Personalized memory-enhancing activities and therapies
• Assistance with activities of daily living (ADLs)such as bathing, dressing, and grooming
• Beauty salons
• Modern living spaces
• Transportation to shopping, local areas of interest, and cultural events

Although many people initially resist moving to senior living, they often adjust and thrive over time. Residents appreciate the opportunity to meet and connect with people who can understand their journey, while families have peace of mind knowing their loved ones are safe, cared for, and surrounded by a loving community.

Wrap-up

Dementia is a journey for individuals and their loved ones. Navigating this journey isn’t easy. Give yourself permission to grieve and feel sad. Be patient with your loved one, let go of guilt, give yourself grace, and take it one day at a time.

Remember, you're not alone. Speak with a therapist, other caregivers, support groups, or senior living experts when you need help.

To learn more, listen to the Family Conflicts Series Episode 4: When Promises Become Impossible episode of The Disappearing Mind, an award-winning podcast hosted by National Dementia Coach Dawn Platt that helps listeners navigate their personal journey with dementia through exclusive and direct perspectives of people diagnosed with the disease, their caregivers and experts in the field.