As a caregiver for a loved one, we want to meet their needs and honor their requests so one of the most common phrases we might say to our older adult, especially when they say to us, “please don’t…” is, “I will never put you in a nursing home, let strangers take care of you or move you out of your home.” We make these promises with positive intent but sometimes we have to reframe our thinking about what we have agreed to do because we can’t keep these promises indefinitely. Although we thought that we could keep the agreement, caregivers often are not thinking about how situations change.

For instance, a loved one with dementia is wandering and needs 24/7 supervision which can better be provided at an assisted living facility or maybe you can no longer lift a loved one who needs assistance with transferring which requires someone with skill and strength to help. If a promise was made that “you would never”, are you holding back on securing the best option for your care receiver? The reality is that caring for older adults is often difficult, exhausting and complex and if you have made “the promise”, you may have to rethink what you agreed to do. If you have not promised, it may be better to resist doing so. You might say, “I will keep you at home as long as it is safe for everyone”. Or, “I will make sure your care is the best that we can afford and provide.”

If your loved one is capable of participating in a conversation with you, you may try to explain how caregiving is affecting your job, family, health and their safety and attempt to discuss solutions to the problems. Your loved one may get upset because they feel you are not honoring your promise and changing the agreement, but it is important for the caregiver to set boundaries so they can avoid burnout or not be able to meet the recipient’s needs appropriately. If your loved one does not understand that you can no longer honor “the promise”, it is important to give yourself permission to reframe “the promise” and find a way to deal with the guilt.

Most older adults want to age in place and live their lives as they have always done with independence and dignity. As caregivers, we want to honor the requests of our loved ones and attempt to do so even if there are enormous costs. While it is admirable that caregivers want to respect the wishes of their loved ones, it is important to recognize that “the promise” may be impossible to keep. In order to stay healthy and well themselves, caregivers must recognize that keeping “the promise” may not be an option. Sometimes it is important to accept that situations change and caregivers have to change their expectations of themselves.