Dear son or daughter:
I take care of your mom. She lives at the end of the hall and has flowers on her door and peppermints in a dish by her chair. She is here in the nursing home because her health is failing.
It has been failing for a long time now, but I understand how hard it was to accept that her falls at home were not just because she was “getting clumsy,” as she said. Her increasing confusion over conversations you had with her was not just because she simply “forgot” or “wasn’t paying attention.”
I recognize your feelings of guilt that she is here after telling her years ago you’d never “put her in a home.” And the mixed emotions you have toward your siblings, who aren’t convinced she needs to be “institutionalized” but also don’t live nearby and haven’t experienced the subtle or not-so-subtle physical and mental changes you have witnessed.
I know that you are grieving. Yes, grieving. This is your mother. The woman who raised you and cared for you when you were sick and helped you become the adult you are today. Despite challenges in your relationship over the years, you love her. And you are afraid to acknowledge that she is dying.
I understand that remaining involved in her care, from keeping track of what she eats to making sure the staff walk her every day, is you striving to do what you can to help even though you feel completely helpless.
What I want you to know is that I’m a daughter and a granddaughter, too. And I work in a nursing home because your mom is vulnerable and needs an advocate and has probably led a pretty incredible life but is modest and will brag about you and her grandchildren but is less likely to tell me she is in pain or not feeling well.
See, she thinks I’m busy and doesn’t want to burden me. But I know this about her. And I find her endearing and sweet, and I’m determined to help make her more comfortable anyway.
I want to work with you to figure out the best plan of care for her. I’m willing to talk to your family, too, because they may need help in understanding what is going on with her. I may not have all the answers you seek, and I may tell you things you don’t want to hear or are not ready to hear.
But your mom’s interests are at the top of my list. I’m here to support you as you make some of the hardest decisions of your life regarding a person you love dearly.
I want you to know that I hear you and I see you and I understand what you are going through. And I admire your dedication and commitment to your mom. I recognize the special person she is, and I care for her, too — that’s why I became a nurse practitioner. I hope that helps in some small way during this difficult time.
Sincerely,
Your health care provider
Howe is an assistant professor of clinical nursing at the University of Rochester and a DNP at the M.M. Ewing Continuing Care Center in Canandaigua. Contact her at [email protected].
