Moving into a care home: family conflict
When someone you look after with dementia moves into a care home, it can bring with it a whole range of emotions for those involved. The outcome can often be family disagreements or conflict.
In fact, in my experience (as a social worker), there’s almost always a difference of opinion within families. After all, we are all unique individuals with differing views. If a person with dementia cannot make the decision about moving into care, then this huge life event and the responsibility for it happening lies with those who care for them. The weight of this is enormous and not without deep emotional impact.
A common scenario – one family member may want the person with dementia to keep living at home. They may have promised them they would never ‘put’ them into care. Another family member may have reached a point where they feel that enough is enough and things have become unmanageable at home.
A family story
Let me tell you the story of the Jones family:
Mrs Jones had been living in her marital and family home for over 60 years. Her husband had passed away 5 years ago and her world changed. Mr and Mrs Jones had done everything together. The family rallied round, but with their own young families and careers, they could only support Mrs Jones for a few hours a week.
Mrs Jones had been diagnosed with dementia 2 years before her husband died and life at home had become more challenging. A ‘4 x a day’ package of care was started for her and she was able to attend a local day-centre twice a week.
However, risk was increasing all the time and after several police incidents where Mrs Jones had been out during the night (looking for her parents), she was admitted to hospital.
During the hospital discharge planning, Mrs Jones was assessed as not having mental capacity to decide on her future care. Mrs Jones’s family had taken out power of attorney for health and welfare decisions and therefore had the legal right to make the decision on where she would reside on discharge.
At this point, it was clear that the family did not have the same views on where Mrs Jones should receive the most appropriate care.
- Mrs Jones was expressed her wish to return home – but lacked insight into her deteriorating health and care needs.
- Her daughter, had promised her mum she would never ‘put’ her into care and the repetition from her mum about wishing to return home was stressful and upsetting.
- Her son, who could not provide regular support due to living some distance away, argued with his sister and caused unintentional distress to his mother by being honest and saying she needed 24-hour care.
This resulted in a series of heated arguments between the siblings (and spouses), involving blame and guilt. Mrs Jones’s best interests were in danger of being lost.
At the root of this, both children loved and wanted the best for their mum. However, emotion and guilt got in the way of their communication to each other and blame was the result.
To resolve this conflict, the Jones family met and gave each family member the opportunity to go through each of the options for Mrs Jones. The positives, negatives and challenges were weighed up for each option. Mrs Jones did move into a care home following this as some resolution was found to ease both siblings’ anxieties.
(This story is based on a real-life scenario)
Working through conflict
The Jones family were able to resolve some of the conflict by working through options in a pragmatic and practical way, taking some of the heat out of the situation. For other families, this may not be possible. In those circumstances, a form of mediation is may be needed – such as family counselling or psychology input.
Communication is always key when trying to work through conflict, as difficult as this may be. If the person with dementia has an advocate, this person will be able to represent their views and wishes. This may take the ownership away from family and help them with acceptance. Of course, it can also lead to further disagreement when family understand the lived situation more clearly and may disagree with the advocate.
Remember you are not alone
Finally, if anyone you look after with dementia needs to move into a care home – with or without mental capacity – it is a huge life decision. Making this choice on behalf of someone is always going to carry with it emotions that can lead to conflict which may, or may not be able to be resolved.
But do remember you are not alone. If you need further support, please join us on zoom where we discuss this this topic in more depth, exploring carers feelings throughout this challenging time and ways of taking care of yourself.
More support online
The Live Online Learning series: ‘Transitions into Care’ explores these issues in more depth. Led by registered health and care professionals, the online webinars support carers through this difficult life event. These sessions help family carers to feel as prepared and supported as possible during this time. There will be time to connect with other carers as well as the professionals in a supportive and protected environment.
By Katy Evans, an experienced social worker based in South Wales with a background in local authority and adult social care.