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Caregiver Mental Health – Part 2

Making the assisted living decision

Large tree with cloudsIn Part 1 of our focus on caregiver mental health, we outlined a few of the factors that can lead to stress, anxiety and depression among caregivers. In Part 2, we take a look at one of the most difficult decisions a caregiver might face: Moving from in-home care to assisted living.

This clip from the Independent Lens documentary “You Can’t Care for Dona Anymore” shows the heart-wrenching moment when a mother leaves her intellectually disabled adult daughter in a residential facility. The mother’s guilt about her decision is apparent in the clip, as is the family’s belief that the move is the right decision for their loved one, Dona. Families face decisions like this one every day, and it can create a lot of stress and doubt.

Why consider assisted living for a disabled adult

As we discussed in Part 1, caring for a loved one with a disability can often become more challenging than anticipated. Caregiving is more than a full-time job, and all the love in the world is often not enough.

Sometimes, in-home care is the right answer, but there are a number of reasons to consider a residential facility instead:

  • If your loved one is prone to wandering, falling or risky behavior, staying in your home might lead to injury. A residential facility can provide a safe, controlled environment for an adult with intellectual or developmental disabilities.
  • Level of care. Keeping track of medications, physical therapy sessions and day-to-day care can place an undue burden on the caregiver. In a residential facility, trained staff provides the right level of care for each resident’s needs.
  • Social aspects. While you can provide love and care to your loved one, he or she may still need friends or other social outlets. A group home or assisted living facility can provide that valuable social network to your loved one.
  • Caregiver’s health. In many cases, the caregiver has health concerns that can make it difficult or impossible to continue caring for a loved one with disabilities. Opting to place your loved one in assisted living allows you to focus on your own health while ensuring quality care for your loved one.

Making the right choice for you and your loved one

There are a variety of options available for adults with disabilities, including:

  • Group homes
  • Assisted living
  • Section 8 housing
  • Skilled nursing facilities

The right living arrangement for your loved one will depend on a number of factors. If your loved one can manage some level of independent care, for example, an assisted living or group home can give them some independence combined with help bathing, cleaning, managing medications and more. This article offers a helpful overview of the types of options available to you.

Another major factor in your decision will be cost. Each option comes with a different financial impact, and assistance programs and insurance only cover some options. To learn more about the financial aspect of caring for disabled adults, this article offers some guidelines and helpful links.

Managing guilt and worry

For a caregiver faced with big decisions, such as choosing assisted living or a group home, feelings of guilt and worry can become overwhelming. If you are faced with making this decision for a loved one, be gentle with yourself first and foremost. Remember that placing your loved one in a residential care facility is often the most loving and responsible choice you can make.

To cope with the feelings that arise along the way, remember to:

  • Seek support. You don’t have to keep your feelings inside. Reach out to understanding friends and family, find a support group or schedule time with a therapist. Talking honestly about your role as a caregiver can help ease some of the stress and guilt you might be feeling.
  • Take time for you. As a caregiver, you often place yourself and your needs last. As you transition your loved one to a residential facility and work to develop a new routine, be sure to take time out to enjoy your own hobbies and interests. Focusing on something other than your loved one’s care can help you relax and reduce the effects of stress and worry.
  • Acknowledge your important role. Too many caregivers are quick to brush off compliments or kudos for the care they have provided a loved one. Take a moment to honor yourself: You have provided such important love and care to someone with a disability, and now you are helping him or her achieve a new level of independence and social interaction in a residential facility. The work you have done matters.

Scott Kohner MSW, LCSW is a psychotherapist in Denver, CO working with individuals, couples and families. To learn more about Scott, visit