Navigating Cultural Conflicts: When a Loved One Needs Nursing Home Care
I’ve been where you are—sitting up late at night, staring at the ceiling, wondering if placing your loved one in a nursing home means you’re failing them. It’s a gut-wrenching thought. Especially when you promised them—or maybe even yourself—that you’d never let it come to this. I know because I’ve wrestled with the same feelings.
This isn’t an easy journey, and if you’re like me, you’ve probably felt overwhelmed by the weight of caregiving, the cultural expectations of keeping your loved one at home, and the sheer exhaustion of trying to hold it all together. Let’s unpack this together, caregiver to caregiver, and figure out how to navigate these emotions while making decisions that honour your loved one and yourself.
When the Caregiving Gets Hard
Let’s be honest—caregiving is hard. It’s physically demanding, emotionally draining, and sometimes isolating. I used to think I could do it all. I mean, isn’t that what we’re supposed to do? For many of us in the Black community, there’s an unspoken (and sometimes spoken) expectation: you take care of your own. We’ve been taught that nursing homes are the absolute LAST resort, a sign that we’ve somehow let our loved ones, and in some cases, God down...and it doesn’t stop there. If you belong to a church family, you’ll often hear the condemnation from brother or sister so and so express their disappointment without having a clue about your situation. You’re asked, “So what are you going to do?” with eyes expressing how ‘ungrateful’ you are.
But what happens when caregiving starts taking a toll on your health? Your way of making a living? What happens when your parents' needs grow beyond what you can manage? What happens when you try to explain to other family members why you are unable to keep up with the demands of the home such as regular cleaning, being present and attentive to your children or spouse? They say “Once a man, twice a child”. However, if you are a parent, and have managed the care of your aging parent(s), you will see while there are some similarities, there are several differential factors. Let’s begin with your perception. There is excitement and anticipation in seeing the arrival of a baby or watching your child achieve their milestones. The opposite is true when we observe the changing health of a parent. We do NOT anxiously anticipate our once vibrant, agile parents to gradually lose their independence. We have certain expectations of our children as it pertains to careful instruction where we will see changed behaviour over time. When we try to instruct a loved one who is living with dementia, we need to prepare ourselves for the likelihood of carry-over to be negligible or non-existent.
Looking back, I wish I’d had “the talk” with my mom in more detail before things got tough. Ironically, mom worked in a skilled nursing facility for over 30 years and I would frequent her workplace as a teenager/young adult to borrow her car during her shifts. I’d walk in and familiarize myself with her coworkers and even some of the residents. Yet, not for a second did I believe I’d ever have to consider placement for my mother. When she was still healthy, I could have asked her more in-depth questions about how she felt about nursing homes and discussed her preferences. I could’ve toured places together, taken notes, and gotten ahead of the curve. If your loved one is still in the early stages of illness—or even healthy—start the conversation now. Approach it gently:
“Mom, I want to make sure we’re prepared for the future. Can we talk about what you’d want if you ever needed extra care?” It’s not an easy discussion, but having it early helps. You’ll have a better idea of what they want, and they’ll feel like their voice matters.
Tour Homes Before It’s Urgent
One thing I am learning: learn more about the homes in your area. To be honest, I’m still grappling with this as we speak. There are times I feel like I have no option and then there are times I ask myself “What are you doing, Valene?” I have had several stop-and-go moments with my research because what I’m also dealing with is the grief around her current state in addition to the grief I feel in struggling with her care and life overall. In speaking with our social worker, she mentioned based on her experience that when the need for a nursing home becomes urgent, the pressure to make quick decisions can feel suffocating. What I do know is that I don’t want to become so busy with day-to-day caregiving that I avoid thinking about it—until I have no choice. Let’s try not to wait until you’re in crisis mode.
My advice. Start visiting nursing homes in your area now. Look for ones that have good reviews or get referrals from people you trust. Bring a checklist of what’s important to you—cleanliness, activities, cultural sensitivity, proximity to home, staff-to-resident ratio. Ask questions like:
• How do they handle emergencies?
• What’s their staff turnover rate?
• Can residents bring personal items to make their rooms feel more like home?
Seeing the homes and meeting the staff might help ease some of your fears. You’ll have a clearer picture of what to expect, and you’ll know which ones feel right for your loved one if the time ever comes.
Dealing with Guilt
Guilt comes with the territory, doesn’t it? You might feel like you’re breaking a promise or letting your family down. I’ve been there, and in many ways, I still am. What is helping me is reframing my perspective. Moving my mom to a nursing home doesn’t mean I love her any less—it means I loved her enough to consider her needs with the support and care that is likely to be more beneficial to her than I can give.
If you’re struggling with guilt, remind yourself:
• You’re not abandoning them. You’re finding them the care they need.
• You can still be involved. Visit often. Get to know the staff. Show up for special events. Your presence will make a difference. (This is also advice from an old friend of mine who went through this same situation with his grandmother. He mentioned the staff seemingly provided extra attention to his grandmother because the staff became aware of the abundance of family involvement).
Staying Involved
Even after moving a loved one to a nursing home, you’re still their advocate. Visit regularly. Pop in unannounced sometimes to see how things are going when no one’s expecting you. Pay attention to how your loved one looks and feels—are they clean, comfortable, and engaged?
Bring a sense of home with you when you visit. Bring their favourite lotion or play their favourite gospel songs. These little touches remind them that they are loved and cared for.
• You’re human. You can’t do it all, and that’s okay. Remember, there are people who do ALL of your roles, full-time as a single job: chef, housekeeper, nanny, tutor, chauffeur…I’m sure I’m missing something but you get the picture.
When Caregiving Becomes Too Much
If you’re reading this and thinking, I’m not there yet, but I’m getting close, it’s okay to ask for help. Whether it’s in-home care, respite care, or even just having family members take on more of the load, you don’t have to do this alone.
Burnout is real, and it’s dangerous—not just for you but for your loved one, too. When I hit my breaking point, I realized I wasn’t being the caregiver my mom deserved because I was so drained. Getting help doesn’t mean you’re giving up; it means you’re making sure they get the best care possible.
Managing Your Own Emotions
Making the decision to place your loved one in a nursing home isn’t just about logistics—it’s about navigating your own feelings, too. The guilt, sadness, and even relief can be overwhelming. Here’s what helped me:
• Give yourself grace. This isn’t an easy decision, and there’s no “perfect” way to handle it.
• Find support. Talking to others who’ve been through it—whether in a support group or just with friends—can make a world of difference.
• Take it one day at a time. You don’t have to have all the answers today.
Balancing Caregiving and Family Life
If you’re a member of the “sandwich generation” like me, you know the unique challenge of caring for an aging parent while raising kids. My daughter needs me, my mom needs me, my dad needs me and at times, I felt like I was failing all.
What helps me is remembering that I don’t have to be everything to everyone all the time. I’m setting boundaries, delegating tasks, and learning to say no when I need to. It’s okay to prioritize your own family, and it’s okay to take breaks.
Caregiver, all I have to say is that NO ONE, not even your closest friend truly understands what you’re going through. Make the decision that is best for you and your loved one. There will always be opinions on how you should live your life or the decisions you should make. Keep it honest for yourself and keep it in prayer—you WILL, find your way. Lastly, of all of the ‘to do’s’ and most importantly, be kind to yourself. You’re doing the best you can in an incredibly difficult situation, and that’s something to be proud of.