The reminders show up as soon as I hit the front stoop.
The door is always locked. A doorbell summons a nurse who wants to know why I’m there.
I sign in on a sheet of paper permanently posted by the door. I don’t have a fever. Check. I haven't knowingly been exposed to a virus. Check again.
“She’s in her room,” they say.
I move past the others, some in wheelchairs, some huddled together watching the Hallmark Channel, some who don’t seem to know or care where they are. A few smile sweetly. I wave. They wave back. We’re all trying to ignore the smell. Why must sickness and sadness be so pungent?
Her room is tiny compared to the beautiful house and yard she spent decades tending. A little sitting area holds photos of our family in happier times. Dried flowers protrude from an empty vase. There are cards and letters displayed from friends. We love you. We remember you. Those are the sentiments I see as I read between the lines of what they wrote. Who could ever forget her? She’s the best mom, grandma, and friend we’ve ever met. Still we take no comfort in knowing our goodbye will take so long.
My mom is in her late sixties. Her brain is bent and battered by the ugliness of early onset Alzhiemer’s. There have been many hard turns in the journey, but by far the worst (so far) has been the decision to transfer her from home to a memory care facility. It was not strictly my decision to make—I am blessed to be a part of a loving family, and we have shouldered the weight of this illness side by side. Nor have I been merely a passerby. Part of returning the favor of my mom’s selfless love for me has been being a part of her care, especially when it’s hard . . . and it often has been.
No one dreams about putting their loved one in a home. We all hold out hope that we will be able to manage when age and disease come calling. That’s a beautiful hope, worthy of clinging to. I’m not here to pop that bubble, but the fact is, seventy percent of us over age sixty-five will need long term care at some point, not to mention extended hospital stays, rehabilitation, or psychiatric treatment. As we wrestled with how to provide my mom with the best possible care and the highest quality of life, all while honoring her wishes and keeping ourselves afloat, I struggled to find insights that moved beyond merely clinical and offered a biblical perspective. I don’t claim to have all the answers. There’s no way to sugarcoat something as sour as a loved one diagnosed with a relentless and terminal illness. But I do believe that God’s Word gives us everything we need to live godly lives (2 Peter 1:3), perhaps especially when we seem to be wedged between a rock and hard place. Maybe you’re in that hard spot. You’ve got a decision to make about someone you love. You want to serve sacrificially. You want to do the “right thing.” You want to honor God. As you move forward, let God’s Word illuminate your path, one tender and needy step at a time.
Lead with Dignity
Never has Genesis 1 been more appealing and convicting to me than during this Alzheimer’s journey. The first chapter of God’s inspired Word reveals that God made mankind with divine intentionality. Adam and Eve stood apart from the rest of creation because they bore the image of God (v. 27). The Imago Dei is more than a theological bullet point. It is meant to inform the way we relate to all people, great and small, sick or well.
Your loved one is as made in the image of God in their deteriorated state as they were on their most vigorous day. They are no less loved by God when they cannot care for themselves than they would be if they were entirely self-sufficient. The world says we matter because we can produce; God’s Word says we matter because we are stamped with the image of our Maker.
This can become a practical waypoint as we seek to provide the care our loved one needs. It’s not just about certain medications or therapies. Nor is the cost of care the most important metric (though it’s not insignificant). The best question to keep asking as you make decisions is “What kind of care will provide my loved one the greatest dignity?”
This is rarely cut and dry, but in seeking to honor your loved one’s value, you are honoring God. You can trust that He sees your heart and is eager to guide you.
Love Is Patient
It’s been a long time since I was a baby. I’m well into adulthood now, but forty years ago my mom changed the wet and poopy diapers I was helpless to remove from myself. She fed me when I was hungry. She rocked me when I was tired. It took years for me to even say her name, much longer before I could truly reciprocate her kindness. Still, her love was steadfast and patient. In those formative years, she wrote a playbook on my heart for how to care for her in these years.
My mom is in a facility but that doesn’t mean my call to love her has been outsourced. She may be someone else’s patient, but she is my mother. I’ve held onto a little phrase throughout this difficult journey: my mom isn’t giving me a hard time, my mom is having a hard time. She’s the one whose brain has betrayed her. She’s the one now confined to a wheelchair. She’s the one who cannot remember the names of her own children. So regardless of the size and shape of her care at any given moment, I have a responsibility to play a long game. Nurses come and go in shifts. Doctors check in and call in scripts. But my calling in this matter is to love my mom patiently, in part, because that’s how she has loved me, but more significantly because patient love looks a lot like Jesus.
God’s call to honor my mother is still carved in stone (Ex. 20:12). I cannot in good conscience abandon her fully to the care of others, nor do I want to. It took time and wisdom for me to see that it was possible for me to love and serve her well in her new environment. Patient, steadfast, loving care is most important. The wheres and hows are secondary.
Beware Sneaky Pride
If you find your feet on the difficult road of loving someone who needs care, the last thing I want to do is heap on guilt or shame. Those things tend to pile up on their own as we struggle to love someone through an illness that is rarely linear. Symptoms and emotions go up and down, side to side. There are good days, bad days, and horrible days. I would invite you to ask the Lord to continuously search your heart. There was a time when I tried to maintain a white-knuckled grip on my mom’s future. “I’M GOING TO TAKE CARE OF HER,” my self-sufficient heart wanted to scream. It was pride, wrapped in the illusion of sacrifice. Though I love my mom, my deeper heart motivations were often rooted in fear and an unwillingness to get help. Even the idea of seeking full-time care for her felt like a massive failure. When someone else’s care becomes about other people’s perception of us or we become closed off to a plan that deviates from what we want, it’s time to cry out to God, confess pride, and ask for His help.
Here’s a mantra I adopted through our journey. Repeat it as often as you need to. (I often repeat it daily.):
God’s plan.
God’s way.
In God’s timing.
(Or not at all.)
Let Others Be Your Safety Net
Sickness and grief give us cataracts, making it seem impossible to make the “right” decisions. Many medical decisions, including type of care, can fall into the realm of Christian freedom, meaning Scripture doesn’t give us a mandate. That doesn’t mean we are left to throw a dart. Proverbs 11:14 promises, “In an abundance of counselors there is safety” (ESV).
My own safety net has held taut during this process. Several close friends intervened by helping me see the ways my caregiving was impacting others, particularly my small children who are still at home.
That pill wasn’t easy to swallow, but it was given in love and grounded in godliness. As you make the hard decisions along the way, don’t trust in your own wisdom. Seek God and lean hard into the insights of the wise counselors He has surrounded you with.
Jesus Is in Every Nursing Home
In this and every decision, what God requires from you is surrender. He never asked you to shoulder the full burden alone. He doesn’t require you to muscle through the valley with white knuckles and high blood pressure.
What makes the yoke of life light is that Jesus bears its weight. His invitation is to come to Him and rest in His sufficient care.
In the days leading up to my mom’s move, grief and fear set up a movie screen in my mind. I kept imagining her in her room, alone and afraid. Ultimately, I couldn’t find comfort in the quality of the place we chose or how homey we tried to make her new surroundings. But I could find hope in knowing that Jesus has promised to never leave or forsake my mom (Heb. 13:5). He is everywhere all at once (Psalm 139). No walls or diagnoses can separate her from His love (Rom. 8:38–39).
When the day came, my mom acted like she’d always lived there. She went to her room as if she’d traveled that hallway a million times before. It was one of many mercies we’ve experienced on this long and crooked road.
Our hope is not in a certain kind of care. It’s in the One who cares for us deeply.
An Opportunity to Cry Out
Acts 17:26–27 is a gold nugget you can keep in your pocket as you make this decision. Here the Holy Spirit boldly declares, “From one man he has made every nationality to live over the whole earth and has determined their appointed times and the boundaries of where they live. He did this so that they might seek God, and perhaps they might reach out and find him, though he is not far from each one of us” (emphasis mine).
God is on His throne. No hospital or nursing home intake form is an indication that He has lost control. In fact, He decides where we live, how we live, and when we die. He is no grand puppetmaster, pulling the strings to make us squirm. He is a loving Father. His sovereign hand moves us into places that remind us of our need and cause our hearts to cry out for His help.
I’ve never felt more needy than I have in these caregiving years. I can affirm that God is who He claims to be and He does what He says He will do. I have cried out in grief. He has responded in love. I have cried out in anger. He has responded with grace. I have cried out for help. He has provided again and again and again and again. As sweet as that is, I take greater comfort in knowing He has done the same (and more) for my momma. He will do the same for yours.
Move forward. Make the best decision you know how to make with your person’s dignity in mind and leave the rest to the One whose shoulders are broad enough to carry it. Cry out to Him. Reach toward Him instead of reaching for human answers. You will find Him every time. For no matter where you or the one you love lives, Jesus is never far.
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