Being a caregiver is an important and demanding job. As the level of care your loved one needs increases, it may be time to consider whether a nursing home is the next logical step.
“Each situation is unique,” says AAMC Associate Chair of Medicine Jeanette Abell, MD. “It depends a lot on the person, family, overall condition and symptoms. In general, it might be time if there are home safety issues, problems with falling or needs beyond what the caregiver can provide.”
It may also be time to consider a nursing home or extra support if you are experiencing burnout as a caregiver. Caregiver burnout can include feelings of frustration or anxiety, physical illness or negative impacts on your other relationships.
“These situations are never easy. One of the most important things is letting caregivers know that it’s OK to ask for help,” says Dr. Abell.
It’s normal to feel stressed, guilty or anxious. It’s important to get appropriate support for what you need. You can’t continue to be a caregiver if you are not healthy yourself.
If it doesn’t seem like quite the right time to move your loved one to care outside the home, Dr. Abell notes that there are several options to consider. She suggests adding support in “layers.” These could include making sure your house is safe, having someone to go grocery shopping or cook meals, or putting in place an alert system to notify the right people if your loved one falls. There are also adult daycare facilities, where older adults can go during the day for socialization, recreation, meals, and occupational or physical therapy.
When possible, Dr. Abell suggests discussing your loved one’s wishes ahead of time. Have a conversation with your loved one and write down who should make healthcare decisions when he or she is unable to do so. Additionally, you may want to research and visit care facilities in your area, so you are prepared before a crisis strikes.
“There is a real disconnect in the importance of these conversations and who is actually having them,” says Dr. Abell. “That’s why it’s important to have these conversations before a crisis. I like to refer to them as ‘kitchen table conversations.’”
Jeanette Abell, MD, is the AAMC Associate Chair of Medicine. 
