Her husband must leave the hospital, and there is no way she can care for him at home. She has been the caregiver in the home for a few years since he first became ill, and then he fainted and fell. After some time in the hospital he was transferred to the extended care wing for therapy. The most he has been able to do is walk a few steps on his own. He cannot get up by himself and is too heavy for her to lift by herself. She has consistently said there is no way she can take him home until he can get up on his own. But, the time has come for his release from the hospital. The decision to release him is based on insurance not on his condition. Even though he does not meet the criteria she set for her giving care in the home, she is planning to do just that.

There will be some help available through home health, and she seems able financially to hire help for a short period of time. She could end up spending all of the money they saved for their care on him and have nothing left for any care she might face in the future. Their case is made more complicated by their having no children to step in and help now or when she needs care. None of this seems to register with her. She will take him home.

Her case is just one of thousands like it that take place in hospitals every day. No matter how hard the physicians and the hospital staff talk, no matter what counsel she receives from those trying to guide her. If she had children involved, they might as well be speaking to a door, their words will not register.

People make the hard decisions of life when they are ready to do so. No one can really determine when they will be ready. This proves to be maddening sometimes. It may seem like there is no way they cannot be ready, but until they are, our counsel falls on deaf ears. For those giving the care, stepping back and letting them come to the place on their own is hard to do. It is even harder for the family.

There is no blindness like the blindness of just not wanting to see. She sees him walk a few steps "on his own" and forgets someone had to lift him out of bed, and walk with him in case he falls. She just knows he will get better as soon as he gets home, and there is no stopping her.

Turning over the care of a spouse of over fifty years, is a terribly hard decision to make. They long ago promised to care until death, and they have walked through life as one. There is no logic that makes that an easy decision. There really is no physical reality that makes it a decision they can feel good about. Their very existence is wrapped up in caring for one another. Neither would know how to adjust to this new reality and role. So she clings to any small sign to justify her giving care at home.

Sometimes, we have to step back and let them get ready the hard way. That sounds dangerous and uncaring, but we have a much better chance of helping them come to a better solution if we do not fight them at this stage. If they have to make the decision in spite of tremendous pressure, it is that much harder to change that decision latter. Too many care givers work themselves to death trying to prove some point or justify some bad decision.

I am listening to her, and simply showing her options being careful not to come across as trying to talk her into anything or force any decision. She probably will have to take him home and try before she can really see the truth about the situation. If we do not become her enemy and alienate her now, the door is open for us to gently lead her in the very tough decision she will inevitably have to make. 

Sometimes tough love means we have to make decisions we don't want to make. Sometimes the tough part is holding our tongue while waiting for the one who has to make such a decision finally gets ready.