Dilemmas: When is it time for mum to leave home?

My mother, aged 90, has always been a very determined woman and in the past has often made me swear that I would never put her in a home. But her behaviour is getting increasingly bizarre. When I went round this week, she had left a gas burner on , the phone was off the hook, the cat had not been let out for days, and the place was stinking.

She has a home help, but even though I've found her a room in a lovely nursing home very near to me, she is adamant that she won't go. She says she will die in her own home, and that if I move her into a nursing home I will kill her - though I have a feeling that if I really used every inch of emotional blackmail, she might agree.

She has already had two very bad falls and has days when she's very confused, but still manages somehow to struggle on. She refuses to see the doctor. I am sick with worry. Have other readers had to face this problem? Yours ,Gemma Damned if she does; damned if she doesn't. By taking complete responsibility for her mother's welfare, Gemma has put herself into a no-win situation. If she lets her mother stay at home in cat-stinking squalor and her mother then dies from a fall or a heart attack on her own, Gemma will feel responsible; if she puts her mother into a nursing home and the old lady immediately dies or loses her marbles, Gemma will equally condemn herself for her demise.

There are two questions for Gemma to ponder: first, whose interests does she really have at heart when she considers putting her mother into a home? It sounds as if the idea is actually a short-term and a selfish one, designed only to help Gemma sleep easily at night, having transferred the responsibility of her mother's care into the hands of paid nursing staff. Never mind the fact that her mother may well not be sleeping as easily herself, imprisoned in a "nice, clean room" from which death is the only escape.

And when her mother finally does die, what will Gemma feel then? Will she berate herself for the rest of her life for not trying harder to keep her promise that she would never put her into a home? Probably.

The second question is, what were the subclauses of the original promise Gemma made to her mother? It may, after all, turn out to be an untenable promise. Were both their homes to be burnt to the ground, obviously the promise would have to be broken. Were her mother to turn into a homicidal maniac, again there would be no problem about breaking the vow.

Most of us regularly make promises that, when circumstances change, we break through no fault of our own. When our partners, who we've sworn never to leave, turn into alcoholic wife-beaters, we pack our bags; when the book we promised to return is stolen, we break our word.

Indeed, it is always worth remembering not to make wildly emotional promises about the future to anyone, just in case the words return to haunt you - as they have to Gemma.

Most promises are actually preceded by the unspoken words: "I will do my best to ..." In Gemma's case, after the words "I will never put you into a home", the unwritten conditional clause surely runs: "until all other avenues have been exhausted".

As readers have pointed out, Gemma has not begun to exhaust the other avenues. When and if she does, probably she will not have to use emotional blackmail to get her mother into a home; a doctor would take the decision for her.

.Damned if she does; damned if she doesn't. By taking complete responsibility for her mother's welfare, Gemma has put herself into a no-win situation. If she lets her mother stay at home in cat-stinking squalor and her mother then dies from a fall or a heart attack on her own, Gemma will feel responsible; if she puts her mother into a nursing home and the old lady immediately dies or loses her marbles, Gemma will equally condemn herself for her demise.

There are two questions for Gemma to ponder: first, whose interests does she really have at heart when she considers putting her mother into a home? It sounds as if the idea is actually a short-term and a selfish one, designed only to help Gemma sleep easily at night, having transferred the responsibility of her mother's care into the hands of paid nursing staff. Never mind the fact that her mother may well not be sleeping as easily herself, imprisoned in a "nice, clean room" from which death is the only escape.

And when her mother finally does die, what will Gemma feel then? Will she berate herself for the rest of her life for not trying harder to keep her promise that she would never put her into a home? Probably.

The second question is, what were the subclauses of the original promise Gemma made to her mother? It may, after all, turn out to be an untenable promise. Were both their homes to be burnt to the ground, obviously the promise would have to be broken. Were her mother to turn into a homicidal maniac, again there would be no problem about breaking the vow.

Most of us regularly make promises that, when circumstances change, we break through no fault of our own. When our partners, who we've sworn never to leave, turn into alcoholic wife-beaters, we pack our bags; when the book we promised to return is stolen, we break our word.

Indeed, it is always worth remembering not to make wildly emotional promises about the future to anyone, just in case the words return to haunt you - as they have to Gemma.

Most promises are actually preceded by the unspoken words: "I will do my best to ..." In Gemma's case, after the words "I will never put you into a home", the unwritten conditional clause surely runs: "until all other avenues have been exhausted".

As readers have pointed out, Gemma has not begun to exhaust the other avenues. When and if she does, probably she will not have to use emotional blackmail to get her mother into a home; a doctor would take the decision for her.

My own mother, fiercely independent, suddenly started to become confused at about 82. She lost a great deal of weight by forgetting to eat; she stopped telephoning my sister and me, and eventually did not answer the phone, or left the receiver off; the house became dirty. The crisis came when, after trying to contact her by telephone from 6pm to 10am the next day, we had to call the police to break open the front door. My mother, normally an early riser, was asleep, and a telephone call to her doctor, who admitted she might have hypothermia, did not even rate a visit from him.

Eventually, my sister found a very nice nursing home, and after a Christmas visit to us, she was taken back there, rather than to her cold, neglected flat. We both felt guilty and apprehensive, even though previously we feared the next call would be to say that she had died or had an accident.

This was two years ago. My mother has put on weight, has a lovely clean room with many of her own possessions. She is still confused but seemingly happy and well looked after. The problem with dementia, even in the early stages, is that people lose the ability to make judgements for themselves. We have the consolation of believing that we did the best we were able to do.

Even if Gemma does not need to go to the lengths of "tricking" her mother into a nursing home, she should use all the emotional blackmail she can, for both their sakes.

Yours sincerely, Lisa Pennington,Wiltshire My mother is 95 years old. Over the past year or two, when she was living at home, she had a series of blackouts, resulting in falls. Her appetite was failing and she struggled each day to go shopping with her "pusher". After a few weeks in hospital for a check-up and assessment, she was discharged and sent home.

Social services came up trumps with a package of four home visits a day from care assistants. Unfortunately, my mother did not respond to this. She neither ate regularly nor took her medication. All day she would sit in a chair and not read or listen to the radio or watch TV, all of which she had previously enjoyed. I tried to reason with her that this situation could not continue and that unless she co-operated, I would have to put her in a home, which I shortly did.

She protested and swore but realised that her time had come to do as she was told by someone who cared about her future. She is now in a reasonably happy state with her memories and does not want to see relatives or friends.

I can only stand being with my mother for 20 minutes at a time, but I am happy that she is being well looked after, and I know she is safe. I have made the decision and have to live with it, although I do not like it.

Paul Underhill,Knutsford I had to put my mother in a nursing home when she was in her early seventies, after she had lived with us for 10 years. Helping her to clean out her room was one of the worst days of my life. Yet I do believe that in the last sixmonths of her life, she was happier than during the last six months spent with us.

She did remind me from time to time that I had put her in a home and I still feel guilty. The truth is that I did it for the health of myself and my family. Gemma must do the same.

Yours sincerely, AJP Dalton No, please do not use "every inch of emotional blackmail" to force your dear mother into a home she does not wish to go to. Use it instead to help her to stay in her own home.

As her daughter, you have the responsibility of your mother's wellbeing, but as her daughter and friend you can also see her needs, too. After all, many elderly people do not consider themselves to be "old" and the last thing they want to do is share their precious last years with a whole lot of other old people they have nothing in common with, apart from their great age. Unless there is no other alternative, I cannot see why your mother cannot stay at home.

Yes, I have had experience of this and although I was fairly young with a mother of advancing years and disability, I respected her views and wishes for her own life as she did mine. If you work full time, I know how difficult it is to fit everything in,and my mother knew I could not look after her on a daily basis. Nevertheless, with the help of aids, including a trolley to lean on so she didn't fall, suitable non-slip flooring, an electric cooker, a home-help, a nurse who bathed her weekly, two ve rykind neighbours (one who is now 93 and with "help" stays in her own home, too), a caring doctor (I think doctors are obliged to visit their elderly patients regularly anyway, so perhaps yours just needs a kindly reminder) and a special emergency telep hone that incorporated a press-button worn as a necklace which could be pressed in a real emergency, my mother managed her day-to-day life very adequately. The latter aid was for my own reassurance - not hers.

Good luck, Adeline, Edinburgh Next week's dilemma: Dear Virginia I have two goldfish in a tank, which were given to us as a wedding present. One of them has developed a tumour on its eye. I have taken it to the vet and he says, to my amazement, that it could be operated on. The problem is that it will cost about £60.

As we are on rather a tight budget, my husband is very against the idea of spending this. He says it is only a fish, and that it will die anyway, and we should either flush it down the loo or let it die naturally. I see the logic of this, but something makes me feel I am wrong to agree and that we should pay for the operation. What shall I do? Yours,Margaret All comments are welcome, and everyone who has a suggestion quoted will be sent a Dynagrip 50 ballpen from Paper:Mate.

Please send your comments and suggestions to me at the Features Department, The Independent, One Canada Square, Canary Wharf, London E14 5DL, fax: 071-293 2182, by Tuesday morning. And if you have any dilemmas of your own that you would like to share with readers, let me know.

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