When caring feels like a betrayal

The name is fictional, but the man is real. Here’s “Sal” in his new home.

“The fact is, I’ve simply lived too long.” My friend Sal’s eyes filled with tears as he surveyed his new apartment. “I’ve outlived so many friends … and …” He didn’t have to finish. I knew what he was thinking: “… and to end up in a place like this.”

The fact is, I helped put him there.

Sal didn’t want to end up in a nursing home. He’s fiercely independent — and just as fiercely private — so I’ve been trying for the past three years to help him stay in his home. I was happy to help, of course: It was easy to pick up some groceries before our weekly visits, or to pick up the occasional pile of mail.

Sal’s mobility gradually became more restricted, however, and soon he needed more help. He hired a housekeeper and my shopping became more substantial. “Sal shouldn’t be living at home anymore,” my husband would say when I’d mention our old friend.

Eventually, sometime last year, I began to agree. Sal could barely shuffle between the living room and the bedroom anymore, and his kitchen was a mess. Every surface — every table, every counter, even the floor — was covered with half-empty fish tins and stacks of paper.

I worried he might slip or trip on the mess but he rebuffed my offers to tidy up. He rebuffed lots of other offers, too: He didn’t want a nurse, or assisted living, or even extra housekeeping help. He just wanted to live at home, on his own, just as he always had.

My husband was growing more insistent: “Sal shouldn’t be living at home. And by helping him, you’re enabling an unhealthy situation.” I knew my hubby was right, and I agreed. But I couldn’t bring myself to not help.

Then, one Saturday a couple of months ago, the bottom fell out. “I think I’m coming to the end of my life,” Sal said to me over the phone. I rushed to his home that afternoon to find him feeble and pale. He couldn’t walk or even feed himself; the end really did seem near.

Sal’s cousin, his housekeeper, my husband, and I started caring for him around the clock, divvying the day into shifts. My poor hubby got the worst of it: He drew the overnight shift, which meant sleeping on the old carpet and waking in the wee hours to help Sal pee.

Within one week we were all exhausted. Sal, however, was thriving on the attention. “Love has brought me back,” he said to me one day, beaming. But he was still too weak to meet his own most basic needs.

I talked to Sal about how we might arrange for longer-term, more professional care. “I don’t want a nurse in my house,” he snapped. He was even more resistant to the notion of a nursing home. If we moved him “to some facility” he said he’d “… simply stop eating.”

A day or two later I got the phone call: “I found blood in Sal’s diaper,” his cousin said, “so I’m taking him to the hospital.” I was deeply relieved that Sal was no longer my responsibility — so relieved, in fact, that I felt guilty.

Sal spent two days in the hospital and two more weeks in physical rehabilitation before his cousin moved him to a nursing home. Sal’s private apartment is smaller than his home, of course, but just as quiet and cozy. It’s full of light, and full of Sal’s furniture and paintings and books.

Yet, four weeks later, Sal is still angry with me. He still cries sometimes. He’s still confused about where he is and how he got there. He feels betrayed by those closest to him — including (maybe especially) me.

I find myself wondering if my husband was right: By helping Sal stay at home, did I enable his decline? Should we have moved him to assisted living sooner, against his wishes? Or should we have respected his wishes and let him die at home?

The glossy brochures on “caring for an older adult” don’t answer these questions, of course. No one tells you that there’s no single right answer. And no one tells you that, sometimes, taking care of someone you love can feel like a betrayal.