I was speaking to someone last week when we hit on a subject close to my heart…nursing homes in the midst of COVID-19.

Nursing homes have been hit hard, and it’s not close to over. Limitations on visitors, group meals, and activities will continue for some time in many places.

Over the last decade, a few of my family members have been in nursing homes. If I’m being honest, I’m relieved I don’t have a loved one in long term care right now.

I am horrified that residents are getting COVID and dying alone. I’m saddened at the social isolation impacting a population that is already social isolated. I don’t have solutions, but I am grateful for all the caring employees who are going above and beyond to meet the needs of residents now. (Before you message me, yes, I know not all nursing home employees are caring.)

In the middle of my conversation with an acquaintance, she said to me, “If could never leave my loved one in a nursing home right now. I’d go pick them up and bring them home.”

I frequently heard variations of this statement BC (BC stands for before COVID):

I love my husband too much to put him in a home.

She’s been such a good mother that I can’t do that to her.

I don’t know how people leave their family in places like that.

It’s easy to look at a situation from the outside and identify a simply solution without considering the complexities.

So….why are people leaving their loved ones in nursing homes when 1) they can’t visit, 2) their loved one is at risk of COVID, and 3) life within nursing homes is sadly limited by health guidelines?

A friend of mine said something to me a few months ago that resonated. She knew the nursing home was about to close to visitors and it might be some time before she could visit her mom with Alzheimer’s again. She considered bringing her home.

“But then I thought…if I could care for her at home, she wouldn’t be living in the nursing home in the first place.”

The reality of life is that not everyone is able to care for a loved one at home. Sometimes nursing care is needed, and we must admit we are not nurses. Sometimes we could provide care with paid help, but we cannot afford the necessary paid help and must rely on Medicaid to chip in for a nursing home. Many of our homes are not equipped for those who live with medical needs and disabilities.

Most of us cannot quit our jobs to provide care at home because we have to pay the bills. Many of us have responsibilities for younger generations–kids and grandkids–that would limit the attention we could give someone who needs care. Some of us are physically unable to provide care at home because of our own health issues and disabilities.

Sometimes people with dementia do not maintain a consistent sleep schedule. They may require a caregiver to be up all night. Often wandering is an issue, and a caregiver must monitor their loved one 24/7.

The reasons people make the choices they do in caregiving are unique and complex. Our society is not set up to support in-home caregiving for aging adults. (In fact, our families became less able to care for elders in the home when women were given opportunities outside the home and when many families started needing two incomes for survival.)

For some people, it works to take care of loved ones in their own homes. And that’s great.

However, it doesn’t mean that they care more. It doesn’t mean that the love more. It doesn’t mean that they’re just willing to try harder.

You have to have some advantages already in place to make it work. Maybe you’re retired. Maybe you are well-off enough to quit your job or hire part-time help. Perhaps you have siblings willing to come over and take shifts so you can run errands. You’re healthy enough to take on the challenge. And even then, I know it’s not easy.

But those of you who have a loved one in a nursing home….you’re not taking the easy way out. You are doing the best you can. And, sometimes, you have to choose the best of a bunch of really bad options. Life is messy. We may want to keep our loved ones at home–but it’s not just about love. It’s about logistics and practicalities and (as much as I hate to say it) money.

I’m bothered that our society makes comments that imply we are punishing our loved ones when they are placed in a nursing home. It’s awful that we joke about putting our folks in a home when they frustrate us. We still guilt people for making what is often one of the hardest decisions of their lives–deciding it’s time for nursing home care.

To all of you who say, I could never put my loved one in a nursing home….

Perhaps this is similar to people saying that they’ll never get divorced. It’s not really part of the plan for anyone, but sometimes it’s a choice we have to make. It’s the unfortunate truth that for many of us a nursing home may become the best choice–even though it’s certainly not a perfect choice.

I’m not saying all nursing homes are great. I’m not saying we should get excited about the possibility of moving our loved ones in long term care. Let’s face it…having a loved one in a facility (especially now) can be pretty damn hard.

I’m just saying that we need to stop judging people who have loved ones in nursing homes.

And–if you have a loved one in a nursing home who you have’t been able to visit for months due to COVID–let go of that guilt. You know that serenity prayer? Accept the things you cannot change? Well, this is one of those things.

If someone says to you that they could never put their loved one in a place like that, you have my permission to curse at them. Or you could just be silent, and know that someday they will more than likely be in the same position you were at one point. A position where you had a few options to choose from in a crisis and you chose what you considered to be the best.

Or maybe the least bad.

Nursing homes aren’t perfect.

But life isn’t perfect, is it?

Let’s stop judging people for the choices they make when we don’t know anything about the options they had to choose from.

Now that I’m thinking about it, I think that’s pretty good general advice for us with all the craziness in the world lately. I’m going to write it on a post-it note and put it on my bathroom mirror.

Take care, everyone. Be kind, be brave, and be strong.