Home Care or Care Home
There’s no right or wrong - and for now, Milly’s home is the converted garage and if I only see her for five minutes here and there, that’s okay.
Theme: The Burnout
Quick Take:
There is no perfect choice for us - both family and care homes face limits, pressures, and impossible trade-offs.
Choosing to care for Milly at home, with family support, is rewarding at the moment as it gives her safety, dignity, and love.
Knowing my limits - balancing practical support, self-care, and realistic daily routines keeps us all feeling it’s working - so far!
Truly Compassionate Choice
It’s hard for care homes to offer truly compassionate care when financial pressures are heavy and staff feel undervalued and stretched beyond their limits.
It’s hard for families to offer truly compassionate care when pressures build and they feel undervalued and stretched beyond what’s possible.
There’s no perfect choice.
And our government has not prioritised elderly care.
Where in the world is it best to grow old?
It’s frustrating when I hear from friends with family abroad describing how well their parents are looked after. It’s never easy to compare like for like - so many factors come into play - but some countries consistently stand out. Norway, Denmark, Iceland, Switzerland and the Netherlands regularly appear near the top of studies on healthcare quality, social support, financial security and overall quality of life for older people.
In these countries, elderly care feels like a genuine priority. Families receive proper, specialist support that helps older people remain at home without breaking the people who love them.
Comparing nursing homes is also tricky, but these countries tend to have fewer profit-driven operators. When I was nursing in the 1980s, many UK care homes were small and council-run, often set up by doctors or nurses, offering a more personal, community-based feel. They weren’t perfect - hence my long-held belief that I’d try to care for Milly myself - but the homes I worked in often felt more human.
Over the decades, government policy has shifted. We now have far fewer small or council-run homes, and the care sector is dominated by large corporate or chain operators. My understanding is that care homes have become places for pension funds and big investors to put their money, so once profit becomes part of the story, it’s no surprise carers are underpaid, staff are short, and standards too often slip.
Deciding - For Now
My nursing background has meant I have coped with the practical care. I really enjoy ensuring Milly is fresh, well fed, hydrated, pain-free, as mobile as possible, and feels loved. What I had to think about was the commitment - the reality of it every day.
So I spent time looking honestly at all the factors before Milly moved in with us. I knew that if I didn’t acknowledge my feelings upfront, they could turn into guilt or resentment later, and I didn’t want to risk the fallout of that.
Here’s the short version of my list:
Love - obvious, but easy to forget when stress overshadows everything.
Guilt - a constant background hum.
Fear of regret - the ‘what ifs’ that keep me awake at 3 a.m.
Money - around £8,000 a month for care that isn’t even what I want.
Family history - old irritations don’t magically disappear.
Lack of alternatives - siblings absent, system overwhelmed.
There’s a lot to think about. What feels manageable for one family can feel impossible for another. What feels okay for me one day, can feel crazy on another!
Our Decision
I was lucky that I didn’t have to make the decision alone. My husband has been part of every step, and so has the rest of my close family.
Listening and Learning from Others
I’ve also talked it through with so many people - friends and relatives who shared ideas, stories, and what had worked for them. Listening to other carers over the last five years of looking after my mother has helped enormously.
Why I felt I could Try Home
There was one thing, though, that tipped the balance for me - and I say this with absolutely no judgement toward anyone who chooses a care home - I knew I could make her feel safe and loved and reduce the chances of behaviour that would upset me.
Because of my nursing experience, I understand how fear can drive the kind of behaviours that look like aggression, stubbornness or non-compliance. I know how quickly anxiety can rise when someone is surrounded by unfamiliar faces, rushed communication, or instructions that don’t quite make sense. I’ve seen how easily dignity can be lost when carers - often through no fault of their own - are stretched for time and forced into routines that feel impersonal.
Those were the things that made me feel sure I had to try. Not because a care home wouldn’t try to care, but because I have the training, the confidence, and the support network that make it possible. I would never expect anyone else to weigh those factors the same way - every family has different limits, different resources, and different realities.
Making the Move
Milly moved into what used to be our garage after surgery for a bad fall and a big drop in mobility. She’d lived alone for five years after my father died, but she now needed daily support - sometimes overnight. So while the move was a big moment, it wasn’t a shock. And in some ways, caring for her under our own roof is easier. I can check on her in minutes, I don’t sit in my own home feeling guilty that she’s alone all evening and all night. I might only see her for five minutes in two hours but it’s a meaningful connection.
Knowing my Limits
I keep reassessing what I can manage, and one principle always guides me:
I would never want my daughters to sacrifice their health, relationships, or financial stability for me - and that helps me understand the limits of what I can do for Milly.
If my daughters have to face similar decisions, I hope they’ll put themselves first. Whatever they decide one day, I’ll be fine. I’ve lived my life - and I trust they’ll do their best.
Short Washes and Quick Walks
Some days I need more space, and I’m not able to give Milly ‘super care’, as my husband calls it. And that’s okay. Milly’s in familiar surroundings, with familiar faces and a routine that feels safe and steady to her.
So if her day is a little isolated and looks a little like this - a top-and-tail wash in under ten minutes, two minute drop-ins with drinks and food every two hours and a five minute walk around the kitchen and living room with a trip to the loo every so often - I’m absolutely fine with it.