The Decision You Don't Want to Make in a Crisis

There's a line I keep coming back to, from an article by Joanna LaFleur that I think every family navigating dementia care should read. She writes: 'Waitlists are real, and decisions made mid-crisis are the worst decisions you'll ever make.'

She's right. And I've seen it play out more times than I can count.

A fall. A hospitalization. A moment where everything changes overnight and suddenly a family is trying to make one of the biggest decisions of their lives while running on no sleep, raw fear, and a stack of paperwork from a social worker they just met. That's not a setup for a good decision. That's a setup for regret.

I've sat with a lot of families in that place. The guilt is almost always there, even when it shouldn't be. So is the grief, the exhaustion, and this particular kind of pressure that comes from knowing someone you love needs more than you can give, but not quite being able to say that out loud yet.

For adult children, this road has a strange quality to it. You spend your whole life as someone's kid, and then one day you're the one managing medications and doctor's appointments and safety concerns for the person who used to do all of that for you. Nobody hands you a manual for that. Nobody really prepares you for what it feels like, either.

For spouses, the weight can be even heavier. Joanna puts it in a way that stopped me cold when I read it. She writes: 'If you're caring for a spouse, you made vows, and moving them can feel like breaking them. It isn't. In sickness and in health never specified an address. Love doesn't live at an address. It lives in how well they're cared for.'

I've been sitting with that sentence for days now. Because I think it names something that a lot of spouses are quietly carrying and never quite say out loud. The fear that choosing care, real, full-time, expert care for someone you love, somehow means you've given up. It doesn't. It means you love them enough to be honest about what they need.

What I want families to hear, before the crisis, not after, is that exploring options is not the same as making a decision. Touring a dementia care home, asking questions, getting on a waitlist, learning what good care actually looks like, none of that commits you to anything. What it does is give you options. And options are everything when the moment comes.

Planning ahead means you get to make this decision from a place of values instead of urgency. You get to ask what matters most to your family. You get to take your time. You get to choose from a position of love instead of fear.

That's a gift worth giving yourself, and the person you're caring for.

Thank you to Joanna LaFleur for writing with such honesty about something so many families are quietly going through. If you haven't read her work, look her up. And if you're in the middle of this right now, whether it's a slow unfolding or a sudden crisis, please know you don't have to figure it out alone. We're always willing to talk, no pressure, no agenda. Just a real conversation about what your family needs.