Dear Carol: My mom's lived with me for three years. I'm single and have a demanding job but I've made time for Mom's medical appointments and to keep up with her needs. I love her and want to do my best, but I now find myself getting short-tempered with her, which I hate. The doctor suspects that she has vascular dementia that accounts for her forgetfulness. I've become afraid that she is not safe alone while I'm gone. I'm upset with myself over my own short-tempered behavior, but for many reasons, including concerns about my job, I no longer think that this is the best arrangement. Still, I don't want her to go to a nursing home. Any suggestions? - VE.

Dear VE: You've already done so much that there is no reason for guilt, though having been a caregiver, I understand that it exists against all logic.

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What you are looking at is the reality that your mom will continue to need more help than you alone can provide. Your short temper is a sign that you may be burning out. You can't expect yourself to deal with a demanding job all day and then come home and be ready to cope with your mom's extensive needs each night without consequences for both of you.

I'd suggest that you begin by visiting the website Once there, you'll be directed to find your state and this, in turn, will take you to a list of services available to seniors in your location. You'll find your local Area Agency on Aging (AAA) as well as other resources on this list. You'll likely find that there are several options, but do investigate the AAA as one of them. They can be incredibly helpful.

Additionally, you might want to investigate the services of in-home care agencies in your area. When you talk with them, ask what kind of backup system is in place if your caregiver calls in sick. Also ask if they have enough staff so that your mom can experience continuity in caregivers, what kind of credentials and supervision their caregivers have and if they will provide references.

If you decide to try in-home care, you may want to schedule the caregiver's first visit for a time when you are available so that you become acquainted with the caregiver and can help your mom feel more comfortable. Then you can set up a schedule.

In-home care may work for a short-term solution or even a long-term one. However, accepting the fact that your mom could eventually need nursing home care is a process, so now is the time to work on that possibility, as well.

Try to understand in your core that you must take care of yourself to take care of your mom so there is no need for guilt. Even if the end result is a nursing home, you'll still be an active advocate so you won't be giving up on your mom, you'll just be getting help.


Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of "Minding Our Elders: Caregivers Share Their Personal Stories." Bradley Bursack hosts a website supporting caregivers and elders at She can be reached at