Hey everyone, I'm Maria Santos, and I need to share something that's been the hardest decision of my adult life: what to do about my mother's care. Mom is 78, has early-stage dementia, and can no longer live safely on her own. She forgets to turn off the stove, gets lost driving to familiar places, and recently wandered away from her house for three hours.
Mom lives 20 minutes from me, and I'm her only family nearby. My brother lives in Seattle with his wife and two teenage kids. He's willing to help financially but can't take on physical caregiving. Mom has about $180K in savings (including her house), but care options are expensive.
Everyone has opinions. Mom's neighbors keep saying "just put her in a home—she's too much for you to handle!" My aunt insists "families should take care of their own—you're being selfish!" The geriatric doctor suggests "assisted living before she needs nursing home care." My husband is supportive but worried about how this will affect our family life.
I was drowning in guilt, stress, and conflicting advice. Was I selfish for not quitting my job to be Mom's full-time caregiver? Was I heartless for considering a care facility? I realized I needed a decision making framework to cut through the noise and help us be objective about something that felt impossibly emotional.
🔧 The Caregiving Conundrum: Three Options
After researching and touring various facilities, my family identified three realistic caregiving paths:
Our Three Care Options:
1. In-Home Caregiver - Hire professional caregivers to come to Mom's house 8 hours/day, maintain her independence
2. Assisted Living Facility - Move Mom to a nice assisted living community with meals, activities, and 24-hour support
3. Family Caregiving - I reduce my teaching hours to care for Mom, with part-time help on weekends
đź“Š Our Family's Priorities & Values
Before we could compare options, the WADM 🔧 process forced us to get honest about what mattered most to our family:
âś… Mom's Quality of Life & Safety (35%): This was non-negotiable. Whatever we chose needed to keep Mom physically safe and emotionally fulfilled.
đź’° Financial Sustainability & Cost (25%): Mom's savings would cover some costs, but we needed a âś… solution we could afford long-term.
👨‍👩‍👧‍👦 Family Impact & Emotional Well-being (20%): How would this choice affect my husband, my teenage daughter, and our family dynamic?
🏥 Quality of Care & Professional Support (15%): We wanted Mom to have access to medical professionals and proper care management.
⏰ Flexibility & Long-term Adaptability (5%): Dementia is progressive—our ✅ solution needed to work as Mom's condition changed.
đź“Š The WADM Caregiving Decision Matrix
With our priorities clarified, we đź“Š scored each option honestly. This was eye-opening:
| Factor | Weight(%) | In-Home Caregiver | Assisted Living | Family Caregiving |
|---|---|---|---|---|
| Mom's Quality of Life & Safety | 35 | 7 | 9 | 8 |
| Financial Sustainability & Cost | 25 | 5 | 7 | 9 |
| Family Impact & Emotional Well-being | 20 | 8 | 9 | 4 |
| Quality of Care & Professional Support | 15 | 8 | 10 | 6 |
| Flexibility & Long-term Adaptability | 5 | 9 | 8 | 5 |
| Total | 100 | 6.95 | 8.60 | 7.00 |
Click to import this decision case into the editable WADM tool
🔧 The Numbers Don't Lie: Assisted Living Wins
I'll be honest—these ✅ results surprised us! I thought we'd be choosing between in-home care and me becoming Mom's caregiver. Instead, the Assisted Living path 📊 scored highest at 8.60.
Here's what the math revealed:
Assisted Living (8.60) won because it was the only option that addressed all of Mom's needs well. Quality of care (10/10) because of professional medical staff, quality of life (9/10) with activities and socialization, and family impact (9/10) because everyone could visit without the stress of caregiving logistics. In-Home Caregiver (6.95) had good family dynamics (8/10) but struggled on cost (5/10) and long-term care quality. As Mom's dementia progressed, she'd need more supervision than any individual caregiver could provide. Family Caregiving (7.00) đź“Š scored highest on cost (9/10) but crashed on family impact (4/10). I realized that me quitting my job to be Mom's caregiver would damage my family, my career, and ultimately our relationship.đź“Ś The Plot Twist: Why the "Right" Choice Felt Wrong
Here's the thing—seeing Assisted Living as our best option filled me with guilt. Mom had always said "I'll never go to a home!" I felt like I was betraying her trust and my promise to "never put you in a facility."
My brother tried to comfort me: "Mom isn't the same person who made that promise. The dementia has changed her." But I still struggled with the decision.
That's when the social worker at the facility said something that shifted my perspective: "This isn't about abandoning your mom—it's about giving her the best care possible. Love isn't about doing everything yourself. It's about making the choice that serves her needs best."
âś… Our Decision: Assisted Living with Family Involvement
We chose Assisted Living, and it's been the right decision for our family. Mom is thriving—she loves the activities, has made friends, and feels safer than she has in months. The professional staff manage her medication, meals, and daily needs better than I ever could.
Our family dynamics improved dramatically. Instead of me being exhausted and resentful about caregiving, we could focus on being family. My daughter got her mom back on weekends. My husband and I could return to being partners instead of just co-caregivers.
We visit Mom three times a week, take her to appointments, and celebrate holidays together. She's surrounded by people who care for her professionally, but she's still surrounded by love.
🔧 The Real Learning: Caregiving Is a Family Decision
This decision making framework taught me that there's no "right" way to handle elderly care—there's only the way that serves your family best. The WADM helped us see that taking care of Mom didn't mean I had to sacrifice my family or my well-being.
If you're facing a similar caregiving decision, đź“Ś remember: love isn't measured by how much personal sacrifice you can make. Get specific about what your loved one actually needs, weight those priorities honestly, and let the numbers guide you toward a choice you can sustain long-term.
Sometimes the most loving choice is trusting professionals to provide care while you provide love.
P.S. - Mom recently told me "I love my new home, and I love that you're my daughter, not my caregiver." That made everything worth it. Love is about what's best for them, not about what makes us feel virtuous.