It's something many of us have done. Our parents are in their middle years and have come home from visiting someone in a nursing home. The hospital-like structure of the older nursing home was disturbing to them. While relating their experience to you they say that they'd hate to end up in a place like that. You jump in and say with feeling and genuine belief, "I'd never put you in a nursing home"

Fast forward a few decades. Your dad has died of a heart attack and your mother now suffers from Alzheimer's. You've cared for your mom in your home for three years. You are financially strapped and emotionally burned out. You're physically exhausted and mentally fried.

There's a new nursing home only a mile from where you live. It's a spacious, cheerful building and you've heard good things about it. You think of putting your mother on the waiting list so that she could have professional care and you could work on your own health along with seeing her as often as you wish. But, the elephant in the room is that promise you made years ago. "I'll never put you in a nursing home."

I needn't say that no one should use this phrase because for you it's too late. However, the meaning behind the phrase is that you will provide your loved ones with the best care possible under the circumstances that they - and you - face. That, my friends, is the spirit of the promise that you made.

Will you feel guilty if you place your mother in a nursing home now? Yes. Would you still feel guilty even if you hadn't made that promise? Most likely, yes. What you must do is look at the facts.

Is your mother safe under your care? Yes, you try your very best, but can you stay completely awake and alert 24/7 in case she uncharacteristically wanders? Think of the guilt you'd feel if she walked off when you were sleeping and got hurt or lost. That would rip your heart out more than obtaining help with her care ever could.

Is your mother getting the peer interaction she needs? She and you are together day and night but does she see friends? If your situation is like many others, most of her friends have dropped by the wayside either because of their own illnesses or because they don't know how to relate to your mother in her current condition.

Are you spending most of your time providing physical care or do you really have time to be a relaxed daughter able to laugh, hug and spend quality time with your mom? In other words, can you keep on providing both the physical care all day every day and still be a rested daughter ready for the challenge of a real relationship? Some people can, but not everyone.

How about your own health? Did you remember to keep your last appointment for your physical? Did you have your mammogram or did you repeatedly reschedule until it fell off the calendar? Is your energy sapped so thoroughly that even if your friends still asked for your company you'd say no? Do you even care anymore if you get a haircut or get some exercise? Do you exist on junk food because of stress eating? These are signs that you are completely ignoring your own wellbeing.

If your mother could have known this when you made that promise years ago I doubt that she'd have agreed to your emotional statement. She would have been wise enough to say that you never know the future.

Give yourself a break. If it's still working for you to provide all of the parent or spousal care, that's wonderful. We all have unique lives and challenges and for some this is the best solution or the only solution that they can accept.

However, if you are keeping this promise just because you made it, understand that you've more than honored the spirit of your words. Now it's time to get practical and do what is best for both your mom and you. Start looking for a good place for her to live where trained caregivers can provide care 24/7.

Will any nursing home be perfect? No. That's where family comes in. Visit often. Bring in special treats that go beyond what the nursing home can be expected to provide. Save that ever important listening ear for your mother. Those are very caring things that you can still do. Just your presence will be reassuring. You will also be her advocate so if you see things that you question, nicely speak up. Don't be an adversary to the staff but let them know that you want to be part of the team.

Then drop the guilt. You are doing all that you can reasonably be expected to do. You are honoring the spirit of your promise.

For more information about Carol visit www.mindingourelders.com or www.mindingoureldersblogs.com.