Nursing homes a tough pill to swallow

She still remembers that night back in April.

"In my mind, our parents have sacrificed so much so we could be successful, and now we’re just throwing them into a nursing home just to be done with it," said Thy, a 51-year-old woman living in Tay Ho District,

She said that the more she thinks about it, the more she’s scared of what might happen to her mother.

Will she be sad and depressed without her daughter at her side?

"When I think about this, I just want to hug my mom and apologize," Mai Thy said.

Mai Thy (white shirt) visiting her 91-year-old mother (in a wheelchair) in a nursing home on To Ngoc Van Street, Hanoi's Tay Ho District, May 6, 2023. Photo by VnExpress/Phan Duong

After her father passed away 8 years ago, her mother’s health started declining.

Thy and her youngest brother from Quang Ninh bought an apartment in Hanoi near Thy’s home so he could move nearby and help take care of their mother. But both the siblings’ busy work schedules affected their mother. There were days when the 90-year-old woman had to eat lunch at 1 pm and dinner at 8 pm.

In mid-2017, Thy’s mother was diagnosed with coronary heart disease, and needed to have 3 stents inserted. Since the beginning of last year, her mother has become more sluggish and quick to forget. Every day, she had to coax her mother to eat and make sure that she went to sleep.

Anything bathroom-related is difficult because Mai Thy’s mother is 20 kg heavier than she is. Seeing how his sister has become thinner and older, Thy’s brother renovated an entire room for their mother to live in and hired a caretaker for her. Yet 6 months in, having gone through three hires that didn’t work out, it became obvious that this was not the way to go.

People then started to advise Mai Thy to put her mother into a nursing home.

"Even though I know my mother would be better off in there, I can’t stop thinking about how ungrateful I would be to not take care of her myself," she said.

Mai Thy’s dilemma is also a publicly debated – and divided – problem that has been ongoing for years. In a survey, 4,000 VnExpress readers were asked the question "When your parents have become too old and weak, should you put them into a nursing home?" 5% of readers answered no because it would be ungrateful, 20% of them agreed because they want their parents to be in better care, while 75% said it depends on the family’s financial situation, as well as the parent’s wishes.

Elderly people at a nursing home on To Ngoc Van Street, Hanoi's Tay Ho District before breakfast, May 6, 2023. Photo by VnExpress/ Phan Duong

Dang Khanh (59 years old), currently living in Dong Da (Hanoi), has siblings who are part of the 5% above. In the middle of 2019, his father suffered a stroke. After returning from the hospital, Khanh’s family hired an inexperienced caretaker that cost VND20 million. Their father almost immediately developed bed sores.

"We thought about bringing our father into a nursing home, but that was when the family conflict started," said Khanh.

He said his eldest brother’s arguments included: "If the family can’t take care of father, how is a stranger supposed to help?"

And: "Neighbors and relatives are going to judge us." Or: "We have a good life thanks to our parents, bringing our father into a nursing home is ungrateful of us."

Both Khanh’s sister and eldest brother said they would not share the financial burden if their father was sent to a nursing home.

Despite this, Khanh still believed in his decision. But the family feud was bad and full of intrigue and espionage.

"At first, my siblings snuck their children into the nursing home so they could document anything that they could use to argue against me," Khanh said.

Cultural values

"This problem exists because of the notion that it is ungrateful to send one’s parents into a nursing home," said Associate Professor Bui Hoai Son, a Standing member of the National Assembly's Committee on Culture and Education.

In Vietnam, gratefulness is considered an important cultural value. Vietnamese people often respect their elders’ words and are expected to express their gratitude to their parents. Gratefulness is also one of the core values of Vietnamese people and is considered a foundational value for families and societies. "Gratefulness is a core trait when it comes to caring for the elderlies," Son said.

As such, putting parents into a nursing home is considered disrespectful and ungrateful. The heavy social prejudice might also prevent people from considering using a nursing home, even when it’s their parent’s wish.

After Vietnam introduced its "family planning" program more than half a century ago, the country has begun witnessing an aging population since 2014. That means that elderly people now account for 12% of the population, a figure that is expected to increase to 20% by 2035.

Meanwhile, there have been clear changes in family structures. The rate of elderly people living with their children dropped from 80% in 1992 to 28% in 2017, according to a study conducted in 2021 by the Institute for Family and Gender Studies.

According to Bui Hoai Son, there are many ways children can show their gratitude and care for their elderly parents. Sending parents into nursing homes shouldn’t be considered "ungrateful" because of the nuances of the situation. The most important thing is to respect parents’ wishes and create the best living environment for them.

"If children aren’t capable of caring for their parents and ensuring they are safe and healthy, then a nursing home is a viable method that is not ungrateful, especially when said nursing home is equipped with proper equipment and infrastructure," Bui Hoai Son said.

Khanh’s father was able to use a wheelchair to move around after four months inside a nursing home, and his bedsores had also gone away.

The siblings who ceased their contact and financial support eventually changed their minds after seeing evidence of their father’s treatment inside the nursing home.

Recently, while the family was celebrating their third Tet at the nursing home, Khanh’s brother praised the quality of life their father enjoyed there.

"When my I or my wife passes away, the other will also spend their life inside a nursing home," he cheerfully said.

Mai Thy’s worries were dispelled after spending a night with her mother at the nursing home. The nurses check on everyone living at the home throughout the night, and they will personally come to help with diaper checks and change sleeping positions at 1 am and 4 am.

"I have to admit the nurses are better than me at taking care of my mother. There are nights when I couldn’t be awake to help my mom, even when I was beside her, leaving her cold and wet through the entire night," she said.