For the last two months, as the golden days of autumn have faded into winter's gray, 11 adults have met Sunday nights to help each other through one of life's painful seasons.
Each is trying to cope with the guilt and loneliness each feels after having moved an elderly relative into a nursing home.
"It's amazing how these types of natural life experiences affect people. Some people get physically ill when they face them," said social worker Ruth Roth.
A volunteer with the Mental Health Association of Montgomery County, Roth has organized and led two series of group meetings called Centralized Groups for Nursing Home Families.
"We plan to hold groups twice a year in the spring and fall, now that the first two have been so successful," said Roth, a Garrett Park mother of six grown children who also works as a counselor for the New Carrollton Counseling Center and the Montgomery County Health Department.
Roth has cried with group members and watched patiently as their emotions seesawed from optimistic to pessimistic and back again.
She said people have joined the meetings suffering from high blood pressure, severe stress and mixed feelings of guilt and relief that the burden of taking care of a relative is left to nursing home personnel.
"Old childhood relationships often come out when adult children put their parents in a nursing home. The imminent relationship with death makes them (the children) feel more desperate and they begin to think 'This is my last chance to please my mother or my father,' " Roth said.
At one Sunday meeting, the only man in the group realized that he was trying too hard to please his cantankerous father, who complained constantly about his new life at a nursing home.
The man's wife, however, was the first to understand her husband's problem. She said, "I'm here because of the tremedous effect it has had on my husband to put his father in a nursing home. . . . For 47 years this man (the elderly father) has been difficult to get along with and I don't know why (the son) thinks it's going to change now."
The son thought for a minute and then agreed.
"Well, yes, he was always critical, hard to get along with. He gets in these crying jags, he's always wanting to go. I hate going to visit him. I'm to the point now where I won't go visit him without taking someone along with me. . . . A trait he had when he was younger is starting to come out and that is he's antisocial."
The son said that before he joined the support group he couldn't function for two months because he was so upset over his father, who suffered a stroke early this fall and has deteriorating mental abilities.
Relatives who are placed in nursing homes often feel abandoned and protest through abusive language and drastic actions, group members said.
For example, one member told of a friend whose mother was so upset when she moved to a nursing home that she didn't speak to anyone and stayed in bed, turning her back to visitors, for three months. Now, after finally accepting the situation, she is happy and enjoys living at the nursing home.
"Whenever possible, people who are looking at nursing homes should take their relative along to see how they like the surroundings, and once they are in the home get them involved in an orientation program which many nursing homes have," suggested Roth.
Roth also recommends group members set aside an hour or more each day to concentrate on grieving. She says when the pent-up feelings of grief are released on a regular basis, especially through crying, people gain more control over their emotions.
"It takes a great deal of energy to be upset," she said.
A woman in her mid-60s was the only member of the group who put her spouse in a nursing home.
"I feel guilty because I'm not being totally honest with my husband. He keeps asking how long he's going to be at the nursing home and I tell him that for now he'll have to stay there. I know he'll never leave, but I just don't have the heart to tell him. It would take away all his hope," she says. Her husband suffers memory lapses due to arteriosclerosis, also known as hardening of the arteries.
One group member brought up a common fear.
"Have any of you thought that you may end up there (in a nursing home) yourself?" she asked. Everyone agreed that they had.
Roth explained that, to a great extent, group members are not seeing their loved ones in the nursing home, but instead seeing themselves, which is often why their emotions are so strong.
One group member in her mid-50s said her life had changed drastically when her mother was transferred to a nursing home. She has never married and had lived with her 88-year-old mother all her life. In July her mother suffered a stroke and by August she had to be moved to a nursing home.
"I've never been more emotionally upset in my life. We're not only close as mother and daughter, but we're very close friends, we're pals," explained the daughter, who was visiting the nursing home two and three times a day when the support group began. Now she trys to visit just once a day.
"The group has taught me that I can't feel guilty about my mother; after all, it really isn't my fault that she's there. I've also learned that you do have to go on with your life," she said.
Yet, when the woman was asked about her plans for the future, the void in her life became evident.
"Well, if my mother comes home with me I'd have to move to a new apartment on the ground floor so it would be accessible by wheelchair, so financially I've got to start thinking about that now."