Suppose that you live with your wife, Ellen, and your mother-in-law, Dorothy, who has been diagnosed with Alzheimer’s disease. Dorothy, at 93, is not capable of living alone. Dorothy has become progressively more difficult to live with. Ellen has developed health problems from the pressure of caring for Dorothy. A physician strongly advises Ellen to move Dorothy to a nursing home, a move Dorothy would strongly oppose. It would be easier if you lied – tell Dorothy her move to a nursing home is temporary, while you and Ellen go on holiday.

As you attempt to decide, you experience conflicting emotions and thoughts. How can you do what is best for Dorothy, while respecting her desires and autonomy? Should you simply soldier on, allowing her to remain in your house? Or do you have to take Ellen’s physical deterioration as your main concern? What is the right thing to do for Ellen, for Dorothy, and for the three of you?