If you’re concerned about your parent’s current living arrangement, open and honest discussion with your parent and other family members is key to making a sensible decision that everyone (or almost everyone) supports. There are many options to explore, and developing a strategy for your parent’s care requires careful forethought and planning.
Families are complex. Both positive and negative feelings about your parents and other family members can creep in from the past to cloud your decision-making. Unresolved conflicts, feelings of guilt, or unmet obligations may pressure you into tackling more caregiving than you can realistically manage. To promote objectivity and smooth the way for sound decision-making,
Come to terms with past disagreements between you and your parent.
Be open and thorough when considering how your parent’s relocation will affect you, your parent, your siblings, your spouse and children.
Communicate directly with your siblings to determine the level of involvement each is willing to accept. Come to an agreement regarding what kind and how much help they will provide.
What Level of Care Is Needed?
Determine which activities of daily living (eating, bathing, toileting) your parent can perform independently.
Determine your personal comfort level for providing his/her personal care (which may include bathing or changing an adult diaper).
Evaluate your own health and physical abilities before deciding if you are able to provide care for your parent.
What type of medical care will be needed, and are adequate physicians and services available in your community?
Keep in mind that your parent’s medical and/or cognitive conditions will alter over time.
Explore the availability of services such as visiting companions, in-home care, and adult day care facilities.
Investigate long term arrangement possibilities for the future.
Living Arrangement Options
Moving your parent into your own home may be your initial inclination; but other types of housing and living arrangements should be considered, depending on regional availability and your parent’s needs and finances.
In the event that you and your siblings don’t live in the same city (with each other and/or with your parent), location must be determined first. Keeping your parent in the community where his/her current doctor, grocery store, hair salon, drug store, and friends are situated is ideal—but not always possible. However, it is critical that either you or a sibling live fairly close, or with, your parent, and that must be coordinated.
The pronouncement of location often leads to conflict between family members because those living near the parent will naturally carry the largest burden for the parent’s care, while family members living far away may feel frustrated that they don’t have more opportunity to participate. Open discussion that leads to an agreement on how to share local and long distance caregiving is essential.
In addition to identifying the primary caregiver, geographic location reduces the options since each community offers different possibilities. If your parent’s needs dictate a particular living arrangement, the availability of that arrangement may dictate where your parent must settle.
Before making a choice, consider the following possibilities:
Staying put with a live-in companion: Your parent’s home may be suitable and safe with a few physical modifications and the addition of a live-in relative, friend, or roommate to monitor things on a regular basis and help with transportation. Some city agencies find interested, qualified individuals and arrange shared-living situations when friends or relatives are not an option.
Nearby apartment, house, or retirement community: Your parent could maintain his/her independence if he/she lived close enough for a family member to provide consistent monitoring and support. If more frequent contact is necessary, an independent retirement community—individual units with group meals and social activities—may be the answer.
Assisted Living Facility: If your parent is fairly independent but requires some daily supervision and assistance with chores and personal care, an assisted living facility offers rooms or apartment-style accommodations, social activities, meals, and staff to assist with bathing, grooming, eating, or using the toilet. The monthly charge for assisted living is determined by how much care your parent requires.
An assisted-living-locator service helps identify important features to watch for and can actually take you to visit appropriate facilities in your designated geographic area.
- Residential Care Facility: These are small group homes that provide constant supervision, meals, and personal care, but not skilled nursing care. They also provide socialization and recreational activities.
Intermediate Care Facility: Around-the-clock personal care is provided, along with nursing care during certain hours of the day. Some communities are known as “continuing-care” because they offer different levels of care, ranging from independent living to skilled nursing, that can be upgraded as your parent’s needs change over time.
Skilled Nursing Facility: 24-hour nursing services make high levels of personal and medical care possible, such as managing ventilators, providing intravenous feedings, monitoring blood pressure, and administering injections. Individuals living in this type of facility could not live in a home environment and need help with the majority of their personal care.
Remember that Medicare does not cover living expenses or housing; and alternative living arrangements can be quite expensive. Open discussion about meeting these costs should take place between you, your parent, and your siblings before a financial crisis occurs.
It may be necessary at some point for you to become involved in, or even assume, your parent’s personal finances, including paying bills, monitoring accounts, and managing investments. Problems may develop if your parent or siblings question how you are handling your parent’s money. To prevent financial difficulty and alleviate potential conflict,
Agree upon how much, if any, financial payment your parent will provide towards living expenses and out-of-pocket expenses. This includes rent, food, clothing, toiletries, entertainment, and co-payments.
Openly discuss financial arrangements with siblings. Keep them updated on expenditures and the state of your parent’s accounts.
If you and your siblings need to contribute financially to meet your parent’s needs, an agreement about the particulars (who, how, when, where, how much) should be established from the beginning.
Check into the option of automatic payment of recurring bills.
Investigate low-cost services that assist with Medicare paperwork for older adults.
Research financial assistance that may be available to your parent. Start by reading our section on Managing Finances.
Moving In with You
To avoid unpleasant surprises and ill feelings in the future, openly discuss the many ways such a move will impact you and your family.
Your roles will change. You will become the guardian and decision-maker in place of your parents. Your spouse and children will need to accept more responsibilities and less freedom at home. Are you and your family willing to adjust?
Your parent may become resentful at his/her loss of control and independence. Be sensitive to your parent’s feelings and, when possible, allow for negotiation and joint decision-making.
Packing and moving out of a house is an enormous chore for anyone, but for the older adult with decades of memories and possessions in their home, moving can present a painful, emotional challenge. It symbolizes the end of a major chapter in life—a significant loss to be grieved like any other loss. While helping your parent pack, talk through difficult feelings, acknowledging the loss that your parent is experiencing. Allow opportunities to reminisce. Your patience and understanding will make the transition smoother; however, an outside counselor may be beneficial in some instances.
With more financial obligations and work to be done at home, everyone will need to help out. Your spouse and children may need to make personal sacrifices because of a tighter budget, besides accepting new household and caregiving responsibilities. Consider your spouse and children’s readiness to make sacrifices of time, money, and effort. With your parent’s input, determine what you can expect from him/her in terms of chores or financial contributions.
What about your parent’s continued participation in social networks such as visiting friends and attending a place of worship? How will transportation to these and other activities be handled? Will your parent retain his/her own social identity, or will he/she fully integrate into the family’s activities?
Are smoking/nonsmoking or drinking/non-drinking practices compatible?
Will your parent tolerate the household noise and activity levels?
Discuss what types of food you eat as a family, and what times you normally eat. Do you like similar foods, or will a special diet be required for your parent?
It takes an incredible amount of time to handle someone else’s medical and emotional needs. Can you make the necessary adjustments to your current work schedule? Consider the amount of lost private time you’d normally spend pursuing your own interests or hobbies.
A home must be physically large enough to meet the needs of the entire family. Is there enough space for adequate privacy for each person living in your home? If a child is forced to give up space that was once his/her own, will that cause resentment against you and the grandparent, or will it build character?
The Silver Lining
Your parent’s latter-day living arrangement should be contemplated cautiously and completely to make the best overall choice for all involved. Just bear in mind, there are three wonderful gifts that accompany the hardships of personally caring for your parents during their later years:
First, providing support and care for your parents can be one of your most rewarding experiences in life—the opportunity to give back what your parents once provided to you.
Second, your parents experience the joy of making a priceless contribution to your family by sharing their past and becoming an integral part of your household.
And finally, grandchildren have the chance to reap tidbits of wisdom from a generation all too soon to leave this world, and to grasp a significant piece of family history as recounted first-hand.
Moving Mom & Dad, Robbins, D. (2003). Barclay Press, 2826 N. Kensington, Arlington, VA 22207. (703) 536-6005.
Under One Roof: Caring for an Aging Parent, McGurn, S. (1992). Parkside Publishing Corporation, 205 W. Touhy Ave., Park Ridge, IL 60068.
Choices: Making a Good Move to a Retirement Community, Young, H. M. and Tornyay, R. de (2001). ERA Care Communities. Available at Amazon.com.
Making the Move: A Practical Guide to Senior Residential Communities, Stuart, Lettice (1997). Avon Books. Available at Amazon.com.