As a parent struggles to live independently, your generous first inclination is to open your home. "Come live with us, Mom," or "We've got plenty of room, Dad," is an offer many adult children make. It's a loving gesture to help keep your parent safe and return at least some of the care that you freely received as a child.
More than one in three recipients of unpaid family caregiving live in their family member's household, according to a 2015 report from the AARP Public Policy Institute. Multigenerational homes work well for many families, but these arrangements aren't necessarily best for everyone. It takes forethought and a gut check for all parties involved to succeed.
Arranging for adult parents and children to live together is a complicated process, says Carol Bradley Bursack, a columnist, blogger and author of "Minding Our Elders: Caregivers Share Their Personal Stories." It's wise to make this decision with clear eyes wide open, she emphasizes, rather than through misty-eyed visions of how it should be.
Remodeling is a big planning item. Whether a senior will be sharing a home or aging in place, renovations to kitchens, bathrooms, doorways, lighting and railings may be needed to make living conditions safer and more manageable.
Space and privacy are necessities. In some cases, kids will have to give up or share a room to accommodate a grandparent. Even so, older adults, adult children, teens and younger kids all need their own space at times.
Living situations are different than in the past, Bradley Bursack says. With most couples now, both members work, often out of necessity. So during the day, an older parent might still be home alone, but no longer with accustomed neighbors or familiar friends nearby. Parents actually might feel more isolated than before.
Family dynamics inevitably change. "Not every parent wants to take on the secondary role in the home," Bradley Bursack says. "They're used to being head of household in their own home." It's not easy to suddenly shift that perspective when moving in with the children they raised.
Helping parents preserve their personal boundaries is essential. "As people age, they have a lot of losses," Bradley Bursack says. Friends may die, health can diminish and parents may need to downsize at home. At least, she says, "Let's give them their dignity."
Modesty is an element of dignity for many seniors. For parents who need help with showering, bathing or other personal-care issues, hiring a part-time caregiver can allow them to feel better than having sons or daughters step in.
"We think that it's a loving decision to have a multigenerational household and that it's our duty to care for our parents in a very specific way," says Shira Block, a psychotherapist and co-author of "When Your Parent Moves In: Every Adult Child's Guide to Living with an Aging Parent." However, she says, the actual form this care should take really depends on parents themselves.
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Oftentimes, it's in their best interest to stay in their own home for as long as possible, Block says. "Just because they're getting a little older and a little forgetful, that doesn't necessarily mean you yank them out of the life and lifestyle that they've always known," she says. "It's always good to say: 'How long can they stay here peacefully?'"
Parents have an important voice in all these decisions around them. For some, living near rather than with adult children keeps their boundaries and independence intact, even while offering regular opportunities for togetherness like sharing weekly family meals. Local senior centers can help parents stay involved and engaged.
For parents who can't live alone but who won't thrive in a family setting, other options might work better. "Maybe moving your parent into assisted living is the kindest, most loving decision you can make," Block says. Family members can continue to show care and commitment by making frequent visits and regularly staying in touch.
Marriages can be tested whenever an adult family member moves in. Lack of privacy and caregiving needs can interfere with a couple's intimacy.
It's smart to take emotional factors and personalities into account when weighing these household decisions. You should be able to invite your parent into your home free of resentment, Block says. When couples do resent lifestyle changes entailed by the new arrangement, it's harder for them to stay kind.
For parents and children with a difficult relationship history, living together might offer a fresh start to creating a wonderful new relationship – or potentially make matters worse. "It's only better if there's resolution to the past, and you're not operating as the adult child but [instead] as the healed adult," Block says. That way, any suggestion from a parent won't feel like a deliberate effort to undermine your authority.
Checking the urge to take charge goes both ways. "You have to remember that the parent still has an autonomous aspect of their nature," Block says. "They've been doing things on their own. They're not used to someone telling them: 'Go to the doctor,' 'Take your medication' or 'You can't drive.'"
Sometimes it's just a matter of it being hard for two alpha-type personalities to mix, Block says. "There are other times the parent and child are so close it's a perfect scenario," she notes.
When a parent has dementia, families face more challenges. Adult children need to consider what they'll do as dementia progresses and caregiving demands rise, Bradley Bursack says. For example: Once incontinence becomes an issue, how are you going to feel about handling that in your home? How are you going to handle it when your elder needs 24/7 care?
"Wandering can be an issue," Bradley Bursack notes. "Falling can be an issue. No one person can stay awake 24 hours a day, so you're going to need some kind of assistance." It's better to ask yourself sooner than later if you can handle a caregiver coming in, she says. Eventually, you may face high-impact choices like whether one of you can afford to quit working to stay at home with your parent.
Siblings should be part of the discussion, as well. Adult brothers and sisters can offer all sorts of assistance according to their abilities, such as helping parents keep bill-paying and finances straight or pitching in with moving or storing furniture.
Although it might seem like an equitable solution, siblings alternating taking parents in for six months or a year at a time may actually be unfair to the mother or father. Particularly for those with dementia, each move can take a toll and lead to health setbacks, Bradley Bursack says.
For any parent, periodic moves from house to house, however well-intentioned, can make them believe they don't belong anywhere. With each new move, the parent takes on the role of perpetual visitor instead of feeling like one of the family. "If you treat your parent like a guest, they never relax and everyone walks on eggshells," Block says. "When someone lives here, they're allowed to put their ugly Hummel [figurine] up in the living room."
Of course, multigenerational living offers deep and intangible benefits to family members. "One of the greatest advantages is that your children get to see firsthand what it means to care for the previous generation," Block says. It's a chance to show love, altruism and a sense of family loyalty, she adds: "In some ways, we are meant to be a village. It keeps people close."