October 11, 2011

Mom and Dad want to Move in With You. Now What?

I've written about the effects of having an adult child move back home. There are adjustments and the need for an agreement on topics as varied as loaning versus giving money, charging for room and board, an agreed-upon end date for such an arrangement, an the importance of treating the returning child as an adult.


Another "move-in" situation that I have yet to address is  becoming more common. It is also much more difficult since it tends to be long term with major commitments in time, effort, and expenses: having a parent or two move in with your family. PR expert Ginny Grimsley, sent me the following from David Horgan,  a gentleman with plenty of experience in this area. I felt it worthy of your attention. I pass it along to you, with a few minor edits.


When Your Parent Moves In

There is a rising trend of parents moving in with their adult children. All across the country unexpected problems that arise from this living arrangement can cause family arguments, financial stress, even increased divorce. The arrangement can also be enriching, a strong statement of love for parents from their grown children, and a lesson in responsibility. 

Before moving a parent in and making a life altering change to the family harmony, there are many things to consider. Inviting an elderly parent to move in has far reaching implications on every aspect of your life, from financial impact to changing family dynamics, from role re-assignment to safety issues, from power struggles to eroding privacy. 

  • Be Open: Have a clear and open discussion with your family, siblings, spouse, kids, and ultimately your parent(s), to decide if making the move is the right decision for all parties involved.  Discuss:
    1. The pros and cons
    2. The different ways this move will effect the family
    3. The ways each family member’s routines may be disrupted. 
    4. Expectations that may differ from “the way things have always been”
    5. Any possible monetary issues that could arrive
    6. Compromises that each family member will have to make
  • Medical Management: An elderly parent is apt to have a litany of doctor appointments, medication, and needs.
    1. With the help of medical and geriatric care professionals, assess your parent’s medical needs and gain a clear understanding of how those needs will affect you and your family.
    2. Gather all possible medical resources, containing both specific people and organizations, to minimize frustrations as well as possible mistakes.
    3. Use your support network to create and implement a plan as well as back-up plans. 
  • Moving Day: Moving is stressful under any circumstance. Moving in an aging parent entails a permanent lifestyle change and one that may be met with resistance, which can make it even more difficult. Plan for every detail upfront to minimize the potential strife.
    1. Ready yourself for possible volatile emotions and flaring tempers from all parties.
    2. Use your utmost compassion and support when you decide what stays and what goes.
    3. The move may not have been a parent’s first choice. Avoid sweeping decisions, such as throwing away Grandma’s 50 year-old collection of National Geographics, without discussing it with her first. 
    4. Decide ahead of time on furniture placement.
    5. Make a disbursement plan for who gets items that cannot fit into your house. (Storage, give away, other siblings.)
  • House Rules: Your parent is used to running the household with his/her own rules. Everyone must openly acknowledge that each family member must compromise to make the new living arrangement successful. It is important to create a plan that is respectful to all parties, so your parent doesn’t feel slighted and uncomfortable as the “newcomer” to your home. You also want to make sure that you and your spouse do not feel like outsiders. Decide on:
    1. Chores
    2. Who waters the plants and feeds the cat etc.
    3. Who helps and who doesn’t help in the kitchen
    4. How you like laundry done
    5. Bathroom etiquette
    6. What you make for dinner and what time
    7. When are lights out, and television off


The economic reality is that your, or your partner's, parents may not be able to afford a retirement home, continuing care community, or even a well-run nursing center. As Mr. Horgan points out, there will be changes in everyone's life that could last years. As the parent declines, nursing care will become more of an issue. This is not an issue with easy answers. But, it is certainly a good idea to work out as many details as possible ahead of time. There will be enough stress as it is.

I'd be quite interested in your comments, especially if you have had to face this problem, either as the adult child or the parent who moves in. Your experiences and feedback will be quite valuable to us all. If you'd feel more comfortable sharing anonymously, that is perfectly fine.


My thanks to David Horgan, an award-winning medical educator, filmmaker and director from CaregiverVillage.com. he has written a book that provides his firsthand account of what to do, what not to do, and what can happen (the good and the bad) in his book When Your Parent Moves In. Mr. Horgan is also Media Director for Project-13, a non-profit drop out prevention program in Holyoke, Ma that reaches inner-city kids through film and music production as well as practical work experience. http://www.whenyourparentmovesin.com/


18 comments:

  1. That is a great list. We tried to get my Mom to move in with us at least for winters but she decided to stay put. We were going to have to modify the bathroom she would use to ensure it would accommodate a walker and/or wheelchair. I think changes to the living space is something that has to be added to this list.

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  2. Thank you for addressing this issue, Bob. I believe that this is a trend that will become more prevalent. With the weak economy and the possible slashing of benefits for the elderly, many retirees and working seniors may find themselves housing an elderly parent in their home.

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  3. We have been very lucky in that my parents were able to move into an apartment 2 blocks away. I can visit them anytime, help out when needed but they still have their own place in a wonderful independent living apartment building. They have a doctor on site, a gym, and many activities.

    My good friend was not so lucky. Her mom had to move in with her brother. They have a big house but the one thing they did not count on was her loneliness. They both work so she is all alone all day long. It is so hard for my friend. She wishes they could have afforded something better for her but there was nothing else they could do.

    So I would say that you should add loneliness to your list. It can be really bad for the elderly parent to be isolated from friends.

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  4. My mother did not move in with me...but I did move my mother from 5,000 sq feet to 1,000 sq feet three weeks ago. I have very mixed emotions. It was difficult to see the house break up for my mother. We cleared out cupboards and sideboards. She moved into a lovely senior continuing care community. The paintings are on the wall and favorite china is in the kitchen.
    We do not have to sell the house in a hurry. The plan is to distribute china and silver in November and put the house up for sale in January. Something tells me it is too soon. She can last, easily, a few years on the money that she has without selling the house. But, then, the house will be empty- which is not good either.
    There is an in between making the move to end of life and elder age. I am not sure where that is. I know my mother will be happier in her new home, but there is a type of "robbing" that feels wrong at this point. I think I am more confused now than I have ever been.
    My mother did not move in with any of us...but the responsibility for her is daunting...

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  5. After Dad died in 2000 Mom moved in with us for three years and yes they were pretty stressful three years. Senility was setting in and Mom just couldn't understand that she was not the boss of the household. The tension between my wife and my mother made this a sad sad time for me.

    Looking back I'm not sure we should have lived in that arrangement as long as we did. Mom would just get so upset when we mentioned assisted living but that eventually had to became the reality. It should probably have happened much sooner than it did. She passed last year as just a shell of a human being.

    The list provided here is a good one if everyone is of a stable mind but that isn't always the case.

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  6. I'm still on Maui and so several hours behind the mainland...and wake up to 5 comments already. Obviously, this is a topic that needs further exploration.

    Juhli,

    Bathroom modification is an excellent point. Even if a parent isn't moving in, as we age the bathrooms in our home should be made safer, with grab rails and raised toilet seats. Living space must be modified as we age and especially to accommodate a parent.

    Anonymous,

    You very well might be right. The cost of elderly care is skyrocketing just when people can least afford it. Sharing living space is one of the few options.

    Roberta,

    Your situation sounds good, for both you and your parents. My dad is in a great facility but it is 35 minutes away. 2 blocks would be great!

    Your friend's predicament is unfortunate and does highlight the issue of loneliness. Even in a good facility that is a real problem, especially if there are no close-by relatives. Too many elderly spend their days staring at a TV just to hear another human voice.

    Janette,

    Luckily, I know there are many good facilities in the city where your mom is now living. But, that loss of one's own space and possessions is tough on everyone. As that person's belongings are distributed to relatives or sold it is hard to avoid the feeling that you are actively preparing for her death.

    My dad is in the independent living portion of his care facility but we must convince him to move to assisted living sometime in the next several months. I am worried that his memory is fading so quickly that he won't be allowed into assisted living and have to go directly to the nursing center. I think that would shorten his life quite a bit.

    RJ,

    Hindsight makes things so clear, doesn't it. Of course, in your situation you could not have foreseen the problems. Once you are in the midst of it, what can you do except grit your teeth and bear it.

    Your last sentence about the list being for folks with a stable mind is a good one. I wonder if I can find a list that applies if that isn't the case, and share it? I'll give it a look.

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  7. I have a few things to add to this list. The first is having a discussion on freedoms lost both in the near and distant future. I have an idea that might make it easier on everyone involved. (Especially if the elderly parent has a loss of memory) Sit down together and write out some of the freedoms that the parent might be fearful of losing (or you are worried about bringing up) Examples would be not driving, using the stove or oven, taking walks by themselves to name a few. Write these down on two colors of index cards - One yellow and one red. Have the elderly parent sign these cards if you both feel it's necessary. Both of you agree that when either of you present one of the yellow cards that it will three months before the red card will be presented (and enforced.) This might take the pressure of both parties.

    Another situation that hasn't been addressed is if there are still children living at home. (Three generations) Will the elderly parent or parents help with the child/pet/house sitting? If so will they be paid for their services? What if the older parents want their own life and don't want to babysit? What if they want to sit but you don't feel they are capable doing so? All of these situations need to be discussed.

    You also need to go through the entire house and see what could be a hazard. Examples would be to take up any throw rugs or instruct everyone when cooking to turn all handles inward. These might seem unnecessary but they really can lead to huge accidents.

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  8. Betty,

    Some interesting ideas. I've never heard of the card idea before but it might make the "talk" about touchy subjects easier.

    I had a post several months ago about making the house safer as all of us age. If a parent is moving in, the need becomes even more critical.

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  9. A couple that we know took in the wife's elderly mother, who was frail and could no longer maintain the large family home where she'd raised her 6 children.

    The couple prepared the lower floor of their split-entry home as a cozy bedroom, den and private bath for Grandma.

    Long story short, husband and wife both worked and were away all day every day. Grandma grew more and more listless and depressed. Finally,upon advice of Grandma's physician, they tearfully placed her in an independent living facility. Grandma, at 83, was one of the youngest residents there, and soon became a favorite of staff and residents alike. She came out of her shell and participated in all of the activities. She looked and acted 10 years younger.

    Husband and wife feel much better now that grandma is happier and healthier, but it took a couple of years to finally find the right solution.

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  10. Anonymous,

    Thanks for sharing that story. Sometimes the best intentions don't end up with the best results.

    The couple is to be commended for everything they did to make the mother happy and safe. Unfortunately, it seems that whatever we do there will be problems.

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  11. I live half the country away from my parents, who are in their 80's. The distance was recently brought home to me when I went back to help after my dad's hip replacement and he had a small stroke about 2 weeks after surgery.

    Luckily, my work can be taken anywhere so I extended my stay and then my 2 sisters took over. My dad got into a wonderful rehab program immediately after surgery and is now ready to come home.

    I know there won't be a time when they will come to where I live to move in with me but I have been thinking a lot lately about the time when they will have to break up home and move to some sort of assisted living. It's hard to see your parents get old and frail and they aren't easy to live with when they have physical problems, failing memory and limitations on what they can do.

    We outfitted their home with all the grab bars around tub and showers and all the necessary things elderly people need. There are agencies which can help you figure out what you need and where to get it.

    One thing we found out through a family experience is that if an elderly person must rely on Medicare for a nursing home or assisted living, those facilities only take a certain number of Medicare because Medicare doesn't pay much at all. The facilities would rather have private pay or other insurance so it might be very difficult to find a place that will take them.

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  12. Joan,

    The Medicare problem you mentioned is an important one to consider, and it will only get worse. As the government looks for way to cut the deficit, the most needy will likely suffer a disproportionate share of the burden.

    My dad is 87 and still doing well independently. But, I know he needs to move to the assisted living section soon.

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  13. Steve in Los AngelesFri Oct 14, 08:20:00 PM MST

    Hi Bob,
    Between early 1999 and October 2002, my Dad lived in an assisted living house that was about five miles (15 minutes driving time) from my house at that time. Unfortunately, I could not care for my Dad at my house as I had a demanding full-time job at that time and needed the income. However, my Dad did not suffer from loneliness (at least not on Saturdays and Sundays) as I almost always spent those days with him. (I would pick him up at the place where he lived in the latter part of the morning and return him in the mid-evening.) We went out to eat on those days (including Costco where he loved their jumbo hot dogs and Coca Cola at their food courts) and often went to visit relatives, all of which he enjoyed doing. What was important was that I kept my Dad fairly busy and occupied on Saturdays and Sundays. He knew that I loved him very much. That is one reason why my Dad lived as long as he did. (My Dad passed away in mid-October 2002 at the age of 81.)

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  14. Steve,

    My dad is 87 and looks forward to visits from my wife and me at least once a week. While he still sings in two choirs, the highlight of his week are those visits. We usually have lunch and go over any paperwork he needs help with. Since losing my mom last December he has done well adapting to being alone, but he really needs that time with us.

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  15. I'm in a bit different situation, my family (myself, husband and two young children) are seriously considering moving in with my mother who is 57, able bodied and working. Unfortunately she doesn't make enough money to keep her house and my younger siblings have moved out in recent months. She wants to keep the family home and I want her to as well. Today's economy has made things difficult for everybody and although it would help my immediately family a little bit financially, I just don't know of the emotional toll. If anyone has any tips or resources on a situation like mine, I would be greatly appreciate it. I can be reached at rosa @ tortilladesigns.com (no spaces)

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  16. Rosa,

    That is a bit of a twist. I gather you aren't moving in because of financial necessity on your part, but to help your mom. That is a tremendously loving gesture on your family's part.

    Will there be an emotional toll? Possibly. I guess the key questions are, does your mom feel OK with you guys doing this, will your family have enough private space so you don't feel like just a boarder, and will you expect your mom to be a built-in babysitter? Will your other siblings get jealous with your closeness to mom?

    If your family is OK with this and so is your mom, I would guess whatever issues you have will be bumps in the road..nothing you can't overcome.

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  17. I recently had a situation where my aunt fell and was put in the hospital. It appears as though she will not be able to return home ever again. My cousin talked with me and said that he will probably move her in with him. Imagine my reaction! Here I am a family member with this book I wrote (with Shira Block) on this very subject and he is ready to make this decision at a time of crisis without thinking it through! This is the reason we wrote "When Your Parent Moves In" We want people to understand what a major decision this is and to take the time to think it through!

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  18. David,

    I wish you well with the book. It is an important subject that can generate more heat than light. Decisions made at a time of crisis can be dangerous.

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