Let’s talk about some things to consider when preparing for an
older adult to become a new member of your household. I researched this subject
extensively and was surprised to find that most of the resources were about
transitioning an elder into an assisted living facility or a nursing home. I want
to discuss the possibility of moving an elderly family member into your personal
home, with you and your family, if you have one.
Perhaps you want to be closer to them and share as much time
as you can with them in their old age. Perhaps they may need help with daily
activities, but don’t need consistent medical care. Perhaps they do need
routine medical care, and you want to be able to facilitate home health visits
in your home, where you can oversee things. Perhaps you aren’t financially able
to move them to an assisted living facility, but you can accommodate them at
home. There are so many different situations and reasons you may want to make
this move! There are also numerous things to consider when evaluating whether it
would be a smart move for everyone, and if it is even feasible. We will discuss
these things here today. I hope you find it helpful!
First, I want to discuss how I would approach things if I
were personally confronted with this issue. I think the main thing that would concern
me about sharing my home with a parent or grandparent on a long-term basis
would be that I would wonder whether I was able to meet their needs. An older
loved one can have many needs and if you are sharing the same living
arrangements, they may assume that you will be available to provide for them on
so many levels. While you may certainly want to do that, it’s often not
possible.
Work obligations and family needs and social
responsibilities can often leave you feeling overextended, and when you add a
dependent and needy elder to the mix, it can become overwhelming. Even if they’ve
planned to have Home Health visits, or can still manage many things themselves,
they will undoubtedly have some level of expectations and demands on your time
and resources.
In my personal situation, I am single and live alone with my
teenage son, who will be a senior in high school this year. My focus is on
keeping up the house, paying the bills and providing, and most importantly,
making sure that my son is cared for and doing well in school, as well as helping
him to prepare for college soon. I am also a college student, so I must devote
a lot of time to that as well. We live in a small house, so it would be a big
adjustment for us to accommodate a family member. At the very least, we would need
to clear out our family room at the back of the house and transform that space
into a bedroom. This would require moving our sewing and craft areas, our piano
and drums, and our cats’ litter box. We would have to purchase a bed, a
dresser, and come up with some sort of closet unit. I don’t know if my loved
ones are allergic to cats or not, so that may be an issue we’d need to consider.
It would be a big adjustment for us, especially because our house is so small
and I have no other support, physically, emotionally, or financially.
If you’re considering moving an older adult into your
household, you’d need to find out whether they will need wheelchair access
or other mobility aids and implements, such as grab bars in the bathroom. If there
are stairs in your household, can they climb them? If you need a wheelchair ramp or to widen a
doorway to enable wheelchair access, or to elevate a toilet, or install grab-bars,
etc., are you able to provide these things?
You will need to learn about their dietary requirements and
how you will accommodate them. Also, do they still drive, or will you or
someone else be providing transportation to doctor visits and social events? You
would have to keep in mind what a huge adjustment this would be for our loved
one. They may deal with depression with the loss of their autonomy and self-sufficiency
or feel like they are imposing or disrupting our lives. We would have to take
extra care to make sure they didn’t feel like they were being a burden to us or
causing us any harm in any way. We would want to uplift, honor and provide for
them as best as we can. There may be times when you feel burdened with all the
responsibility and loss of freedom. You may find yourself feeling like you need
care as well, and self-care is an important factor in caring for others. You
will need to think about how you will facilitate time for self-care.
Three family structures that are different from mine would
be a traditional family unit that had a husband and wife and children; a single
person family with no dependents; and a single parent family with children and
perhaps other family members living together. Families can have one working adult
or two, and adult children or young school-age children. Some grandparents are
raising their grandchildren. Many cultures have multiple generations living
together. This is becoming more popular due to the strained economy and an aging
population. So, you see, there are many variations of the modern-day family
unit. Every situation is unique and should be addressed individually.
A counselor, pastor, case manager, etc., can provide insight
and ideas on how to best accommodate everyone’s needs during this time. You
should discuss ahead of time how you will handle groceries, cooking, laundry, parking,
etc. It is essential to plan and discuss expectations and arrangements. Will
they contribute anything toward groceries and utilities? Will they want to have
visitors, and if so, what are their privacy needs? Who will handle their cleaning and other
household needs and responsibilities? These are just some considerations. It’s
helpful to understand what each other’s daily activities look like. Who shops
for groceries, cooks, and who does the dishes? Is laundry done weekly, or as
needed, and will you do them separately or combine them? All these unanswered
questions can lead to misunderstandings and friction.
Open communication is probably the most essential element to
successful arrangements. Any issues or grievances can be resolved agreeably
with open, honest and productive communication. Strategies to improve communication must incorporate an
understanding of patient needs. A structured approach which considers timing,
privacy, location and appropriateness for patients and families is needed
(Bucknall et al., 2020).
According to Schiebl et al., (2019), we should consider the
following when planning to move an elder into our household, or into an assisted
living facility:
- Resilience
enables very old people to adapt following relocation. Resilience is not something
we can instill on an adult prior to them confronting change or issues.
However, the level of resilience should be considered when planning events
such as relocating your loved one to a new residence and implementing care.
- Some
very old people prefer having company in residential care to living alone.
Isolation can lead to loneliness and depression, which can be detrimental
in so many ways. Consider how you can help to avoid these feelings.
- Moves
that end life-long local connections increase isolation and loss. Consideration
should be given to promoting socialization and accommodating visitors.
- Establishing
connections with people or place ahead of a move is beneficial. Are there senior
clubs or adult day care type facilities where your loved ones can
socialize and participate in activities?
Personally, there was a period of two years when my middle
school aged son and I moved in with my daughter and her husband. We learned a
lot during that time. We moved in with my eldest daughter and her husband to
help raise their four children while they worked and finished college. This
required many changes. I had to sell our house, and my son had to change schools.
Selling our house involved repairs, staging, boxing, selling things and moving
the rest to storage. We had to adjust to being without our usual comforts and
acclimate ourselves to having bedrooms as our only private spaces. Being
mindful to their house rules and having constant activity, which included four
small children, required patience, flexibility and sacrifices from all of us.
However, it worked out well because we had open discussions, shared
responsibilities, and timelines and plans for the next steps. You may want to
consider some of the things we incorporated that helped us to have a successful
living situation.
First, make sure to discuss ahead of time things such as
everyone’s expectations, needs, responsibilities, routines, schedules, sleep
patterns, space requirements, etc. Consider whether any modifications need to
be made to the space they’ll occupy and use, scheduling visits with other
family members, day activities and places where they may participate in
socialization.
Evaluate all the variables and considerations and talk about
how you will handle requests, disagreements, special needs, etc. It’s best to
discuss potential areas of conflict as soon as they arise to resolve them and
find amicable solutions. I recommend posting schedules and reminders, so
everyone is aware of the various schedules and responsibilities for social
events, work, cleaning, laundry, dinner menus, when bills or their contribution
is expected, etc.
Having clear and concise expectations in writing for
everyone to see reinforces the rules, increases awareness for everyone, and
also prevents anyone from feeling left out of the loop. A little discussion and
planning go a long way. Organization and transparency are the key.
I recommend trying to eat one meal together a day,
preferably dinner, when things are less rushed. This is a great opportunity to
not only bond, but to also evaluate how things are going with everyone.
Further, I cannot emphasize enough how helpful it is to have a weekly
“meeting”. This can be a conversation over Sunday brunch, or just a gathering
in the living room, but everyone should plan to spend 15 minutes once a week to share any news, present any requests, suggest ideas, resolve conflicts and clear the
air. This is such a helpful and productive way to share and resolve issues that
could otherwise linger, fester and may result in resentment, conflict and
emotional outbursts. Some like to start the conversation in prayer and thanks,
taking turns to talk and vocalize appreciation for kindness that might
otherwise go unrecognized. These little gestures can go a long way when a
family member is feeling overworked, overwhelmed, underappreciated or going
through a hard time. It’s the little
things that make people feel welcome, loved and appreciated.
I found some helpful resources, such as AARP.org, which
provides helpful information and resources for that can facilitate this
transition. You can find it here: AARP
Resources for Caregivers and their Families. They also provide a caregiving
organizer tool, resources and more in one place. You can access it here: AARP
Care Connect - Simplifying Your Caregiving Journey.
This YouTube channel, titled “A Place for Mom”, provides
helpful information, tips and insight to the subject of caring for your elders.
This video, titled “8 Essential Tips for Moving a Senior Parent into Your Home
/ A Place for Mom” can be found here: https://youtu.be/zH4ltHbbT6k.
Some helpful things addressed in this video include: assessing your elder’s
level of independence; considering whether you can care for them; whether you
can provide proper care; ensuring the safety of your home; adapting to
relationship changes; covering necessary costs; remembering your own well-being;
communicating effectively with family; and preventing social isolation. This
channel is a wealth of information.
In summary, it’s important to think about all the
considerations regarding moving an elderly loved one into your home. Planning
and preparation help you to do what’s right for everyone involved. Most
importantly, I hope you can show up for them in the best way you can, as they
did for you. Be in the moment, and don’t let anything get in the way of
expressing your gratitude and love for them while you can. You never know whether
you’ll get the chance again.
References
Scheibl, F.,
Fleming, J., Buck, J., Barclay, S., Brayne, C., & Farquhar, M. (2019). The
experience of transitions in care in very old age: implications for general
practice. Family practice, 36(6), 778–784. https://doi.org/10.1093/fampra/cmz014.
Tracey K.
Bucknall, Alison M. Hutchinson, Mari Botti, Lauren McTier, Helen Rawson,
Danielle Hitch, Nicky Hewitt, Robin Digby, Mariann Fossum, Anne McMurray,
Andrea P. Marshall, Brigid M Gillespie, Wendy Chaboyer, Engaging patients
and families in communication across transitions of care: An integrative review,
Patient Education and Counseling, Volume 103, Issue 6, 2020, Pages 1104-1117, ISSN
0738-3991, https://doi.org/10.1016/j.pec.2020.01.017.(https://www.sciencedirect.com/science/article/pii/S0738399120300446).