More than 1 in 5 adults — a total of 53 million adult Americans — are now unpaid family caregivers, according to a new report from AARP and the National Alliance for Caregiving (NAC).
The number of caregivers has climbed from 18 percent of adults in 2015 to more than 21 percent in 2020. This is an increase of 9.5 million adults providing assistance (financial, emotional, physical) on everything from grocery shopping to wound care to medication management to, my current situation, in-home caregiving.
Our Story: Mom Moves from Kansas to Colorado
When my stepfather-in-law passed away 6 1/2 years ago after a long illness, I only imagined how difficult it would be for my then 82-year-old mother-in-law. After all, they had been married for more than 45 years.
During the week of the funeral, we sat around Mom’s kitchen table with my husband’s family to discuss her situation. We learned she had developed medical problems (from COPD to mobility issues to high blood pressure), and her financial situation wasn’t the best. She needed our help. Long-distance support wasn’t going to cut it anymore. When no other family member volunteered, my husband and I stepped up and invited Mom to live with us.
As a blended family with 5 adult children and many grandchildren, we had been empty nesters (off and on) for 10 years. Inviting your mother-in-law to cohabit with her son and daughter-in-law is a big step. And the journey includes many bumps in the road.
Nothing could prepare me for how much my own little world would change with all the little details of settling my father-in-law’s estate. Our family became submerged in the ever-pressing task of selling their small Kansas farm to move Mom away from her friends and back to Denver.
Mom had grown accustomed to her own little world in Kansas, with her husband doing most of her errands. Moving back to Denver in unfamiliar settings, her social anxiety overcame her at times, and the thin mountain air wasn’t kind to her COPD. She ended up in the hospital within the first week of living in Denver. She also quit smoking and is now on oxygen 24/7. Let’s just say those first few months had all three of us questioning our decision – and sanity.
So here we are. Post 6 1/2 years as a family of three, experiencing both sad and happy moments and lots of in-betweens. I’ve watched Mom step out of her comfort zone and explore the world – or at least our neighborhood. I can now say I wouldn’t change a thing, but it ain’t been easy!
So let me help you out – and I’m not saying I have all the answers, so I reached out to experts and other like-minded caretakers. Start with these tips for preparing for your aging parents to live with you.
1. Communication is Key!
Bayu Prihandito, Founder of Life Architeckture & Certified Psychology expert, says, “I think it’s crucial to first establish an open dialogue about the caregiving situation. This will allow both parties to express their feelings and set expectations, avoiding any misunderstandings and resentment towards one another.”
“It’s important to understand that it’s a tough transition for the parent as well,” Mr. Prihandito says. “They might feel a loss of independence, which can also become emotionally challenging for them. Try to develop a deep sense of empathy, understanding, and patience, as it will ease this process.”
Trust me – we had dozens of conversations with Mom. Be open, be honest. Ask questions. This is a BIG change!
2. Assess the Safety of Your Home.
It’s second nature to child-proof your home when bringing your newborn home, but it’s also equally as important to assess the safety of your home for your elderly parent.
According to Phillippa Quigley, a fully qualified Health and Wellness Coach and lead writer at Soma Analytics, “Before your parents move in, you’ll want to make your home as accessible and comfortable as possible. Think about the placement of your living quarters. If possible, arrange space on the ground floor to avoid stair-related issues. You might be surprised at the hazards you’ve never noticed before.”
Hazards, such as loose rugs, low lighting, unsecured furniture, stairs, and dimly lit spaces, can present challenges for the elderly. “Simple changes,” she says, “such as installing grab bars in the bathroom or increasing lighting in dimly lit spaces. This is not about radically changing your home but adapting it to fit your parent’s need.”
Easy to say, right? Because our Mom lived in Kansas (a 9-hour drive!), we lived outside their bubble of day-to-day activities and medical issues. We had no idea how seriously ill our stepfather was before he passed, nor did we realize how many medical challenges Mom had.
But when Mom moved in, we figured that out quickly. A small-town elderly mother with mobility issues does change your world. It’s like Mom Guilt in reverse as you feel guilty going about your usual Before-Mom routine.
Before she could move into her basement apartment, we installed a people-mover to transport her up and down the stairs.
Ms. Quigley also recommends: “While this may seem unconventional, consider a baby monitor or intercom system. Communication is key, and having a simple way for your parents to reach out to you offers peace of mind for both parties.”
3. Stay Flexible and Plan for Change.
With her vision and mobility issues, my husband and I felt she could no longer drive. We sat down and spoke to her openly, acknowledging that this would take away her independence. Luckily, Mom agreed that was the best step – and she wasn’t excited about driving in the “city.”
That put us in the driver’s seat as we are now her transportation to all those doctors’ appointments, shopping, and errands – whatever. After some initial struggles, Mom does her best to schedule around our work schedule when possible. We also add in extra time (at least 30 minutes on each end) to get her into the car, back out of the car, and to her appointments.
We prepare more meals at home and dine out less often. We both work full-time, so we also adjusted our evening meal to earlier as Mom is sitting down by 5 p.m. Often, this means a quick rush home to make dinner, but this also allows me and hubby some alone time after Mom retires.
4. Be Creative.
As a parent, you’ve grown accustomed to taking care of your children, from toddlers to teens to adult years, and we are mostly okay with that. But when you become the caretaker for your elderly mother, often overnight, no one hands you a set of rules.
In that first month as our roommate, Mom approached me about trimming her toenails as she couldn’t reach them – and she was embarrassed to show me her toes. I resisted running the other way because, ewwww, I think feet are gross!
I didn’t run. Instead, I booked her a manicure and pedicure at my nail place, a short 15-minute drive. On the way, she rather shyly asked what to expect, informing me that this would be her first professional manicure and pedicure! What? What! I told her that this was her lucky day – and the beginning of an obsession with pampering.
Bottom line? As caretakers, we must become creative.
My husband and I both agreed early on that we would do our best to make Mom’s last years (whether one, ten, or more) the best possible. It is a constant struggle, but my first reward happened when Mom sat in the massage chair while the nail tech rubbed her heel callouses and massaged her legs. Mom looked over with a big smile and asked, “How often can we get these?” Now, I love our monthly mother-and-daughter afternoon nail day.
5. Professional Home Caregivers are Lifesavers!
“It’s not about admitting that you can’t do it all,” says Ms. Quigley. “It’s about creating a support network for you and your parents. I’ve seen this with several of my clients who’ve juggled caregiving duties with other responsibilities. If budget or financial assistance allows, hiring a professional home caregiver can also be tremendously helpful.”
I personally can say this has literally saved our lives. We both still work full time, and the added caregiving duties caused tension in the home due to simple exhaustion. A caregiver took the pressure off of us. It can be expensive, so do consider that cost as well.
If a professional caregiver isn’t viable due to cost, ask for help! Our adult children and grandchildren (Mom’s great-grandkids and great-grandchildren) and our friends have been amazing. When we go out of town, they step up, call Mom, stop by to visit, and even bring her meals. It really does take a village!
6. Start Small.
My husband and I are lucky to have most of our adult children and grandchildren in the same town, and we have many close friends. We like spending time with both family and friends.
But there’s that elephant in the room – our mom living with us. Sometimes, she simply does not have the energy to go anywhere, and frankly, taking Mom on those short outings is more work than fun.
We started small. We invited Mom out for (early) Friday evening dinners at one of our favorite family-friendly restaurants, occasionally inviting family and friends to join us. After a couple of months, we even invited Mom to join us at our local sports bar (honky-tonk” as she calls it). Our friends welcomed her with hugs and conversation, and we’ve taken her on several occasions including to watch her favorite team, Denver Broncos Football. We can’t tell you how awesome it is to see Mom laugh and chat with the gang.
7. Tune Into the Patient’s Needs
Before embarking on a long afternoon or evening adventure, when possible, we give Mom a few days’ notice so she takes it easy, rests more, and takes longer naps.
I also always consider Mom’s mobility issues when planning an outing. We ask questions when we go out with Mom. Are there stairs? How many? How far will she have to walk? Should she take her cane or her walker? Is portable oxygen charged? How many hours can she be gone with how much oxygen she has?
And even more questions arise based on each situation, time of the day, and Mom’s physical or mental health on that day. When the outing is longer than usual, Mom usually takes a nap to be more rested and ready to tackle the day.
In addition, with her health conditions and her age (89 years young!), these fun outings can turn into a trip to the hospital when she overdoes it. Don’t push, and don’t be upset if your parent is just not up to an outing.
8. Be Ready for Emotion.
Allow time for adjustments for your elderly parent and yourself. Julius Cermak, Holistic Healthcare Provers, Wellness Consultant, and Naturopathic Practitioner, recommends taking it slow. “Both sides need to be realistic as to where both fit into each other’s days and routines.:
This is new for everyone who will experience all the emotions. Sadness, happiness, anger, frustration – all the things! And it’s okay. Address the situation when possible – before “it” gets out of hand.
As the holidays approached that first year (and every year since), Mom experienced more sad periods (understandably), reverting to not wanting to leave home. She missed her husband, and she admitted she was feeling melancholy.
This is the time to be supportive and listen. We listened, and she also made an appointment with her local physician.
9. Enlist Reinforcements.
Take breaks! To continue to care for your elderly parents and not reach burnout, it is important to schedule breaks, take care of yourself, and ask for help when needed. This gives you time to breathe, re-energize, and not lose patience and tolerance.
This is the most difficult part of being a caretaker: realizing and accepting that you need help – and then asking for it. Until your parents live in your house 24/7, you will have no idea how incredibly exhausting caretaking is.
Ask for help – and do reach out to family members.
However, accept that other family members will likely never realize how challenging it can be working a full-time job and being a caretaker to their mother, grandmother, sister, or friend. Until you’ve been there and done that, you won’t know.
So, ask for help when you need it. Don’t feel guilty about asking, and don’t let them make you feel guilty for asking. Do be firm. Communicate that you need a break or that you’ve already spent the last two non-working days taxi-ing Mom around, and you REALLY need their help.
Chances are they will step up.
And if they don’t step up? Try to resist feeling bitter (seriously, I know this is not easy!). Because in the end, all we can do is what we can do – and we can’t make anyone else do anything. Period.
10. Take Care of Yourself and Each Other.
It is challenging becoming a caretaker, but we try to remember we are still husband and wife. When Mom first moved in with us, we felt guilty about leaving at all. But after time, we’ve learned to respect our new family unit.
Mr. Prihandito says, “In practice, caregivers often neglect their own needs, leading to exhaustion. I’d suggest practicing regular self-care, not as a luxury, but as a necessity!”
11. Powers of Attorney, Healthcare Proxies, Medicaid Qualification, Oh My!
So much paperwork, and yet so necessary. My mother-in-law had only just prepared a will a few years before her husband passed away – thank goodness! However, it’s important to secure the appropriate documentation when taking in an ailing and/or aging parent.
According to Elder Law and Trusts & Estate Attorney Stuart Schoenfeld at Capell Barnett Matalon & Schoenfeld, “This includes Powers of Attorney, Healthcare Proxies, and even Medicaid qualification and caregiver payment programs.”
Mr. Schoenfeld adds, “Adult children caring for an ailing or aging parent should focus on managing health, social, and financial needs. An important part of this is making sure appropriate documentation and information are in place. It is important to note that these documents be executed timely before there is always a risk the parent can become physically or mentally unable to sign them. It is also recommended that if there are existing documents in place, they be reviewed from time to time to make sure they do not need updating.”
To follow are his documentation recommendations:
- Health Care: Health Care Proxy, Living Will, and Long-Term Care.
- Financial: Power of attorney authorizes your agent (son, daughter, granddaughter), whomever you choose to manage your real estate and financial assets, banking, and financial institutes. Discuss with your attorney what is appropriate in your parent’s situation.
- Legal: Last Will and Testaments and/or Trust.
For all of the above, consult with an attorney with experience in Elder Law.
What I’ve Learned
The bottom line? These past six-plus years, we’ve really gotten to know our Mom. I know she loves chocolate, and she likes hanging out with her family and friends. She likes watching old Westerns, and she’s kind and thoughtful – and sometimes demanding.
Whether spending time around the dining table together, going to a family barbecue, or adventuring out for an evening at the theater, we’re creating lifetime memories with our parent roommate and friend, Mom – and that is enough reward for us.