Multigenerational households are not as common here in the U.S. as they are in some other parts of the world, but the idea is gaining steam, according to Pew Research Center analysis of Census data. According to their analysis, in 2021, about 18% of the U.S. population lived in a multigenerational home, up from a mere 7% in 1971.
While there are many reasons why more Americans are choosing to move into multigenerational living situations, including the after-effects of the COVID-19 pandemic and economic challenges, another big reason is the ever-growing population of older adults who need more help as they age.
If you’re considering moving your parent in with you because they can no longer live independently, read this first. We’ve unpacked all the issues you need to consider to prepare for this big shift in living arrangements.
[READ: Common Caregiving Tasks to Do for Your Older Loved One]
Should You Move Mom or Dad In?
There are multiple ways to create a multigenerational household, and while it’s common for an older adult to move in with their adult children and their families, sometimes the adult child moves back in with mom or dad to take care of them.
That’s been the case for Alyson Austin who recently moved from California back to her home state of Maine to help her mother. The 57-year-old public relations professional owns her own business and says that because she had more flexibility than her siblings, she was able to take the lead in caring for their 90-year-old mother.
Austin had no family ties in California, so she bought the house her mother had been living in for decades and moved in with her.
For many other families, the parent moves into the adult child’s home, which often means sharing the space with the child’s spouse and their own children too. Either way, navigating this big adjustment takes a lot of forethought and care.
Before your parent moves in, it’s important to evaluate the practical, financial and emotional considerations that will shape how well the arrangement works for everyone.
[Read: 11 Signs Your Aging Parent Needs Senior Care]
1. Physical and Logistical Preparation
There are many things to consider when thinking about moving your parent in with you, from the basics of where they’ll sleep to who’ll be in charge of dish duty most nights.
Consider the following key physical and logistical questions before moving your parent into your home.
[READ: How to Set Up Your Home for Aging in Place]
Making home modifications
Many homes aren’t designed to meet the needs of older adults, especially if they have mobility issues and are using a walker or wheelchair. Some common modifications that you may need to make include:
— Adding ramps or a stairlift
— Removing carpets and rugs to prevent falls
— Widening doorways to accommodate mobility aids
— Adding grab bars in the bathroom
— Converting the tub into a walk-in shower
— Converting first-floor rooms into bedrooms
— Building an addition on the home
Such modifications can easily cost tens of thousands of dollars, says Joseph Fresard, an attorney at Simasko Law in Mount Clemens, Michigan.
Plus, these modifications may need ongoing maintenance that can also become costly. For Austin, a key concern has been the stair lift that her father installed nearly 20 years ago when he was aging so that he could get to the second floor of the home. Her mother uses it now, and Austin says she carefully monitors the device and budgets for annual service to keep it functional for as long as her mother needs it.
In addition to the stair lift, Austin says she’s in the process of modifying the bathroom on the first floor to accommodate her mother’s needs. “It was a half bath, and I need to add a shower,” a renovation that her research suggests will likely cost about $10,000.
2. Financial and Legal Details
Money can be a sticking point for any household, and when combining multiple generations into a single household, it’s important to be upfront and transparent about expenses and expectations.
For starters, you’re going to be budgeting for an additional person for food, toiletries and other household supplies for the duration of their stay.
“Be frank and practical about these matters,” Fresard says, adding that working with an attorney who’s versed in elder issues can help you navigate some of the more complex issues that may arise around sorting out financial matters.
Essential documents to prepare
You’ll also have to consider the legal implications of assuming management of your parent’s situation, and that means you’ll need the right documentation. Documents you may need to secure or draw up before your parent moves in include:
— Durable power of attorney and health care proxy designations
— A living will and advance directives
— Identification documents, such as their birth certificate, passport, driver’s license and Social Security card
— Health insurance cards and plan information
— Military service records if they served
— Banking details including account numbers and any outstanding debts that need to be managed
— Investment documents, such as stock certificates and brokerage accounts
— Retirement and pension plan information
— Long-term care insurance information if they have such a plan
Exploring financial resources
You’ll also need to consider how you’ll pay for your parent’s health care needs. Medicare covers most medical needs but does not provide coverage for caregiving expenses. But you might have other options and resources available to you.
For example, if your parent served in the military, they may be eligible for certain veterans benefits that could help offset some of the costs of care. Contact the U.S. Department of Veterans Affairs for more information about whether your parent might qualify for benefits and how to access additional funds or services.
There may also be tax implications for moving your parent in with you. A financial planner who’s versed in elder care issues can help ensure you’re getting the most you can for your money.
Medicaid implications
Moving your parent into your home can have costly Medicaid implications down the road, says Evan Farr, a Fairfax, Virginia-based certified elder law attorney with Farr Law Firm, P.C.
Typically, a parent moves in with an adult child because their overall health condition has significantly deteriorated, and they often need long-term care within the next few years years. But Medicaid’s five-year look-back period can complicate this.
“A ‘gift’ made during that timeframe could result in a delay or denial of eligibility for Medicaid,” Farr explains.
And we’re not talking birthday gifts here, he continues. Many families don’t realize that using the parent’s money to renovate a basement, build an in-law suite or buy a home in the child’s name counts as a “gift” under Medicaid rules. Unless your parent’s name is on the title of the home, Medicaid may view these payments — even if they’re being made to benefit the parent specifically — as gifts that impact eligibility.
If parents want to contribute financially toward home improvements, “they need to have a legitimate ownership interest in the home,” Farr says.
It’s best to contact an experienced elder law attorney to walk you through the specifics to ensure you’re not going to run afoul of Medicaid rules when the time comes.
Sharing expenses
You’ll also need to be careful when it comes to sharing expenses, Farr says. “Another financial problem I see regularly that can create havoc with Medicaid eligibility is that children will have their parents contribute random amounts each month towards home expenses.”
Such payments can also be viewed by Medicaid as gifts if they aren’t documented by a formal home-sharing or co-ownership agreement.
Plus, if your parent intends to pay you for your caregiving serves, you need to have “a written caregiver agreement, validated by extrinsic evidence such as a report by a geriatric care manager, detailing the exact nature of caregiving and the number of hours each day of support the parent will require,” Farr says.
If you don’t have this documentation, “Medicaid will likely view any monies paid by the parent to the child as gifts.”
The point here is, it’s important to talk ahead of time and consider drawing up a written agreement with your parent, Fresard says. “Putting things down in writing can be important.” And make sure your and your parent’s expectations are compatible; for example, if you expect that your parent will compensate you for your time in providing care, you need to create an agreement with your parent outlining that expectation.
3. Emotional and Caregiving Considerations
While there are plenty of logistical, financial and legal issues to consider, some of the less concrete but often most difficult issues revolve around navigating the emotional and caregiving dynamics of bringing your aging parent into your home.
To help ease potential issues before they start, take stock of your parent’s emotional and psychiatric needs, says John Puls, a psychotherapist practicing in south Florida. This may necessitate a mental health assessment to find out what their specific challenges are, especially if your parent is experiencing cognitive decline.
If you determine you can meet those needs, it’s time to start setting appropriate boundaries. Healthy boundaries are crucial to effectively navigating the emotional dynamics of caring for an aging parent, Puls notes.
For example, you must make time for your own spouse and children if you have them, and you need to give yourself some space for your own life and needs too. “It will take time to adjust and found out what boundaries need to be set,” he notes. But keep at it.
Fresard says this all means lots of ongoing communication. “Don’t put these conversations off too long or it becomes more difficult,” he says.
Still, setting boundaries can be very difficult for the adult child of an aging parent, and that can lead to other challenges. “We have seen divorces initiated because one spouse is less willing to set boundaries with their own parent,” Fresard notes.
It’s also important to work on caregiver burnout prevention, Puls adds. Recruit help in taking care of your parent from other family members or a professional caregiver you hire. “Build in breaks and respite for yourself.”
When to Reevaluate the Arrangement
Moving your mom or dad into your home can create a vibrant, multigenerational dynamic that’s enriching for everyone in the family. However, there may come a time when you need to reevaluate the arrangement and make a change, for example moving them into senior living.
Simply, it doesn’t always work out. For this reason, Fresard recommends having a back-up plan in mind before you make the transition. “Living together might not be easy and could end up being more difficult than what you planned for.”
What’s more, there may also come a time when your parent’s needs exceed your ability to look after them. For example, if they need 24/7 nursing care or are having behavioral issues related to dementia, you may no longer be capable of caring for them appropriately.
“Before you have an elderly parent move into your home, please recognize that your parent’s care needs usually increase quicker than you anticipate,” Farr says.
Preventing caregiver burnout
Another potential problem is caregiver burnout. It’s very common, and Austin says she’s aware of this possible pitfall. “One of my biggest challenges for this arrangement is the personal toll it can take.”
For example, she has limited her circle of friends to protect her mother, and says she battles loneliness in trying to “find a balance between my care for my mother and my well-being.”
There may come a time when her own mental or physical health needs outweigh those of her mother’s. Therefore, it’s important to have some idea about making the transition to assisted living or a skilled nursing care for your loved one.
It’s best to set a general timeline for reviewing the situation, such as when your parent has their annual wellness visit. Take a look at how things are going and determine whether the situation is still sustainable.
Being able to live with your parent and help them in a time of need can be very rewarding, but it’s not always simple. “It takes a big life change to make living with an elderly parent happen, but it’s worth it,” Austin says.
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Moving Your Senior Parents Into Your Home: What to Consider originally appeared on usnews.com