By Lisa M. Petsche
For Coastal Senior

If you have a parent who is living alone, you may be concerned about his or her physical or emotional well being - or both. Especially if she does not live close by or is clearly not managing well, you may wonder whether you should invite her to move in with you.

Before making an offer, though, there are many things you need to carefully consider. Ask yourself the following questions and take time to honestly and thoroughly answer each one.

Interpersonal issues

· What kind of relationship do the two of you have? If you've a spouse, child or sibling living with you, how do they get along with your parent? Any personality clashes are sure to be magnified when both parties are living under the same roof.

· Are you comfortable with the idea of role reversal, whereby you are the caregiver and your parent is the care recipient? Even if your parent does not require a significant amount of assistance at present, this may change in the future.

Your needs

· How is your physical health? Would you be able to provide hands-on assistance if needed?

· What about your mental health? Caregiving involves a considerable amount of stress over time, and if you are already dealing with other stresses, this may be too much for you to take on.

· Would you still have time for yourself - for exercise, hobbies, volunteer work or whatever else is important to you?

Your family's needs

· Would you have enough time to devote to the rest of your family - spouse, children, grandchildren, other elderly relatives?

· What do others in your household think of the idea of your parent moving in? It's crucial to have their support in order for such an arrangement to work. If they have reservations, take them seriously and discuss them at length.

Lifestyle issues

· If you're employed, how might the primary caregiver role affect your work life? How would it affect your social life, vacation plans and other pursuits? What adjustments or sacrifices are you prepared to make?

· Do you and your parent have similar lifestyles and values? If not, are differences likely to be an ongoing source of conflict?

Your parent's needs

· What kind of practical assistance does your parent require at present, and how much time is involved on a daily or weekly basis? If she's been diagnosed with a chronic illness - for example, Parkinson's or Alzheimer's disease - how are her needs likely to change in the future?

· Would moving in with you uproot your parent from important relationships and community connections such as longtime, supportive neighbors, a church congregation or seniors' clubs?

· Can your parent be left alone? If not, do you have a reliable plan for 24-hour supervision - either family members being present around the clock or outside help for the times when no one can be there?

Available supports

· If you have relatives in the area, what kind of support would they be able and willing to provide to help make this work? If you have siblings close by, it's reasonable for you to expect them to provide regular respite. This might take the form of accompanying your parent to appointments or on shopping trips, regularly having her over for Sunday dinner, or periodically taking her into their home for the weekend. Many creative arrangements are possible whereby caregiving responsibility is shared among family members at least to some degree. This helps to prevent caregiver burnout.

· Would your parent's friends and former neighbors be able to visit frequently? Consider the distance they would have to travel to get to your home and what type of transportation is available to them.

· What kinds of community support services are available in your area to assist you in meeting your parent's needs, either now or in the future? Find out about accessible transportation services, seniors' recreation centers, day programs, home health care services that offer nursing, homemaking and various types of therapy, and residential respite programs.

Finances

· How would household expenses - such as property taxes, utilities and groceries - be shared?

· Does your parent have savings or insurance that would cover the cost of any needed medical equipment or health care services? If not, are you able and willing to pay for them yourself, or could you and close relatives share such expenses?

Your geographic location

· Do you live in the same city or town as your parent? If not, how easy would it be to link her with needed medical supports, such as a new family physician?

· If your parent is mobile and able to get out on her own: Are you within walking distance of a convenience store, pharmacy or bank? What about proximity to a place of worship if that's important to her? Are you close to any public transit routes? Easy access to at least some amenities would maximize your parent's independence - good for both her and you.

Home setup

· Is there sufficient space in your home to meet your parent's and the rest of your family's needs for privacy? Would your parent have separate quarters, or would it be a communal living arrangement? Could she have her own phone line and cable hookup?

· How accessible is your home? For example, are there steps to get inside, does it have multiple levels, are doorways wide enough to accommodate wheelchair passage? What kind of adaptations would need to be made, what is the estimated cost and who would pay it?

· Do you have esthetic concerns about alterations to your home, should an entrance ramp, stair lift, hallway railings, grab bars in the bathroom or a raised toilet seat be needed?

Your parent's wishes and expectations

· Would your parent want to move in with you? If so, can you anticipate her expectations in terms of privacy, financial arrangements and practical help? If you decide to feel her out about this, be careful to emphasize that you are only exploring possibilities at this point. Don't make any commitments. It may be better not to raise the subject, though, until you have made up your own mind. That way you don't set your parent up for possible disappointment.

Other options

Before making any decisions, explore alternatives: home health care services and other home supports such as meals on wheels; live-in help; and moving your parent to a condominium, seniors' apartment complex, assisted living facility or nursing home. Find out if any of these options are appropriate and affordable. Consider the least disruptive ones first - namely, bringing in support services and adapting your parent's existing home.

The decision

Don't allow yourself to be pressured by your parent, other family members or cultural norms. If, after careful consideration, you conclude that moving her in with you is not feasible, stick to your decision and don't be swayed by guilt. Help your parent develop a workable plan - whether it be arranging in-home services or finding another place to live - and provide as much practical and emotional support as possible.

If you do decide to move your parent into your home and she's agreeable, consider a six-month trial period with a clear understanding that other options will be pursued if you, your parent or other household members feel it's not working out and issues can't be resolved.

Keep in mind that such a plan involves changes in family dynamics and household routines that will affect daily living. Therefore you need to allow plenty of time for everyone involved to adjust.

There are bound to be some difficulties, but these can usually be worked through if all of you are committed to making the new arrangement work. The rewards can be great: a closer relationship with your parent; a feeling of fulfillment that you're doing something worthwhile; the satisfaction of being able to give back to someone who has done much for you; and the peace of mind that comes from knowing your loved one is well cared for.

No matter how positive you feel, though, about the long-term viability of your plan, don't promise your parent you will never pursue placement in a care facility, since you can't be sure what the future holds in terms of your own situation or her health care needs. Unexpected events can alter the best-made plans, so flexibility is key.

Lisa M. Petsche is a geriatric social worker and freelance writer.