Does the thought of a parent moving in with you strike joy or terror in your heart? Until recently, an extended family member living under the same roof was not very common in Canada. That is all changing as more young adults remain with their parents and senior adults move in with their own adult children. In fact, the 2021 Canadian Census shows that the number of multigenerational households has increased in by 50% since 2001.[1]

Reasons for Choosing the Family Home as an Option for Senior Care

Several reasons may factor into the decision to bring an elderly parent into your home. People are living longer and are thus likely to experience more health problems which complicate independent living. Rentals and property taxes are both on the rise, making housing more expensive. Hiring private personal-care workers to remain independent can be onerous due to a short supply, and fees—especially from an agency—are very expensive. As well, the waiting lists for facilities such as retirement and long-term–care facilities are now numbering in the months and years.

Costs v. Benefits of Living with an Elderly Loved One

The arrangement to bring an elderly parent home can work out well for some families. There is the huge emotional benefit of facilitating closeness between grandparent and grandchild. An older parent in reasonably good health may also be able to help support the family with childcare and household chores.

From the senior’s perspective, living with family can lead to a reduction in stress, a return to healthier eating habits, assistance with medical needs, and the vital companionship that is especially cherished after the loss of a partner.

Sharing a space with an elderly loved one may also be a source of stress for families, especially if their health is declining. Poor health may mean that a lot of time must be devoted to their care, or in monitoring their safety. Also, the living space may not be ideally designed for the physical needs of a senior with reduced mobility. There may be some financial strain, emotional friction between the adults, or the children may exhaust the seniors with their excess energy.

Five Tips to Consider before the Big Move

Bringing an elderly parent into your home requires careful thought. Families may feel tremendous pressure from the hospital regarding the discharge of a senior after a major health event. A couple of years ago, I published a short course outlining the steps on how to successfully move a senior family member home after a stay in the hospital.[2] Here are some points from that course, as well as tips from my own ongoing experience as a family caregiver.

• Do you have more than one family member committed to taking on a caregiving role, or are you planning to hire extra help? This is essential, since the primary caregiver needs to be able to sleep through the night and take breaks during the week to maintain their own health.
• Do you have at least one fully accessible entrance to your house, and are the doorways wide enough to accommodate a walker or wheelchair? If the elderly loved one does not currently need a mobility device, they may do so in the near future.
• Is there a bedroom and a bathroom on the main floor? Ideally, these would be close together. Is the bathroom fully accessible? Showers are easier than baths, and there needs to be enough room to get a mobility device in the bathroom.
• Provincial publicly funded home-care services can be beneficial, although they often have limited resources. It is advisable to enroll your loved one early, even if they currently require minimal assistance. In Ontario, these services are managed by the Home and Community Care Support Services, offering nursing and various other support services directly to your home.
• Do you have a “Plan B”? Given the shortages in good-quality long-term care homes, now might be a good time to put your loved on a waiting list or two. The screening process for long-term care homes is also handled by Home and Community Care Support Services in Ontario. The period of time they will live with you is unknown—it could be anywhere from weeks to years—and if one day their health deteriorates beyond your ability to help them, or if something happens to the primary caregiver, the only other option for their care at that point is a hospital. It may be worth it to tour some long-term–care facilities together before the need becomes absolute.

Does the Arrangement Meet All of Your Loved One’s Needs?

It is equally important to think about how you will meet the physical, mental, emotional, and spiritual needs of your elderly parent. It is wonderful when the language, culture, and religion are shared at home, but will your loved one get enough socialization? How will exercise needs be met? Often, community day programs can provide companionship and activities for seniors. Your local branch of the Canadian Alzheimer’s association or a local senior centre are worth consulting. Dementia-specific programs are often very reasonably priced: They allow a caregiver to drop a loved one off in the morning, pick them up in the late afternoon, and provide lunch and interesting activities. Virtual programs are also available.

Will It Work? That Depends on the Elderly Parent and the Family

The dynamics of living with a senior family member are shaped by a combination of factors, including their history and relationships between the adult children and the elderly parent, as well as the latter’s health condition. A senior who remains self-sufficient, is mentally alert, and is capable of making sound decisions offers a markedly different experience for the family compared to an elderly parent who requires extensive care and supervision due to being bedridden, emotionally volatile, or prone to wandering.

Financing Senior Care

Many family caregivers, particularly women, often face the tough decision of either sacrificing their employment or reducing their work hours to accommodate the needs of their senior family member. This becomes more pronounced as the senior’s health declines, further limiting mobility and independence. While there is no direct financial compensation for family caregiving, caregivers can avail themselves of the Canada caregiver credit, providing a tax credit based on their other income sources. Additionally, limited publicly funded home care is available through the Home and Community Care Support Services, offering assistance with nursing and other care tasks. However, once private agency hiring comes into play, costs can escalate significantly. For instance, planning for 24‑hour personal support worker (PSW) care through an agency may incur expenses of around $15,000 per month. Alternatively, having a self-contained apartment within your home could allow for partial housing in exchange for the services of a live-in caregiver or caregiving couple.

Prevent Caregiver Burnout

Caregiver burnout is a significant issue often overlooked in societies where informal caregiving, particularly by women, is undervalued. This unrecognized labour can lead to isolation and loneliness for caregivers, with a high incidence of physical and mental health challenges. It is imperative to provide support for caregivers, acknowledging their vital role. Additionally, unresolved relationship issues between the caregiver and the elderly loved one may require professional intervention. Prioritizing senior care over spending time with young children at home could also potentially affect their emotions. It is crucial to consider whether your partner will offer assistance and support. Furthermore, while extended family living arrangements offer benefits, it is worth exploring if older children can provide respite for senior care or assist with household tasks like cooking or cleaning.

Enjoy the Memories!

Embracing the presence of an elderly parent in your home can create countless cherished memories and foster warmth for the entire family, enriching each member’s life. However, it is crucial to recognize that every family operates with unique dynamics and resources, both human and financial. By undertaking careful preparation and addressing potential challenges head-on, inviting your elderly parent or in-law to live with you and your family has the potential to be one of the most rewarding decisions you will ever make.

Wendy Presant, RHNC, CFMP