While there are cases in which elderly parents and adult children coexist under the same roof peacefully, it’s not for everybody. In fact, more often than not, the disadvantages outweigh the advantages.

Take a look at the situation from a parent’s point of view. Generally, elderly parents resist moving in with adult children, citing a loss of independence as the primary reason to stay in their own home. For one thing, the parent may be forced to move away from a familiar neighborhood, and a support system of friends and peers. Such a move can create a debilitating feeling of isolation for the parent.

Even when a parent agrees to live with a son or daughter, their attempt to contribute to the household - which affords them a feeling of self reliance - is frequently not encouraged. That is, their money is refused, and their actions are considered more burdensome than helpful. Witness the well-meaning mother that insisted on peeling five pounds of potatoes before her daughter arrived home from work in an effort to "help” with dinner preparations. The family’s potato consumption never could keep pace with the mother’s rapid-fire peeling.

Furthermore, historical conflicts can bubble up as the tension of the role reversal - child caring for the parent - often uncovers long held dysfunctional patterns of behavior, including depression, stubbornness, and misdirected anger. Indeed, negative personality traits seem to crystallize and surface when older adults feel that they have ceded all of their control to their children.

To be sure, the changing times also makes it more difficult to keep a failing parent at home. For example, the rise in the number of working women has created a serious problem for daughters who want to care for their elderly mother or father. (Note that in most cases, the primary caretaker is a daughter or daughter-in-law.) Unlike decades ago, working women aren’t home to watch over a parent during the day. This means that if supervision or a high-level of care is needed, the family has to either hire in-home help, or someone has to quit their job. Both alternatives can create a heavy financial burden on a household.

In contrast, seniors who can no longer live alone have the option of moving into an assisted living or nursing home facility, something that many eldercare professionals recommend. Entering one of these facilities is not always the terrible ordeal that that people imagine it to be. Of course, it is important to select a reputable facility that offers quality care and a safe living environment. More important, the facility should be close to the primary caregiver because frequent visits ensure proper care.

At these facilities, elderly parents are reunited with peers, and if physically able, self-reliance is encouraged. Activities and trips are planned, and basic needs are taken care of without any parent feeling like a family burden.

However, despite describing the disadvantages of having a live-in parent, and highlighting the benefits of healthcare facilities, many families feel confident about inviting an elderly parent to live with them. For those who make that decision, it’s best to keep in mind three basic principles that will help keep the peace:

• The topic should not be taboo. Concerns may not remain unspoken. Adult children and their parents should discuss how they feel about assisted living and nursing home alternatives, and the ramifications of living together. Everyone’s perspective should be considered including the children, who may have to deal with a grandparent who is frail, forgetful, or acts inappropriately or in unpredictable ways. In some cases, children and teens may be uncomfortable bringing home friends. If room permits, you may want to designate an area of the house as the kid’s retreat. While living with a grandparent often can be an enriching experience, it can also be a confusing and embarrassing one. All the cards need to be out on the table for this discussion.

• If the elderly parent is still capable of following guidelines, drawing up some house rules will help head-off conflicts and avoid festering anger. Again, involve the entire family and come up with a plan that will help create harmony. For instance, allow the parent to contribute to household in ways that make sense; or figure out schedules in advance to make sure the burden doesn’t fall on any one person.

• Take time off. Caregivers need a break if they ever hope to sustain a healthy mind and body -- and juggle the myriad responsibilities that come with middle-age. If you’re looking for a few hours away from the house, check out church and community groups. Many provide volunteers that can sit with elderly parents while you shop or go out on a date. Interestingly, one California nursing service runs a program that matches up older adults who have similar interests - the opera, baseball, or gardening, for example. Also, friends and neighbors usually are glad to pitch-in, so give them a ring. Friends and neighbors truly want to help, but often don’t know where to begin. Ask for help with specific tasks, such as assistance with laundry, a home cooked meal or an afternoon "off” for the caregiver. If you need a longer break, contact local assisted living facilities to find out if they have personal respite rooms available. These are empty rooms that the management is usually eager to fill, and therefore are made available to the public at very reasonable rates.

[info]Paula Tchirkow, MSW, LSW, ACSW is President of Pittsburgh-based Allegheny Geriatric Consultants which specializes in geriatric care management for aging parents and middle-aged adults who have chronic illnesses. Paula is also the daughter of an elderly mother. Visit her website: www.caregivingadvice.com or reach her by email at Paula@caregivingadvice.com. If you want more practical tips on how to care for your elderly relative or family member, click here http://caregivingadvice.com/signup.html for my online newsletter, "Caregiving Advice from a Licensed Geriatric Care Manager."