Economic Realities: Advice for Caregivers in Multi-Generational Households

Economic Realities: Advice for Caregivers in Multi-Generational Households

A combination of rising health care costs and the economic downturn mean more and more families are piling into one house together, especially when a loved one needs to be cared for.

“It’s like a perfect storm, but not so perfect for relationships,” said Dr. Debra Castaldo (, a family and couples therapist and faculty member at Rutgers University Institute for the Family. “The economy has a lot to do with this – adult children might bring an elderly parent in to live with them [to provide senior care] because retirement living is really expensive.”

Castaldo counsels many families who are dealing with the strain these new living arrangements have on marriages and other relationships.

“Issues from childhood come right back up,” she said. “And sometimes characteristics can get worse with aging.”

Despite these challenges, people step up every day to make major life changes that include loved ones under the same roof.

“Because of financial and health reasons, my mother-in-law had to move in with my wife and me just over a year ago,” said David Bakke, an editor at

“She’s a widow and could no longer afford her mortgage payment. She also has high blood pressure and suffers from bouts of fatigue due to her medication.”

While Bakke says it is not as difficult to live with his mother-in-law as he expected, and he really appreciates the live-in babysitting she provides for their children, there are hiccups between them.

“At times she attempts to circumvent my wife and me to instill her values in my son,” he said. “While I think her motivations are admirable, I believe that it is my and my wife's job. If she has a comment to make or has a suggestion as to how to improve my son’s upbringing, she should first mention it to me or to my wife.”

Castaldo’s main advice for multi-generational households like this is: “Boundaries, boundaries, boundaries! [That’s] the key to living with extended family,” she said. “A couple has to preserve and protect their boundaries as much as they can.”

This extends to making time to be together as a couple, communicating with one another when they feel too stressed to handle their caregiver role, and being clear about responsibilities with each member of the house.

But, as Castaldo says, sometimes it’s about history and not what’s going on right now.

“My wife actually has many more issues than I do. She and her mother have very different personalities and they frequently clash,” Bakke said. “Their differing opinions on household cleanliness, how meals should be prepared, and so forth often lead to quarrels. Therefore, I have to deal with my wife’s venting from time to time.”

Yet Bakke’s mother-in-law is still healthy enough to help out around the house and does not require full-time physical care.

Ken Brown, owner of Free Beneath, moved with his wife to be closer to his in-laws and unexpectedly became a full-time caregiver for them. After brain surgery, his wife’s stepfather began showing signs of Alzheimer’s disease. Around that time, her mother had a stroke that left her partially paralyzed.

“It is a tremendous undertaking and sacrifice, but no less so than the commitment our parents made to us when we were children, and certainly no less than the efforts we made to raise our own children,” Brown said, noting that he and his wife operate two businesses full-time. They hire a caregiver part-time, but do the lion’s share of the caregiving themselves.

“At first, it was uncomfortable for both my wife and I to assist her parents with bathing, bathroom, etc., but one becomes accustomed to it and you learn to treat it with humor,” he said. “Our highest priority is not our work, nor our recreational enjoyment of life, but our satisfaction comes from taking care of our responsibilities. We simply cannot place them into a nursing home merely because we wish to live our own lives.”

Castaldo says families need to communicate about all of these potential issues before they make the offer to live together.

“Really think about it and weigh all of the issues before and don’t leap into it,” she said. “Once you are in it, it is really difficult to get out of it.”

Bakke says he enjoys a good relationship with his mother-in-law.

“Try to focus on the positive aspects of your relationship,” he said. “If there is a particular activity you both enjoy, do it together more often. You might find that if you take the time to get to know your mother-in-law better, you can work out your disagreements more easily.”

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