Ask HN: Advice about aging parents

Also, if he has dementia and is begging and crying to his family for food, they're not going to respect the prior wishes. They're just not.

Readers here might not realize that $5K per month is really affordable. Outside a major metro area, it could be as much as $300-$500 PER DAY.

And just because the building is new and the grounds are beautiful does not mean you get better care.

We are dealing with the same issues, but not with a multi-story home. My in-laws are roughly the same age, have medical issues ranging from fall risks to severe dementia, yet drs won’t remove drivers licenses. In-laws live in another state, yet still rely heavily on us for many things, so we have made the decision to make the cross-country move to go live with them so they are able to stay in their home as long as physically possible. We will be their caregivers for as long as we are physically able to do so. All of us have discussed this in depth, what it will entail to make this happen, etc. In my opinion, it may be time to start thinking of doing the same, if the home is large enough to accommodate all of you, as it will give plenty of time to spend with your parents as well as taking care of your own family. It is difficult dont get me wrong, so take what necessary steps you need to do to make your life easier as well. I know I will be once we are there.

I'm in an expensive city facing a similar scenario with my mother and my father-in-law. My wife and I are planning on adding space in the form of an ADU, which we will be able to rent out before and after our parents use it. The catch is that so far we only have a plan for how to house one of them at a time. My father-in-law is ten years younger, in good health, and already living in the same city, so we're hoping we don't need space for both of them at the same time, but if we do, we'll need another idea.

It's interesting how much the conversation around this has changed. Twenty years ago you could believe you could find a nursing home that you could afford and that your parents could have a good enjoyable life in. Now I kind of figure that when they need more care than we can provide, the best institutional care we can afford, even at our income level, may well be a neglectful hellhole, so we're concentrating on keeping them with us right to the end if possible.

I think this is a good solution, but I want to add a few disclaimers after watching my parents make a similar decision with my grandparents.

My parents moved into my mom's childhood home with her parents, and renovated to build out a second floor with separate living/sleeping space (no extra kitchen). This was great in that the property became the de-facto gathering place for a large and geographically distributed family, and in a crunch the house could comfortably sleep 10 while my grandparents kept their comforts.

That said some things were not smooth:

* My parents and grandparents had trouble directly addressing uncomfortable topics. A significant example of this was when it was time for my grandmother to stop driving. The car would start to show surprise scratches and dents. My parents did not want to challenge my grandmothers stated sense of independence, and also had not budgeted a way to allow her to run her errands while they worked without driving (a driver a few hours a week, essentially). I consider this a high-liability failure.

* I got the sense that money was also not talked about directly enough, and there was frequently an undercurrent or sense of resentment about who was footing what bill, and whether said bill was even necessary.

* My mother, very sadly, started to deeply resent her parents after a long while for her perception of being trapped by the situation and unable to move on to other lifestyle choices. Part of this was due to my father taking a job out of state and being flying back for weekends, and my mom wanting to just join him in the new city full time. This resentment really soured their final years together, and is a real shame. Know going in that the decision you're making may go a decade longer than you initially calculated, and that your goals and priorities may shift in that time too, I guess.

* My younger sister moved in with the four of them in her early 20s while trying to re-figure out how to launch. The result was a lot of arrested development and strange regressive relationship behavior - my sister literally started acting like a pre-teen around my parents again, they started talking to her like a child, and my grandparents went back to the scorn-filled gramp-grumps they'd been with little kids. Everyone leapt backward 10+ years in terms of their adult relationships and communication methods with each other.

In the end, my grandparents were well cared for in their final years, and everyone did have more together time. The main benefit was the central gathering place for the extended family, and the house would fill for a few weeks of each year across all the holidays. I bought a house with room to build out a first floor en-suite that I hope my parents or in-laws will someday use, but I'm also keenly aware of the hiccups above. I think the main thing is clear communication about expectations, finances, and boundaries. Which I guess isn't different from normal life :)