Your heart may be in the right place, but there are some logistics to figure out.

The decision to have your elderly parent (or both of them) come live with you shouldn't be made lightly. Once they move in with you, they'll have to adjust to new surroundings, daily routines and the way of doing things; plus, if you have children of your own, they will have to get used to a new family dynamic. Helping your parents manage their day-to-day lives will require more of your time and energy. Here's what you need to figure out before the big ask.

Will their insurance cover the new residence?

Health insurance is obviously important, so find out if they'll still be covered if they move. "If you'd be moving them across state lines, make sure their insurance is valid in the new state," says Mattan Schuchman, M.D., medical director, Johns Hopkins Home-Based Medicine (JHOME). "This may be an issue if your parent is on Medicaid." If they'd be changing their primary care provider, find them a new one, preferably a geriatrician, near where you live.

What's your reason for thinking of moving them in?

If your parent is ill or can't take proper care of themselves, moving in with you could make sense, but what if you two don't get along? If you're both going to be stressed, coming up with a new arrangement, such as moving in with another family member or an assisted living facility, may make more sense.

What is their willingness to live with you?

Many elderly folks would prefer to stay in their own home, even if it's impractical. But before assuming they'd be better off living with you, Jane Marks, R.N., associate director, Johns Hopkins Geriatrics Workforce Enhancement Program, suggests looking into all options that would keep them in their home and provide support services to maintain their independence, such as grocery delivery or a driving service. Also depending on their needs and finances, consider some in-home assistance. "Engaging with a private care manager or social worker from their primary-care practice or Department of Aging or Area Agency on Aging (AAA)," she says, "may facilitate understanding their needs and what options are best for them."

What is the level of care they need?

Marks says you need to understand your parent's current care needs to make sure you're able to meet them as well as their potential needs. "Plan for the future, in case their care needs are more than you can handle, and understand the options and your parent's wishes."

Do you have the living space?

This is all about logistics: Where will you put them? Can you convert a den or office into a bedroom suitable for your parent? Will one of your kids have to give up their room to make way for their grandparent? In order for this transition to work, it needs to be practical for everyone.

Will stairs be an issue?

If they have mobility issues, having to climb stairs to get to and from their bedroom could be a problem. "Removing clutter and fall hazards and improving lighting will be important," says Dr. Schuchman. "Having a home assessment by an occupational therapist can help identify modifications that will make day-to-day life for you and your parent easier."

What is the family's commitment to financial support, in-person care, and back-up coverage?

"Caregiving is a full-time job," says Dr. Schuchman, "especially if you have children or work. You will need support from friends, family, and possibly from paid professional caregivers." Adds Marks, "I suggest the primary caregiver identify members of their care team and know their willingness and strengths in assisting with care. For example, one may be better at taking the parent for their doctors' appointments, one may like to run errands, one may take them to church, and so on." Remember, emergencies come up—who are the one or two people you can call if you need assistance quickly, such as you may have to work late and you need someone to pick up Mom from the senior center.


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