Aging and Baby Boomers

“It used to be older people whose money had run out who were living with their children, and now it’s the next generation that can’t keep up,” says Louis Tenenbaum, a founder of the Aging in Place Institute, which promotes “multigen” remodeling.

True, multigenerational families bunking together is hardly news in certain cultures. In 2009, 9.4 percent of Asian households, 9.5 percent of African American ones and 10.3 percent of Latino homes were multigenerational (compared with 3.7 percent of non-Hispanic white households).

Could this be an idyllic world of built-in child care, elder care and three square meals? A solution for avoiding isolation in old age? A way for pooled finances to go further?

Another Pew report did find that more than three-quarters of “boomerangs” — the young adults ages 25 to 34 who move back in with their parents — were satisfied with their living situation. Almost half paid rent and nearly 90 percent helped with household expenses. And in a 2011 report of multigen dwellers by Generations United, a Washington, D.C.-based advocacy group, 82 percent said the setup brought them closer, 72 percent mentioned improved finances, and 75 percent saw care benefits.

Consider long-term care costs alone. A 2012 MetLife Mature Market Institute survey put the average annual cost of a private nursing home room at $90,520, a semiprivate at $81,030 and assisted living at $42,600. Add to those costs the value of peace of mind knowing a loved one is being cared for by family, and multigenerational housing may be the new assisted living plan.

Designing for multigenerational living

Builders and remodelers are ready to support the growing trend. Want or need to stay put? The number of certified aging-in-place specialists who help older folks remain safely at home has more than doubled to nearly 5,000 since 2008. And the construction of new houses has started to get off the ground again.

Some builders have begun offering two master suites, a den or family room that can be converted into a bedroom and bathroom on the first floor, and other “bonus areas” with flexible space that can change with family needs. A two-car garage might shrink to one car and the extra area morph into living space for a grandparent or boomerang kid. Builders and remodelers are offering universal design features (wider hallways and doors, good lighting, few or no steps) that work for a baby stroller or a wheelchair. Some builders are installing infrastructure for future bathroom grab bars and stacking closets for down-the-road elevators.

In 2011, national builder Lennar introduced its first Next Gen house in Phoenix, geared to more than one generation. Now Lennar offers more than 50 Next Gen floor plans in 120 communities in California, Washington, Arizona, Nevada, Minnesota, Texas, New Jersey, Florida, North Carolina and South Carolina.

Next Gen’s concept is two houses in one: The main home has three or four bedrooms, and there’s an attached unit with its own front entrance, kitchen, bedroom, living space and garage. Perfect for an aging parent (or lucky nanny or guest, or as a man cave), it’s typically one-fifth the size of the main house. An adjoining inner door can be left open so the house can be one big home or, when closed, two residences.

Last November, Tom Moser, 60, a financial planner, and his wife, Kristin, 56, a registered nurse, moved into a Next Gen home in Marana, Ariz., with Tom’s dad, Lee, 82, a widower, who had lived 20 miles away. Tom had worried because night driving was becoming a concern for Lee and he “was kind of housebound.”

Each sold his respective home and chipped in to buy the $300,000, 3,200-square-foot, two-unit residence. (Tom’s living space is 2,500 square feet; his dad’s is 700.) Lee pays 15 percent of the utilities and helps with errands.

Tom’s sister Diane Weeks, 58, and brother-in-law, Wes, 57, along with Wes’ parents, have moved next door into another Next Gen home; their son, his wife and baby lived there for a while, too. Tom’s mother-in-law, Susan Liem, 81, just bought the house on Moser’s other side. “Everyone has separate space. We’re not stepping on each other,” he says. “This is my dream of being able to care for one another, but not do it alone.”

Tom has his own elder care plan: “When I’m 80, I know exactly where my wife and I are moving: right into my father’s place. Hopefully, my son or daughter [now 23 and 26] will slide into my place.”

A helpful arrangement

Multigenerational setups were common during the Great Depression but declined once people began to rebound economically. Now, as John Graham, coauthor of Together Again: A Creative Guide to Successful Multigenerational Living, observes, the recent recession has prompted a move back from valuing independence to interdependence.

“Families may be coming together because of the economy,” says Donna Butts, executive director of Generations United, “but they’re staying together because it helps them all.”

Jason Ng, 38, his girlfriend, Jamie Sonoda, 30, and their 20-month-old baby, Addison, live in a home he and his parents rebuilt on their property in Aiea, Hawaii. His mother, Karen, 64, has dubbed the den “the nest,” because she and her husband, Melvin, 69, have private space to watch TV. The two couples split bills equally: mortgage, utilities and groceries. Karen and Melvin adore caring for their granddaughter during the week when Jason and Jamie are at work, and don’t charge the new parents.

“I dream of having my own house, but the land in Hawaii is expensive,” says Jason. “If I moved where it’s cheaper I’d have a 1.5-hour commute. I love where I grew up, and a comparable house goes for $700,000 to $800,000. We got everything we wanted for $500,000 and split that. And we live in the same house as my parents, so if there’s an emergency, I’m right here.”

Then, the challenges

But the multigenerational housing scenario is not so rosy for everyone. Family friction, strain on spouses, and less opportunity for work and personal time are very real concerns.

Kris Radjewski’s 92-year-old mother-in-law has lived with her, Kris’ husband, Ed, 55, and their 14-year-old daughter, Lexi, in Lake Hopatcong, N.J., for 13 years. The elder Mrs. Radjewski has taken over the family room in the basement, where Kris’ older daughter, now away at school, would entertain friends. Now Lexi feels she has no space for hers. “She’s fed up and wants her life back,” says Kris, 50. “My daughter needs her mom, and I’m either working or taking care of Grandma.”

Ofelia Ramirez, 37, a housecleaner from Kyle, Texas, can relate. She has the 24/7 company of her husband, 42, her children, ages 16, 14, 7 and 6, and her 80-year-old mother-in-law. “The kids like having her around and we get to share a lot of memories,” says Ramirez. The downside is unsolicited advice about how to raise her children and feeling she can’t have their own friends over for dinner. And yet, on days her mother-in-law is not around, “it feels like somebody is missing.”

Ellen Lewis, 49, of Leonardtown, Md., describes having her mom, now 78, live with her, her second husband and her four kids, ages 10 to 20, as “not bliss, but it’s not hellish either.”

Lewis, who owns two knitting shops, says her parents (her dad died in 2001) were incredibly helpful when she was raising her kids, dealing with a failing first marriage and then dating her future husband. “But the dynamic has changed a lot over the years. You can’t look at this as an equal relationship,” she says. “It’s OK. It’s my time to take care of her. I have to remember the good times. I don’t want to see her in a nursing home.”

If you like this multigen concept, check out these tips to make the arrangement work.

The website Pandora.com will tailor a radio station to match your musical taste when you select an artist, song or genre. And Musicandmemory.org offers a free guide to creating a personalized playlist. (Find music collections we’ve put together from the website Spotify to help you with caregiving.)

Use music to alter moods

Diagnosed with Parkinson’s, Domenic Trifone, 59, of Newington, Conn., has difficulty walking and doing things on his own, which leaves the retired postal worker depressed. But when his wife, Susan, 56, plays Gregorian chants or opera, he is soothed. When she plays his favorite Billy Joel or Jim Croce songs, she’ll often dance, pulling him up to join her.

Donna Poulos has seen the effect music has on her 90-year-old mother, Grace Long. “When I’d leave her house, my mother would be sad, but if I put on classical or opera, she wouldn’t miss me. Instead, she’d wave good-bye, close her eyes and be transported by the music,” says Poulos, a grade school music teacher from Los Altos, Calif. When Poulos is driving with her mother, Long sways to the music and taps her toes, or they sing old tunes such as “Oh, What a Beautiful Mornin’ ” and “This Land Is Your Land.”

“I really think music is one of the things that has kept her alive and happy,” says Poulos.

Gear music to activities

You can use music to get loved ones through transitions, whether it’s moving from one room to another or on to a different task, says Alicia Clair, professor of music therapy at the University of Kansas. Play peaceful music when Mom is waking up. Pick up the pace with active, upbeat songs when getting her dressed for the day.

“One of the best ways to get directions across is to sing, rather than speak, them,” says Clair, who for 20 years has used music therapy for people with dementia. “Never use loud, frenetic music,” she warns. Need to coax a loved one into the shower? Put on Duke Ellington and dance together into the bathroom.

Make music together

Sitting together and listening to music can be bonding. Taking care of someone who can’t communicate can make a caregiver feel lonely and unable to relate, but music can provide a way to connect that is profoundly meaningful.

A pilot study by New York University Langone Medical Center’s Comprehensive Center on Brain Aging found that members of the Unforgettables, a New York City chorus made up of those with early to mid-stage Alzheimer’s and their caregiving spouses and children, reported more self-esteem, better moods, less depression and a greater quality of life after 13 rehearsals and one concert.

Joe Fabiano, 65, has been bringing his wife, Anita, 65, to the two-hour weekly rehearsals since the chorus was formed two years ago. “This is something we can share,” says Joe. “It makes me think of the old days, when we were happy.” Says Anita: “It’s good for my husband and helps me a lot. I like the camaraderie.”

That camaraderie can also ward off the loneliness that often accompanies caring for those with dementia. Husbands, wives and partners appreciate being with others who are dealing with the condition. “Having a place where there are people who can be together in a supportive, caring group is wonderful,” says Josephine Gruder. She brings her husband, Herman, 85, a former longshoreman.

Social worker Suzie Engel, 66, sang in the chorus with her mother, Norma, who died in January 2012. Engel still attends. “This group is like family,” she says.

The Unforgettables’ co-conductors, Dale Lamb and Tania Papayannopoulou, a music therapist from the Institute for Music and Neurologic Function and a pianist/singer, teach the group breathing, vocalizing, musical memory exercises and movement—good stress relievers as well as mental and physical exercise for all.

Not a singer? Consider rhythm. Drumming with others later in life is also a growing trend, according to Encinitas, Calif., music therapist and author Christine Stevens, who teaches health care professionals and family caregivers about percussion. “You don’t have to be musical whatsoever,” says Stevens. In her hospital room, former Rep. Giffords participated in a drum circle with her family and friends. Remo, a drum manufacturer, offers a “health rhythms” section on their website that discusses the health benefits of drumming and how to find a drumming group.

Tune in to your own needs

Music can be a great source of relief and pleasure. When her husband is at adult day care, during other times of the day, or before bed, Susan Trifone will turn on the tunes. “My body gets in rhythm to the beat and it makes me feel much better. But even more, music helps me get away from my everyday problems.”

There’s a (Music) App for That

I wrote this piece from the point of view of a long-distance caregiver. I can only imagine the added intensity when you are a 24/7 caregiver (and a few nasty emails told me I have no clue what it’s like!) The story has info for both long-distance and ’round-the-clock family caregivers. Let me know what you think:

At age 16 with my mother

Ever since I’ve been a caregiver, I’ve been waiting for The Call. If you’re caring for a loved one, you know what I mean — the telephone rings, and you learn that your parent has taken a turn for the worse and you must rush to his side. In the past 12 years I’ve taken care of my father, then my mother and now my 93-year-old mother-in-law. The Call keeps coming, and I’ve been on edge the whole time, waiting.

Last August my husband and I were reluctant to take our annual family vacation. Would something happen? But we went, knowing that time with our adult children, who live all around the country, was also important.

We had just entered the rental house when the phone rang. My mother-in-law had been admitted to a hospital many hours away. My brother-in-law gave us bedside reports, and she was released the next day.

Caregiving brings about a swirl of feelings: sadness, frustration, anger, anxiety, guilt, resentment, confusion, isolation, loss, fear, grief, impatience and stress. I have been overwhelmed, drained by sibling tension and torn between my own family, work, personal time and parental needs.

I’ve also experienced devotion, tenderness, intimacy, gratitude, patience and purpose in my role. In fact, a recent study from the Sloan Center on Aging & Work at Boston College found that older Americans who feel they are making a difference in caregiving and are highly engaged in what they’re doing feel happier and more content. I understand that, as well.

But from my on-the-job training, professional reporting and research, including writing a weekly blog for AARP on the topic, I believe most caregivers confront three distinct and difficult experiences. With help from experts, I’ve also learned ways to manage them.

Caregivers frequently grieve the loss of the person they once knew, even though their loved one is still alive. Until her first stroke, in 2008, my mother, a former university English teacher, read a book a day, without glasses, and was in three book clubs. Post-stroke, she could no longer see well enough to read and couldn’t process Books on Tape. Instead of dashing to a play, a lecture or a party, she stayed home, unable to walk unaided or get up from a chair by herself. She was a different person.

“When someone dies, it is an overwhelming and horrible experience, but it is the end of something,” says Suzanne Mintz, cofounder of the National Family Caregivers Association and author of A Family Caregiver Speaks Up: It Doesn’t Have to Be This Hard. “But with a caregiver, the grief is perpetual; it goes on and on and on.” Mintz has watched her husband, diagnosed with multiple sclerosis in 1974, lose his independence. “You grieve because you’ve lost the life you had, and you know it won’t be coming back. Both of you have the diagnosis — the person with the condition and the family caregiver,” says Mintz.

The arts, in fact, give caregivers and their charges a powerful way to connect. Interactive creative programs — such as songwriting, storytelling, dancing, playing instruments and painting — provide ways for caregivers and care recipients to relinquish their usual roles and enjoy a fun and stimulating sensory experience together.

New York’s Museum of Modern Art opens its doors to those with dementia and their caregivers each month. An art educator leads a discussion about master artists — van Gogh, Picasso, Degas — while the group views their works. This exercise taps into little-used senses and memories and ignites lively conversation, often making it impossible to tell who’s taking care of whom.

My mother had always loved poetry, so I would bring Robert Louis Stevenson’s A Child’s Garden of Verses, a collection of the same poems she had once read to me and I had read to my children, when I visited. She’d smile as we finished the lines together, and I felt close to the mother I remembered while relating to the person she had become.

Guilt

During caregiving guilt is constant. Guilt for not spending enough time with your loved one. Guilt for not tending to your own family. Guilt for having negative feelings. And guilt for resenting your new role. On my hundreds of trips back and forth to visit my mother, I remember thinking that — shame on me — I wish this would be over so I could get my life back.

What caregivers must remember is that this is a situation over which you have limited control and shouldn’t feel guilty about, says Alexis Abramson, a gerontologist and author of The Caregiver’s Survival Handbook. ”However, you are in control of how you react to it,” she says. And that is empowering.

Abramson advises reaching out to caregiving organizations that offer education and support, investigating elder-care benefits at work and resources in the community (respite programs, adult-day-care centers, transportation services), and scheduling time for yourself.

Without a network of support, caregivers often become isolated, which can lead to depression and their own serious health issues, and further exacerbate problems — one being guilt.

One way for caregivers to handle guilt is “to accept that having negative feelings about caregiving is normal,” says Barry J. Jacobs, a psychologist and author of The Emotional Survival Guide for Caregivers. ”You love the person you’re caring for, but you hate the caregiving. That’s normal.”

Caregiving often leaves the caregiver feeling depleted, both physically and mentally. For years, every other Saturday or Sunday my husband and I would pull a “doubleheader”: driving two hours to see my mother, then driving another hour to be with his mother, and finally getting back home by 8 that night, when I would fall into bed and not move. It was physically draining, sure, but the mental toll also wiped me out for the next day and left me dreading the time we’d have to return.

“That’s when the caregiving plan needs to be changed,” says Jacobs. “Caregivers need to be smart and strategic about setting limits on the tasks they take on, and recruit others to pitch in.”

Yes, taking the pressure off yourself is key. Hire outside help. Involve other family members and friends. A sibling or in-law who lives far away may be able to pay Mom’s bills online, deal with insurance companies or take time off to stay with her so you can take a breather. “When family members do pitch in, then everyone feels like a team in caring for a loved one,” says Jacobs. “Caregivers feel better supported and more resilient; family relationships become stronger and more enduring, even after their loved one has died.”

Talking out emotions with a friend, an elder mediator, a therapist or a peer group can also lighten the mental load. “Many of the caregivers I see who do well go to support groups,” says Lisa Campbell, a clinical psychologist who specializes in 50-plus issues at the Willow Wellness Center in Park Ridge, Ill. “It’s normal to feel overwhelmed,” she says. “Families are complicated.”

This is why, in part, there is no pat formula for navigating your own maze when you become a caregiver. Each experience is unpredictable, ever changing and unique. Your plan will require constant revision. You’ll need to reach out to others for ideas, advice and help, and that includes finding ways to take care of the caregiver — you.