A family is a system, and that family system is disturbed to any major change. Moving their older parent affects the balance of that system and throws it off. The relationship of the adult child and her/his spouse as a couple can be affected, due to the extra time attention and loss of personal space needed by the parents. The children in the family can be affected by the change in parental attention diverted to the grandparent or the lack of privacy and space, especially if they are teens. The adult child should be made aware of this new family balance ahead of the move so that they can plan on how to maintain the equilibrium of the family with the addition of the extra family member
Social support is another part of the GCM psychosocial assessment of the elder who is moving in with an adult child.
First the Geriatric Care Manager should use the psychosocial assessment section and identify family members and siblings who might offer support. A genogram can be used to assess those who are close to the parent and those who have strained relationships. Those who have agreed to support including daughter and son in laws can be organized to share the care with the adult child through offering socialization of the parent. This may be driving to appointments and social events, keeping a calendar of all appointment, paying parents own bills, and having the parent for weekends to offer respite. If this is a difficult issue then the GCM should hold a family meeting either telephonically or in person to discuss this issue with siblings and close family to build a support system for the adult child.
With in family dynamics involve establishing boundaries between the aging parent and the family. This should be done before the aging family member moves in. As a grandparent has moved in can they tell the teenager to turn off the loud music, make his her friends go home?. What boundaries must be set for the children and the grandparent ahead of time? What if the grandparent does not enjoy eating with family every night? If the wife wants control of her own kitchen will she allow her mother in law to cook some meals? What boundaries can be set here that will meet everyone’s needs? These family new family rules needs to be established jointing between everyone in the family so when the aging parent moves in there is and agreed upon manual for operating the family to keep the family systems balanced
Moving an aging parent in encompasses not just the present but perhaps 20-30 years in the future. It means accepting the parent as they are in the moment, which may be ambulatory, cognitively intact and independent but seeing they will be gradually affected by the decrements of aging. So your parent may have perfect vision now and because of macular degeneration need a great deal of support in mobility, eating, and all the activities and daily living in the future. They may eventually be bedbound or is the later stages of dementia. The geriatric care manager needs to discuss the move in terms of what the future may bring for the adult child care giver and discuss whether they feel they can accept this increasing level of care, if they could face caregiver burnout, if there are financial assets to hire caregivers to assist them or should there is a plan that may move the older person eventually to a higher level of care when care needs increase. The GCM can do a caregiver assessment if care needs to be rendered when the parent moves in. This will help the adult child see their strengths, skills and abilities needed to provide care. This might include their own medical issues preventing caregiver tasks like lifting and tasks that they find and tasks they find repulsive, like changing adult diapers. This assessment can include a care plan that recommends family caregiver solutions, like aging technology, social supports, formal supports, respite and training.