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    When Your Parent Depends on You

    Deciding what's best for an ailing parent is tough. But there are more options now than just the nursing home.

    Your home or somewhere else?

    Some people consider moving an older parent into their own home. Is this right for you?

    Quiz your parent about needs and preferences. If your parent welcomes the idea of moving into your home -- and not all do -- think hard about how the new proximity could affect relationships: Will it destroy a good bond, help a distant one, or be a neutral factor?

    Critique your home, too. Do you have enough space? Are any stairs a danger? Can you add grab bars to toilet and tub areas?

    What about you? Are you healthy enough to take on caregiver duties? Are you comfortable with the idea of helping your parent bathe, dress, and toilet? Do you still work outside of the home? Would your parent be better off in a living arrangement that provides more companionship?

    Would too much closeness pose a problem? If so, consider ECHO housing, or "Elder Cottage Housing Opportunities." You can add these small, manufactured living units -- also called "granny flats"-- to the side or backyard of your house. When you no longer need the unit, you can remove it. With ECHO housing, your parent will enjoy both privacy and ready help.

    What about an assisted-living facility?

    This may be a good option for a parent who craves some of the independence of a retirement community and doesn't need much medical attention, but could use some daily assistance. For example, assisted-living facilities provide help with bathing, dressing, and taking medicines. Seniors often live in their own room or apartment, with meals, house cleaning, activities, and perhaps transportation to the doctor or shopping center provided. Assisted-living facilities, which range from a small home to a large, apartment-like building, may offer some nursing care or none at all.

    Nowadays, many assisted-living choices have sprung up to cater to individual tastes. Among the more unusual: ones that enable residents to make wine and go crabbing, or university-affiliated ones that offer classes and discussion groups.

    Or a skilled nursing facility?

    A skilled nursing facility or nursing home delivers 24-hour nursing care and higher levels of medical and personal care, a good choice if your parent is frail or dementia has worsened. A nursing home also offers supervision to prevent a patient from wandering away, for example, if he or she has Alzheimer's disease.

    If your parent enters a senior living facility, be sure to visit regularly. Not only do you offer your loved one companionship and comfort, but you can also keep an eye on quality of care. If you're a regular presence, you'll also develop a better relationship with the staff.

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