Additionally in Norway, the stigma of "putting Mom in a home" isn't as strong as it is in the United States, Daatland says. In fact, the practice is relatively common: About 70 percent of the country's elder care resources go toward nursing home care. And assistance is affordable. Those who can stay in their home pay 2 percent of the cost of home health care. The rest is covered by the government. Once a person needs a nursing home, his or her cost for the care is capped at 75 percent of their basic pension, plus 85 percent of any additional pension or other income, regardless of how much money or assets they have.
Because care is affordable, families are not fighting over who will pay for services or worried that Mom and Dad will run out of money. Each generation in Norway retains its autonomy; the younger relatives don't feel as strongly about a sense of "duty" to their parents as families do in Spain, another country profiled in the study.
In Spain, adult children and aging parents were more likely to live together, because of cultural norms but also because the country lacks strong social programs to help older people. In Norway, however, independence is valued, and while parents often support their adult children financially, it rarely works the other way around, Daatland says.
In America, the desire for independence crashes into the realities of the demands of caregiving. Add to that an immigrant heritage that values providing direct care to aging parents, the rise of two-income families where women work and are strained by caregiving responsibilities, and the financial burden of the cost of in-home and long-term care — and you have a recipe for disharmony.
When Linda Higueras was growing up, her grandmother lived with her family until she died. "My parents were born in Latin America, and you don't put your old people in homes," she says. So when her parents' health declined — her father, 88, has dementia, and her mother, 84, was no longer able to care for him by herself — she moved her parents into her Sonoma, Calif., home. Culturally, it was the right thing to do. But emotionally, it was difficult.
"Things became so combative at my house with my parents living with me," Higueras, 55, says. "My mother and I were in opposition about what had to be done, and my father was just getting worse."
And then Higueras woke one night to a thud. Her father had fallen; there was blood all over the carpet. After the emergency room visit came a stint in a long-term care facility for people with dementia. But Higueras and her mother felt he wasn't getting enough supervision there, so they struck a compromise: Her parents would move back into their own home, but they had to agree to some paid help. Now Higueras and her brother pay for about 20 hours of assistance a week, and Higueras does most of the rest of the caregiving.
"One night I was changing my father's diaper and he said to me, 'I hate this. I hate this so much,' " Higueras says. " 'This is not the life I expected. And this is not the life I want for you either.' "
Higueras can't argue with that statement. She misses her old life, and that adds to the tension. She used to run marathons but hasn't been on a run, a hike or to a single Pilates class in months. "I think like most adult children we all have our separate lives, but now my life is intertwined with them," she says. "I can't take vacations. I have to be conscientious about trying to be over there as often as I can."
Loss of identity
It's that struggle to retain our individual identities that adds to the strain on the relationship, says psychiatrist Scott Haltzman, M.D., author of The Secrets of Happy Families: Eight Keys to Building a Lifetime of Connection and Contentment. This is a quintessential American trait that defines the boomer generation: those who are now doing the caregiving and are becoming the ones that have to accept being cared for.
"It was a little less than 50 years ago that Jack Kennedy said, 'Ask not what your country can do for you,' " Haltzman says. "People pay lip service to that now. It's really not an issue of what you can do for others, it's what can others do for me, it's about what will make me happiest."
Haltzman also says adult children often feel as if they're being robbed of their golden years. Their children might have finally left the nest, and parents who dreamed of being done with racing from soccer games to piano lessons now find themselves driving to doctor visits and pharmacies.
"I don't believe any generation has focused so much on the minute-to-minute care of children as our culture," Haltzman says. "It may very well be that young adults are exhausted by the time their kid leaves the home. They can't envision putting any more energy into caring for somebody — meaning their parents."