In the 12th century, two great Jewish scholars debated the responsibility for taking care of elderly parents.

Maimonides, the famous legalist and physician, asserted that if a child could no longer care for their parent (his example was a case of advanced dementia), the child may leave their parent and hire someone else to care for them. 

Rabbi Avraham ibn Daud (Rabad of Posquieres) strongly criticized this ruling:  “This is not a correct ruling! If he goes and leaves him, who shall he command to watch him?!”

This medieval debate well encapsulates dilemmas regarding eldercare and living arrangements for older adults: On the one hand, children have a responsibility to care for the welfare of their parents. At times, this might include them living in their homes. On the other hand, this might not be feasible nor might it be the best option for either the parent or their child.  The question of how best to honor the parent now centers on quality of life: where can older adults best preserve their physical and emotional health as well as the well-being of the entire family?

Modern society has developed different solutions for this problem.  Many people prefer living in their longtime home or with their entire family as they age. Yet sometimes is not feasible.  For example, their home is too expensive or too difficult to upkeep; at other times, people might require some form of living assistance not available in their home. Moreover, even when it is feasible for them to remain in their homes, it might not provide sufficient social outlets for their emotional well-being.

At times, the best solution may be an older adult to move in (or close to) the home of a child. This opportunity may provide for much intergenerational love and support. 

Yet such an arrangement may destabilize home environments. Further, children of aging parents might live far away, and the parents likely would fare much better by remaining in the area they may have called “home” for decades. Many older adults are happier living in a community of others near their age with a range of activities geared toward them rather than in a home with a family involved in their own busy daily activities. Finally, at times, an older adult’s health needs require greater support than can be given (or afforded) in a private home. 

Today’s assisted living facilities and nursing homes sometimes provide the best option to maximize quality of life by meeting elderly parents’ physical, social and psychological needs. Sometimes these senior living communities are better suited to meet an ailing parent’s needs than adult children, who usually lack the training and time to create a suitable care environment on their own.

Such assessments are contingent on an honest evaluation of the older adult’s needs and the means that they and their family have to provide for them. Such evaluations should be regularly reviewed as health, financial, and social variables can quickly shift. 

The Ematai conversation guide helps families discuss these critical physical and social independence. Older adults and children frequently feel guilt or angst about discussing these matters.  Yet these are normal and common issues, and  it’s important to share mutual concerns while discussing preferred and alternative solutions.

Open discussions are necessary to help preserve dignity and maximize love in your most precious relationships.