When I think of multigenerational families, what comes to mind is the image of Big Daddy and his family from Tennessee Williams’ play Cat on a Hot Tin Roof. Now not all multigenerational families are dysfunctional (ignoring images from All in the Family now). It used to be very common in the US. In many cultures, other than the US, multigenerational families are the norm. I am reminded of homes I visited in Kuwait that were huge with many living areas for several generations of family members.

Big Daddy and his extended family

It seems to be there are three options in the US for living quarters as we age.

  • Live alone or with a spouse, sibling or a friend/peer.
  • Live with relatives from another generation.
  • Live in some form of institution, nursing home, assisted living, whatever but a place that has paid staff to help out. Options 1 and 2 can be augmented by paid staff too but let’s just focus on location not arrangements.

The trend has been to avoid institutional living until that’s the only option. However, are people choosing multigenerational settings over living alone?  Philip Cohen, professor of sociology at the University of North Carolina, said, “We’ve seen for a long time that people tend to live in multi-generational households when they don’t have as much choice as they’d like. So it seems like Americans, when they can afford to, don’t do this. So when we see a strong uptick in multi-generational living, we have to expect that it’s economic. Although frankly, the numbers have been trending up since the middle of the decade. … Well the long term decline in multi-generational living made us think that it would never turn around. The steep increase in the last few years has us wondering. I don’t know.” (Marketplace Morning Report. Multigenerational Home Numbers on the Rise. Published: August 30, 2011.)

Certainly, the institutional option has it’s risks and the trend to keep disabled people in their homes while providing home-based services has it’s downside as well. Commenting on the quality of New York’s record in providing long-term care for its residents, an editorial stated, “The state ranked 44th in the percentage of high-risk nursing home patients who develop bed sores, which is often a measure of neglectful care. It ranked 50th in the percentage of home health patients and 28th in the percentage of nursing home patients who were sent to the hospital [another indicator]. … It also ranked 50th in the percentage of disabled adults living in the community who always or usually get the support they need. This is an ominous statistic given the drive to move larger numbers of people out of institutions and into community-based care.” (New York Times Editorial. Bad Grades on Long-Term Care. Published: September 12, 2011. Note: sometimes this link takes one to a log in page – I do not know why or the solution.)

In reviewing blogs discussing the ins and outs of maintaining multigenerational homes, many of the posts dealt with healthy participants. One post did comment on the converse.  This is from Rockville Mama, “Parents eventually get old and frail and sick. Then what? There’s no ’sharing’: you look after them like they looked after you when you were little, it is really hard and there’s very few options for help for people in this situation in this country. You should talk to people (especially women) who have had to quit jobs to be able to look after both their kids and their sick parent/s. So the issue is not just how to I manage the ’space’, the chores and the personal conflicts. I do think though, despite all the challenges, this is the best system there is for people of all age to have a supportive family life. It requires a lot of give and take: which it seems like people now simply do not want to be bothered with.”  (New Your Times. Tips for Multigenerational Households. Posted: December 8, 2008)