When my granddad passed away, my grandmother moved in with us. He left very little inheritance, a very small pension she could not live on. Both my mom and dad worked, and soon my grandma was running the household, from cooking to making sure the house was kept clean. She took care of me and my sisters. No one arranged any of this or had a big conversation about it. It was just how things were done back in those days.
For most of history, that was the retirement plan. In 1900, 57 percent of Americans over 65 lived with family. Most men over 65 still worked, and that was the case for my grandfather, who worked at a confectionery shop until he passed away in his early eighties. Retirement as we know it today did not exist. You worked as long as your body allowed.
In those days, if you had no children or were estranged from them, you ended up at the one institution the country offered. The conditions there were dreaded enough that they ended up in Will Carleton's poem, "Over the Hill to the Poor-House." The poem was published in 1872, and was the story of an old woman sent to the almshouse by her own children. By 1923, two of every three people living in American poorhouses were old. Living in the back room of your kids' house was by far the more desirable retirement plan compared with the alternative.
Children's duty to take care of their parents was codified into law by many jurisdictions. England's Poor Law of 1601 made children legally responsible for taking care of their old parents, and the American colonies created very similar laws. Surprisingly, many of these are still the law of the land. There is a 2012 court case in Pennsylvania, where John Pittas was ordered to pay his mother's nursing home bill under one of those old laws. John had two other siblings, but the court put the entire bill on him alone. The court advised him he could sue his siblings if he wanted them to pay their share. To his surprise, a law derived from 16th-century English Poor Laws cost him $93,000.
During the Great Depression, more than half of America's elderly could not support themselves. A massive grassroots movement pushed Washington until Social Security was signed into law in 1935 by President Roosevelt. The first monthly checks arrived a few years later, and over time the program lifted millions of older Americans out of poverty. It was not just Social Security. Pensions became more common. For the first time, an old man who could no longer work did not have to move into his kids' back room. He could afford his own place.
The old arrangement faded so fast that by 1981 it needed a name. Dorothy Miller, a social worker, coined "sandwich generation" to describe adults with their own families who were also caring for their aging parents. My parents were that generation. They took care of my grandma until she passed away in her late eighties, and today both are retired teachers, each with their own pension, living in the house they built. The pensions and Social Security checks retirees receive, the ones we all grew up calling normal, are the historical exception. They have lasted close to a century.
Some of those old arrangements that existed for centuries are making a comeback. This is partly a product of people living longer, and living costs in retirement starting to outrun what was planned through Social Security and 401(k)s. Many companies have stopped offering pensions altogether. Multigenerational households fell to an all-time low of 12 percent of Americans by 1980, and the share has slowly increased since then, standing at about 18 percent today. Nearly sixty million people live with extended family.
Some people in their sixties are still the child who drives a mother in her late eighties to doctor appointments. According to the Census Bureau, 4.3 million Americans send money to an aging parent, typically about $3,700 a year. The help is not always money. It could come as a paid vacation, flight tickets, or a medical bill not covered by insurance. Sometimes the cost is the time spent taking care of an ailing parent. In 2021, family members provided 36 billion hours of unpaid care, worth about $600 billion. Most of this unpaid work is done by women, often daughters, and it often goes unnoticed.
The cost of long-term care has gone up significantly, and a nursing home can cost in excess of $10,000 per month, putting it out of reach for many retired parents. Medicare does not pay for long-term nursing home care or the help most old people actually need. The average Social Security check is about $2,000 a month, a fraction of what a nursing home costs. This, combined with increased life expectancy, presents a challenge for many retirees and their children.
And the problem is getting worse, not better. The cost of long-term care keeps outpacing inflation while many retirees have very little saved. One in five Americans over fifty has nothing saved. This was the case for my grandmother. After my grandfather passed away, he left very little savings behind. All my grandmother was left with was a small pension. The gap between retirement income and what a parent needs typically falls on children, whether they have planned for it or not.
Helping an aging parent live a dignified life does not break families. What causes resentment and conflict is when the burden defaults to one child, usually the one who lives closest or is more empathetic, while other children quietly disappear. This is an arrangement the children never discussed. It just silently settles on one child without anyone agreeing to it.
If you are that child, you need to have the conversation with your siblings, even if it makes you uncomfortable. It does not mean you consider your aging parent a burden or you love them any less. Sometimes all it takes is to express your feelings and ask for help. And there are many ways other siblings can help. Sometimes it is chipping in financially, or contributing time. Or sometimes all you need is for the work to be acknowledged. The goal is not to share all responsibilities equally. Having the conversation makes you feel heard, the work acknowledged, and at the very least some of the burden shared.
If you are the parent, you need to gather all of your children, even if it makes you uncomfortable. Do not let the burden fall onto one child silently, which could create resentment later. Call a family meeting, show the numbers, and ask for help if you must. The conversation will be awkward and something you might not want to do. But the alternative is worse. Not having the conversation will hurt the child who loves you the most.
It is your choice to plan ahead and have the difficult conversations, or the plan will get written for you when you have the least control.
Sources
Pew Research Center, "The Return of the Multi-Generational Family Household," 2010 (57% of Americans 65+ lived with family in 1900). https://www.pewresearch.org/social-trends/2010/03/18/the-return-of-the-multi-generational-family-household/
Joanna Short, "Economic History of Retirement in the United States," EH.net Encyclopedia (labor-force participation of older men). https://eh.net/encyclopedia/economic-history-of-retirement-in-the-united-states/
Will Carleton, "Over the Hill to the Poor-House," 1872; almshouse demographics via the Social Welfare History Project. https://socialwelfare.library.vcu.edu/issues/poorhouse-history/
Poor Relief Act 1601 (43 Eliz. I c.2), England; Encyclopaedia Britannica, "Poor Law." https://www.britannica.com/event/Poor-Law
National Conference of State Legislatures, "States Spell Out When Adult Children Have a Duty to Care for Parents," 2025; Health Care & Retirement Corp. of America v. Pittas, 2012 PA Super 96 (the $93,000 judgment; Forbes coverage confirms the two siblings and the court's join-them-yourself ruling). https://www.ncsl.org/resources/map-monday-states-spell-out-when-adult-children-have-a-duty-to-care-for-parents
Social Security Administration, "Historical Background and Development of Social Security" (1934 old-age dependency; the movement behind the 1935 Act). https://www.ssa.gov/history/briefhistory3.html
Dorothy A. Miller, "The Sandwich Generation: Adult Children of the Aging," Social Work, 1981. https://doi.org/10.1093/sw/26.5.419
Pew Research Center, "The Demographics of Multigenerational Households," 2022 (12% in 1980 to 18% / 59.7 million in 2021). https://www.pewresearch.org/social-trends/2022/03/24/the-demographics-of-multigenerational-households/
U.S. Census Bureau, "Adults Provided Support to Parents," 2023 (4.3 million adults; median $3,749 a year to the typical supported parent). https://www.census.gov/library/stories/2023/06/adults-provided-support-to-parents.html
AARP, "Valuing the Invaluable," 2023 update (36 billion hours of unpaid care, ~$600 billion in 2021; most care provided by women). https://www.aarp.org/caregiving/financial-legal/unpaid-caregivers-provide-billions-in-care/
CareScout (Genworth), "Cost of Care Survey," 2025 national medians (nursing home private room $129,575/yr, about $10,800/month). https://www.carescout.com/cost-of-care
Social Security Administration, "Monthly Statistical Snapshot, May 2026," Table 2 (average retired-worker benefit $2,082.76). https://www.ssa.gov/policy/docs/quickfacts/stat_snapshot/
AARP, "1 in 5 Americans Ages 50+ Have No Retirement Savings," April 2024. https://www.aarp.org/pri/topics/work-finances-retiremen
