RESOLVING THE LEDGER
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See the full story · 1 sourcesThe author's grandparents, Bob and Ruth McMillan, celebrated their 75th wedding anniversary in September 2025. Courtesy of the author
My grandparents wanted to remain in their home until the end of their lives.
Their six children each spent about 30 hours a week helping care for them at one point.
Even with family help, 24/7 paid care eventually cost $4,000 a week.
My grandparents lived at home until dying in their 90s in 2024 and 2025.
Like many people, they had no desire to leave their shared home at the end of their lives. They wanted to stay in a comfortable place together. Through great sacrifice, my mom and her siblings worked to make that happen for them.
My grandparents, a rural, middle-class couple, benefited from an increasingly unique set of circumstances: Their end-of-life illnesses were relatively short. My grandfather's pension provided financial security. Most importantly, they had six adult children ready to pitch in to make it happen.
Even with all of these advantages, caregiving was complicated .
Their family had meetings every Sunday to discuss their care
In their 90s, my grandparents showed typical yet concerning signs of extreme old age, like balance issues, smaller appetites , and forgetfulness. So, my mom and her siblings started a series of "family meetings," Sunday afternoons spent discussing new worries and divvying up to-dos. They divided and conquered to help their parents stay at home.
Bob and Ruth McMillan with their children in 2019. The six siblings divided care amongst themselves to keep their parents aging at home. Courtesy of the author
One sister found great satisfaction in helping with personal care , going the extra mile to give her parents pedicures and style their hair. Another sister fretted over every dust bunny as the primary cleaner. One sister-in-law graciously handled near-daily trips to the grocery store.
My uncles fed the wood-burning furnace every morning and handled indoor and outdoor maintenance.
My mom, a bookkeeper by occupation and by heart, handled financial and legal paperwork . She also managed medications and seemed to be at the pharmacy every time I called her for two straight years.
Their adult children would sleep over at their place
Starting in the final year of my grandfather's life, they took turns spending one night a week together, including cooking dinner. Doctor's appointments, usually an hour away, occurred weekly or more. Whoever was available would drive my grandparents, help them during appointments, and take careful notes.
They did their best to divide the burden equally, with everyone taking the tasks they naturally gravitated toward. Each of them spent about 30 hours a week on caregiving and related tasks in 2024.
Eventually, they required 24-hour care
Even with those hours of family labor, the financial costs increased substantially about a month before my grandfather's death, when it became clear that he and my grandmother were fragile enough to require 24-hour care — not even a large, close family could cover that many hours. A hospital liaison recommended a service that provided home companions, who were not medically trained but helped with meals, housekeeping, and personal care.
The author's grandparents with their youngest great-grandchild (the author's youngest child) in April 2024. Courtesy of the author
At this point, aging required time, devotion, and patience. It also required a significant amount of money. My grandfather received monthly pension payments and quarterly stock payouts that, combined with frugal habits, farming, and occasional site-grading work after retirement, resulted in my grandparents having around $300,000 in liquid savings.
The sitting services started at $39 per hour, and my family initially hired them for 12 hours a day, seven days a week, continuing to cover night shifts on their own. After my grandfather died and my grandmother's dementia progressed, the weekly rate for 24/7 care was $4,000. Their savings could cover about 18 months of it.
But spending money didn't mean gaining back much time. My mom and her siblings continued to spend every night in the home with my grandmother and a care attendant, consoling their grieving mother and being an available extra pair of hands in case of a physical need that required the help of two people. And, of course, when a sitter called out, my mom or one of her siblings would rearrange their days to make sure their mother stayed safe.
My mom was grateful she could honor her parents' desires
After my grandfather died in September 2024, my grandmother's death followed in June 2025. Their savings had been enough to cover their end-of-life care at home. My mom and her siblings were exhausted but grateful they'd been able to make choices that honored their parents' desires.
It's hard to ignore that the most important resources my grandparents had in their final years are becoming increasingly scarce. Two siblings, or an only child, simply can't do as much work as four, five, or six. An adult child facing the reality that their parents' 401(k) balances are reaching zero will have to make choices based on affordability rather than wishes.
It wasn't inexpensive or easy for my grandparents to stay at home. There's no magic number of children or magic amount of money that would make it so. But it was possible.
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