When Pauline Purington moved into her daughter and son-in-law's Rapid City home eight years ago, she never intended to stay.

But she has and, by all accounts, it's been an ideal situation.

"I liked it here, so they can't get rid of me," Pauline jokes.

Don and Donna Hemstock invited Pauline and her husband, Wayne, to move in with them in 1999. The Puringtons were selling their house and preparing to move into an apartment due to Wayne's failing health. They needed a place to stay until they could make the move.

Six months after moving in with his daughter, however, Wayne Purington died.

After his death, Donna suggested that her mother stay with them indefinitely. Pauline agreed. "It kind of just happened," Pauline said.

The Purington/Hemstock living arrangement, although not overly common, is becoming more popular nationwide.

Right now, an estimated 44 million Americans provide unpaid care and assistance to elderly people living in their community, according to a study by AARP. In South Dakota, about 86,000 people provide care to an adult relative.

"I think there are certainly trends that suggest that more and more people are looking at that as more affordable for their families," said Samuel Wilson, associate state director for AARP in South Dakota.

With nursing home expenses running as high as $50,000 a year, the care given by families in South Dakota amounts to the equivalent of $880 million in nursing home costs, Wilson said.

"It's a much more financially feasible way for these families to cope with long-term care expenses," Wilson said. "It is still far cheaper to provide home and community-based services than it is to get into an assisted living facility."

But while those situations tend to be more financially bearable for families, the emotional and physical toll can be more difficult, Wilson said.

Problems occur when the caregivers themselves become overwhelmed. In many cases, the adult child providing the care is working full-time and often taking care of her own children.

"It's a very time-consuming process," Wilson said. "We really need people to become aware of the warning signs when someone is becoming stressed or exhausted … people need time away and they need assistance."

Agencies such as the Division of Adult Services and Aging, a part of the South Dakota Department of Social Services, works to ease the burden by linking families to services. From adult day care to home nursing care, the division works to pair families with the services they need, (see listings above), Wilson said.

Karen Pettigrew of Rapid City knows firsthand the stress that caring for a parent can place on a person.

In 2001, Pettigrew and her husband, Rod, still had one daughter at home and one foreign exchange student from France living with them when they decided to buy a different home so her parents could move in with them.

At the time, Pettigrew's mother Fran had Lou Gehrig's disease. Karen's father, Tom White, did most of the caregiving, but Karen felt he needed more help.

"Sometimes, it's just the only thing you can do, and you know it's the right thing to do," she said. "We were able to care for her at home. She died at home."

As a nurse-midwife, Pettigrew thought she knew what to expect. But the challenges of caring for a dying mother and her own family, while working full-time, took its toll.

"My burnout really surprised me," she said. "I just didn't have time. I was constantly either with work or family responsibilities."

Fran White died in 2003. By then, Pettigrew's father was so much a part of the household that the Pettigrews asked him to remain there. "It just seemed natural that he would stay," she said.

And so he did, until two months ago.

At age 90, after living with the Pettigrews for six years, White moved into his own apartment in Rapid City.

Pettigrew said her father just wanted a little more independence, but she believes that the years they did live together were successful ones.

"He's really easy to live with from my perspective," she said, before adding with a laugh, "My husband might differ."

Today, Pettigrew is cherishing the freedom of an empty nest really for the first time, especially glad to be free of the responsibility of planning and preparing meals.

Like Pettigrew, Donna Hemstock has never really known an empty nest. She and her husband have six children, and their large home often became a temporary haven for their children and family friends, even after the youngest child had left home.

Donna Hemstock said she hasn't dealt with the burnout that many adult children face, largely because her father's illness was so brief and her mother's health has been, for the most part, good.

Donna also believes a large part of the success of their arrangements has been her mother's attitude.

"I give Mom a lot of credit. She's very sensitive," she said.

Pauline, 88, said from the start that she wanted to be as unobtrusive as possible. "I didn't want to come between Don and Donna in any way," she said. "I didn't want it to be a burden to them. When they wanted to go, I wanted them to go."

And they do.

The Hemstocks take vacations and visit friends. "They tell me when they leave not to have any wild parties," Pauline said.

Pauline also has activities, meeting with friends for Bible study and lunches.

Despite their separate activities, they all agree that they've grown closer in the past eight years.

Pauline said she's gotten to know and appreciate her son-in-law more than before. The three say their meals are filled with conversation and laughter.

Don, 71, said people raised their eyebrows when he told them his in-laws were moving in, but he never hesitated. "I never thought anything about it," he said. "It was just something we were going to do."

He's been happy with the results. "The benefit is we get to see her every day, and when we go somewhere, there's someone here," Don said.

"Beside, she makes bread," Donna adds, laughing.

For Pauline, the situation has meant not only knowing her daughter and son-in-law better, but growing as a person. She's adjusted late in life to living with two new people, recognizing the importance of being flexible. "I can truthfully say, I've learned a lot," she said. "We give the credit to the Lord."

Over the years, Pauline said she's never once regretted her decision to move in with her daughter. Both Don and Donna say they feel the same way. It's a situation that has had, so far, very few negatives and plenty of positives, Donna said. And the couple agrees they would do it again in a heartbeat.

"I think we get along better now than ever," Donna said.

Find a work, family balance

AARP offers tips for balancing work and family, especially in the case where an adult child is caring for an elderly parent. Some of the tips include:

- Learn your company's policy about caregiving and whether there is an Employee Assistance Program. If you are uncomfortable talking with your supervisor, look in the company's personnel manual or other human resources publications.

- Ask your human resources or personnel department to give you information on the Family and Medical Leave Act. If appropriate, ask them to send a copy to your supervisor.

- Take advantage of flex-time policies. Ask for a flexible schedule if a formal policy is not in place. Offer to work a less desirable shift to get flex time, or be willing to make up time taken for caregiving by working days or shifts when most people want to be off. This flexibility on your part shows your employer that you are committed to the company and to your job.

- Consider job-sharing or working part-time if it could work for you.

- Whenever possible, avoid mixing work with caregiving. If you have to make phone calls or search the Internet for information related to your parent's needs, do it on your lunch break.

- Manage your time well at home and at work. Set priorities and then accomplish the most important items on your list first. Delegate responsibilities at work and at home; others can almost always take some of the burden. Pace yourself and don't do so much in one area that you can't be effective in another.

- Get all the support you can from community resources.

- Take care of your own needs. Pay attention to your health. Eat right, get enough sleep, and exercise regularly. Try to make time to enjoy yourself even when your schedule is packed. Fun is important. Take a break when the pressure gets too great; even a short walk or hot bath can help relieve the stress. Talk to someone about your feelings and needs: an employee assistance counselor, a professional counselor or a member of the clergy.

- Consider talking to your supervisor or manager at work about your caregiving issues. It's better for them to understand the reasons you're coming in late or seem preoccupied than to let them draw their own conclusions. Chances are that your company will appreciate your honesty and sense of responsibility toward your family and your job.

- Be sure to thank those at work for the consideration and assistance you receive. To help someone else who has heavy family or other responsibilities, perhaps you could agree to take on an extra assignment or special project when you do have time.

Source: AARP

Help available for caregivers

With 86,000 people in South Dakota caring for an elderly parent or relative, families are finding themselves in need of help. The Department of Social Services' Division of Adult Services and Aging links families with the services they need.

Below are the phone numbers for the Black Hills area offices of the Division of Adult Services and Aging:

Rapid City (Jackson, Meade and Pennington counties): 394-2434

Sturgis (northern Meade County): 347-2588

Deadwood (southern Lawrence County): 578-2402

Belle Fourche (Butte, Harding and northern Lawrence counties): 892-2731

Hot Springs (Custer and western Fall River counties): 745-5100

Pine Ridge (Bennett, eastern Fall River and Shannon counties): 867-2236

Pierre (Hughes, Stanley, Sully, southern Dewey, Haakon, southern Ziebach, Hyde and Jones counties): 773-3521

Winner (Todd, Tripp, Gregory and Mellette counties): 842-0400

More information about the services available can also be found on the Division of Adult Services and Aging Web site, including information about adult day care, caregiver programs, homemaker services, nursing services, respite care, senior meals and transportation. To see a complete list of the services and how to contact them, go to http://dss.sd.gov/elderlyservices/services.

The South Dakota AARP also has links to services for families that need assistance in caring for an elderly parent. AARP also has tips for making the care of an elderly parent less stressful. Go to their site at www.aarp.org/families/caregiving.

Contact Lynn Taylor Rick at 394-8414 or lynn.taylorrick@rapidcityjournal.com