"They should be living with us"

The big decision, and the guilt's largest demand. Some readers have already done it. The spare room is now Dad's room, and the marriage is running on fumes. Others have the thought every week and fend it off, and the fending off is its own guilt.

Richard Schulz and colleagues surveyed 1,397 carers in the United States in 2012 and asked one question that turns out to matter more than most. Did you have a choice in taking on the caring role. Forty-four percent said no. And lack of choice predicted higher emotional stress, more physical strain and worse health, after allowing for how much care was being given, the relationship, the illness, and everything else they could measure. The authors called it an independent risk factor.

Read it alongside Cicirelli and Lyonette and one thing stands out. It isn't the care that wears people down. It's the care they didn't choose. A parent moved in because you couldn't see a way to say no is unchosen care in its most complete form, every day, in your kitchen, with no doorstep at all. That doesn't make it wrong. Some people choose it, deliberately, with their partner and their children in the room, and it goes well, or as well as a hard thing can. The difference isn't the arrangement. It's whether it was decided or arrived.

So the question isn't whether they should be living with you. The should is the guilt's word and it has no content. The questions are, what would it take, in hours and rooms and money and your partner's evenings, could you give that, and would you choose it if it weren't a should. If the answer is yes, then choose it, out loud, and it becomes chosen care with all the protection that gives. If the answer is no, then no is a decision about what you can give, not a verdict on whether you love them, and the guilt that follows is chapter 25's business. What you must not do is the third thing, which is let it happen without deciding, because that's the forty-four percent, and the research says it's the group that pays most.