Women traditionally take on the caregiving role in families. For many women, the launching of children into adulthood is followed swiftly by the assumption of care for failing parents or relatives.

Not every caregiver or "helper" feels she* has a choice about taking in that parent or relative. By the same token, not every elder feels she* has a choice about where she will spend her last years. Although adults in midlife may need to bring an aging family member under their roof, these individuals do have choices about how each of them will handle this challenging situation. Taking care of an elder is really about the elder and helper taking care of each other through what can be a very difficult time. Those relationships that thrive are the ones in which people understand that there has to be a cordial give-and-take. When people are gentle with each other, opportunities for love and understanding emerge and enrich the years they share.

There are a number of issues that are common to all such helping relationships:

Communication: Communication is the key. Often elders don't communicate fully because they worry about being a burden or about asking for too much. Grateful to be cared for, they don't feel entitled to ask for what they feel they need. Other elders were never particularly good at communicating and find it even more difficult now that they are unable to take care of things by themselves. Often, helpers frustrate communication because they are in a hurry or they are overwhelmed. A successful caring relationship requires that both parties make an effort to listen carefully and to state things clearly. Assumptions about meaning only lead to trouble.

• Advice for elders: Try to save important issues for when your helper isn't harried.
• Advice for helpers: Find a time each day when your elder can be assured that you have the time and energy to really listen.

Identifying Needs: Many people in helping relationships find themselves in an odd dance around needs. The elder may feel so badly about imposing that she doesn't state needs or she may feel so bitter about needing help that she becomes bossy. More confusing still is the elder who expresses the full range of these feelings. Some helpers assume they know what the elder needs and are hurt when the elder isn't properly grateful. Others feel helpless in the face of so much neediness and don't have a clue about what to prioritize their responses.

• Advice for elders: Figure out what you really need and ask politely.
• Advice for helpers: Don't assume you know. Ask politely.

Privacy: When an elder is cared for by an adult for whom they provided care during childhood, roles are embarrassingly reversed. It doesn't feel "natural" to either party for a child to bath, change, and dress a parent or older relative. The elder may cope by withdrawing or she may be angry at the whole situation. The helper may be embarrassed and awkward or may be overly rough in wanting to move through situations that create discomfort.

• Advice for elders: Be cooperative and helpful when your body needs care.
• Advice for helpers: Take on a "professional" attitude when touching your older family member’s body. A detached, matter-of-fact, approach often feels less intrusive.

Activity: When an elder is housebound or bed-bound, life can get pretty dull. It's no fun to be the last to hear news or local gossip! For some elders, conversation is reduced to issues of health and the repetition of old news.

• Advice for elders: Think about new things you can contribute to the conversation like memories and stories. Make an effort to engage with visitors.
• Advice for helpers: Leave for a while when