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She worries about the day her mother can no longer walk. Adult children are left with the wrenching choice between worrying incessantly and taking on more and more caregiving, or trying to force an obstinate parent to move."The thing that bothers me the most," she said, "is I know that she's lonely." Mary Casavecchia, an outgoing woman with thick, gray hair and lively eyes, won't even consider bringing in hired help, much less moving to assisted living where her daughter thinks she'd like the company. "We don't know what is right," Linda Casavecchia said.It has burnt-orange carpet from the late '70s on the floors, brown early-American-style wallpaper patterned with eagles on the kitchen walls, rows of old novels on the shelves, and family pictures on the walls.

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In late life, increasing medical and cognitive problems are harbingers of the inevitable.

How does a family set goals for its oldest generation's last months or years?

If parents will accept help - and many balk - modern technology and in-home services can help seniors stay at home, but not always to the end.

Often, the conflict simmers until a health crisis forces a move to the "first open bed," said Kimberly Van Haitsma, an expert on senior housing at Pennsylvania State University who also advises the Abramson Center for Jewish Life in North Wales.

She was on her own, raising two children on a bookkeeper's pay. When it was time for Linda, her oldest, to go to school, Mary Casavecchia did an unusual thing for a woman in 1965: She bought a rowhouse by herself in Northeast Philadelphia.

She took the first house she looked at, and she's still defiantly living in it.

Leslie Boyle, a Swarthmore woman whose mother - now in her 90s - is even more adamant about not moving than Mary Casavecchia, agonizes.

"It's probably the hardest thing I've ever done," Boyle said.

His book, Meditations for Caregivers, written with his wife, Julia Mayer, was published this summer.

verwhelmingly, older adults at all socio-economic levels say they want to stay in their homes as long as they can.

Even loving families can find themselves in a standoff, each generation unable to see the other's point of view. She was working part time as a bookkeeper until three years ago.

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