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Birmingham--26,000 Alabamians live in nursing homes. Many of them depend heavily on financial support from relatives. But as the economy stumbles, families have to make tough choices about how to care for aging relatives. Les Lovoy prepared this report for our series 'Making Do: Alabama's Economy'.

It's Saturday morning, and Jason Lockhart and his mom are washing dishes in her tiny crowded kitchen. Lockhart lives with his 67 year old mom in her small two-bedroom apartment in the Crestwood area of Birmingham. It wasn't supposed to be that way. Lockhart had purchased a house, a real "fixer upper." But, his mom developed a serious intestinal illness, and broke her hip. They couldn't afford to hire help, so Lockhart had to move in with her. He works full time. He looks after her at night, but worries during the day.

"It is stressful because there's just, I can't be here during the day, and I don't know if she's taking her medicine and I don't know if she's exactly following her diverticulitis diet that she's supposed to, and doctor's appointments, you name it."

Adding to the stress, doctors say Sue Lockhart is experiencing the early signs of Alzheimer's.

"Their professional opinion is that we should actually have my mother in a facility now while she's able to adapt, with her cognitive memory intact as much as it is, so she can just adapt and just get through and learn her way around here."

Sue Lockhart says she's under stress, as well. She's not comfortable knowing her son's and daughter's lives are on hold.

"It does bother me. They both have been very good to me. I know my daughter wouldn't mind me living with her up there in Chicago, but it's too darn cold up there."

The Lockharts are not alone. Many folks who planned to move their elderly family members into long term care cfacilities an't because they've lost jobs or their investments have declined. And the miserable housing market. And, the miserable housing market. Many families assumed they'd sell their parents' home to pay for retirement living, but the housing market bottomed out. As families spread the information out on the dining room table, here are the numbers they're staring at. Long term care can cost between $36,000 and $150,000 a year.

"So, you're seeing more people moving in with each other."

Larry Minnix is the president of the American Association of Homes and Services For The Aging. He says it's still too early to know how many families are choosing their homes rather than put them in facilities. Some, like Jason Lockhart, do their best to care for aging parents without help. But, others are using professional services. Susan Brouillette is CEO of Alacare Home Health and Hospice. She says business has increased four and a half percent each month, over the last several months. She explains it can be less expensive to care for someone at home, but it can lead to more serious problems that add to existing stress.

"People don't understand how seriously that can be. And, they end up in an exasperation of their illness, which leads them back into the emergency room, quite often and into the hospital for admission and that makes the situation even more stressful for the family, for the patient, for everyone, because nobody wants to go back to the emergency room, back into the hospital."

Jason Lockhart hopes, with his sister's help, he can continue caring for his mom at home. But for now...

"It's stressful. I feel like I'm under a lot of stress, my mother's under stress. There's things we'd like to have like an in-home health care worker, but I can't afford to pay the four hundred a month, or whatever it would cost to do that. You know we're actually suffering."

The situation's even worse if the caregiver is elderly - say a husband or wife. Elderly caregivers with a history of chronic illness have a 63 percent higher mortality rate than their non-caregiving peers.

~ Les Lovoy, March 25, 2009.

| FAQs about nursing homes and longterm care

| Listen to an NPR conversation about the financial and emotional dilemmas that often come with eldercare.