For decades, Marcia Ory has researched the changing dynamics of caring for America’s elderly. Now she is living the reality.

A year ago, she left Washington for a job at Texas A&M University to be closer to family, particularly her elderly mother in Dallas. She swapped a three-hour plane flight for a three-hour road trip to do what many adult children mostly women are faced with doing: caring for their elderly parents from afar.

This, I am certain, will be the next big work-family balancing act, as medical advances keep us alive longer but sicker longer, and a swelling generation of baby boomers discovers that our prized mobility, liberating at 25, turned confounding at 75.

“To provide care for an aging parent who is declining is a constant negotiation over time and space,” Ory says. The negotiation was difficult enough when Grandma lived upstairs, down the street, or in a nearby town, when adult daughters rarely worked outside the home, and when the sick and frail elderly were not the social pariahs they are today.

In other cultures, elder care is an honored part of family life. But only 7 percent of America’s sandwich generation those between 45 and 55 live in three-generation households, according to a recent AARP study. Not only are the logistics of caring for elderly parents and relatives more complicated and expensive to conduct from afar, but the social cost is rising, as well. The isolation of the elderly in balmy retirement “villages” or gated care communities has left younger generations clueless about what it means to grow old.

“Three, four generations used to live on one block, in one house,” notes Fran Barg, a medical anthropologist at the University of Pennsylvania. “Now you don’t necessarily see generations in your family, never mind deal with them on a daily basis. No one is born knowing how to take care of parents.”

Instead of this care being a natural part of life, a skill learned through observation and action, it’s becoming a management issue something else to delegate because you have neither the time nor the expertise to do it yourself, or because your company is moving to California and, sadly, mom won’t leave Cottman Avenue. Brand-new industries are sprouting up to do what once was family obligation without a second thought.

When Rona Bartlestone opened her care management company in Florida 21 years ago, she was the only one in the state; now there are dozens of similar outfits hiring caregivers for snowbirds who can no longer walk, never mind fly. The National Association of Professional Geriatric Care Managers started in 1984 with 30 members; it now boasts 1,500 nationwide.

Bartlestone says a growing number of her clients have more parents to care for than children, thanks to multiple marriages and dropping birthrates. “I could potentially be responsible for seven older adults, and I only have three stepdaughters,” she says.

Caring for a growing elderly population in America will be much too expensive to contract out, much too complicated to delegate. Even the Cadillac of private care leaves a multitude of judgment calls and Hobson’s choices scattered at the feet of bewildered family members.

The problem is not that aging is difficult; it is, as the old joke says, usually better than the alternative. The problem is that aging is invisible to so many of us. We don’t know what it looks like or smells like. We fear its discomforting outward manifestations and its many indignities, so we do all we can to postpone confronting its inevitable arrival.

Negotiating this balancing act requires flexible workplaces, innovative housing and a tighter safety net. It also requires a national attitude adjustment. Caregiving can no longer be considered only a burden. Let’s start seeing it as a duty, an honor carried out by grateful children with the sweet expectation that one day it may be their turn to receive.

Jane R. Eisner is a columnist for Philadelphia Inquirer. Her e-mail address is jeisner@phillynews.com.