Maybe it was a phone call that didn't sound right, or a visit where the fridge was nearly empty. Many families notice small changes long before anyone says out loud that a parent needs help. As a nurse who has spent 15 years helping families arrange care at home, here are the signs I tell families to watch for, and what to do next.
Signs a parent may need help at home
One sign on its own isn't always cause for alarm. What matters is a change from what's normal for your parent, or several signs together.
Personal care
- Wearing the same clothes several days in a row
- Changes in hygiene, like unwashed hair or body odour
- Avoiding the bath or shower (often a sign they don't feel safe getting in and out)
Meals and weight
- Expired or spoiled food in the fridge, or very little food at all
- Unexplained weight loss
- Relying on snacks instead of meals
Mobility and falls
- Unexplained bruises
- Holding onto furniture or walls to get around
- Trouble getting up from a chair, or a recent fall (even one they shrug off)
Medications and health
- Pill bottles that are too full or empty too soon
- Missed appointments
- Health conditions that seem harder to manage than before
The home
- Clutter, laundry or dishes piling up in a home that used to be tidy
- Scorched pots or the stove left on
- Unopened mail, unpaid bills or calls from collection agencies
Memory, mood and connection
- Repeating the same questions or stories
- Getting lost in familiar places
- Withdrawing from friends, hobbies or faith communities
- Seeming sad, anxious or more irritable than usual
Driving
- New dents or scrapes on the car
- Getting lost while driving, or friends mentioning they're worried
If you notice sudden confusion, a serious fall or signs of a medical emergency, call 911 or seek medical care right away.
What to do next
1. Look and listen before you decide
Spend a little more time with your parent if you can, and write down what you notice. Specific examples ("the milk was three weeks expired") are much more helpful than general worries, both for conversations with your parent and with their doctor.
2. Talk with your parent, not about them
Most older adults want to stay in their own home, and many worry that accepting help is the first step to losing their independence. Start with what they want, and frame help as a way to keep living at home safely. Expect more than one conversation.
3. Involve their doctor
Some changes, like confusion, weight loss or falls, can have medical causes that are treatable. Ask your parent if you can join an appointment, or send the doctor your notes ahead of time.
4. Understand your options
- Publicly funded home care: in Canada, your parent may qualify for some home care through the provincial health system (in Ontario, through Ontario Health atHome; elsewhere, through your regional health authority). Hours are often limited, and there can be a wait.
- A private home care agency: the agency screens, trains, schedules and supervises caregivers, and handles payroll and backup coverage. It usually costs more per hour, but takes the most off your plate.
- Hiring a caregiver privately: often less expensive per hour, but you become the employer, which can include payroll deductions, contracts and finding backup when your caregiver is sick.
- A retirement residence or long-term care, when needs are higher than home care can safely meet.
Many families use a mix: a few hours of publicly funded care, topped up with private help.
5. Make a plan and put it in writing
Write down who's doing what, your parent's medications and contacts, the care schedule and what happens in an emergency. A shared plan prevents a lot of stress (and family arguments) later.
A note for U.S. readers
The signs are the same. For options, start with your local Area Agency on Aging, which can point you to programs and services in your community.
Tools to help your family
Our resources for families were created to make this easier:
- Home Care Options Guide ($12): compare an agency, private hire and a residence, side by side
- Family Caregiver Kit ($49): everything you need to hire and manage a private caregiver with confidence
- Family Care Binder ($19): keep medications, contacts and the care plan in one place
- Home Safety & Fall Prevention Pack ($19)
- Free Caregiver Contract, if you're hiring someone privately
Not sure where to start? Book a 30-minute Family Care Planning Call with Alyssa ($75) and talk it through.
This article is general information and not medical advice. If you're worried about your parent's health or safety, speak with their doctor.
About the Author
