What to do When a Holiday Visit Reveals the Need for Home Care
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Visiting parents during the holidays is an honored tradition, although COVID-19 has changed our habits and altered visitation patterns. You may not have seen your parents in quite some time, or if you live at a distance, this makes it harder to visit often. More time may have gone by between visits than normal, and things may not be the same.

For many, these visits are a time of reunion and joy. Although, when you visit, you may notice some significant changes in your parent that are concerning, and not know what to do about it. A family get-together may not be the best time to address these issues, but it is a very good time to take notice of changes.

7 Changes in a Parent That May Reveal the Need for Extra Support at Home

Denial is a strong emotion and a powerful motivator. Recognizing denial in yourself and your loved one will help you see things more clearly so that you can take action. An aging parent has a vested interest in appearing independent. They might not want to admit they need help and don’t want to burden you. A parent can be very skilled at hiding deficits.

As the adult child of an aging parent, you, too, want to see your loved one as being the independent and robust person they have always been. There may be a tendency to overlook or justify what are otherwise troubling signs of decline or impairment. These tips will assist you in telling if a parent needs extra support at home. Be on the lookout for:

  1. Mobility problems. According to the National Council on Aging, “Every 11 seconds, an older adult is treated in the emergency room for a fall.” You may not know if your parent is falling because they deny it, but you can observe their mobility for clues. Since your last visit, do they appear more frail or unbalanced? You may want to pay particular attention to how they navigate stairs. Have they started using a mobility device like a walker or a cane? An in-home caregiver can integrate fall prevention strategies for seniors in their home by making sure that fall hazards in the home are mitigated, and that your loved one is moving around safely with supervision.
  2. Medication errors. Although you might not be able to confirm whether your parent is taking medications correctly, you can observe some details that might help. First of all, is there a medication management system in place, for example, a weekly medication box? Take a look in the medicine cabinet. Are there bottles of expired medications? Does the entire medication system seem disorganized and chaotic?
  3. Problems with cooking or shopping. Take a look inside the refrigerator and the kitchen cabinets. Is there spoiling food? Does it seem as though there are adequate food supplies? Observe your parent’s cooking to see that they are following proper steps and aren’t confused. Do they leave the stove unattended?
  4. Poor hygiene. Poor hygiene is a red flag that something is wrong, and there are several possibilities. One is that your parent has a physical problem that makes it difficult or unsafe to shower. The other possibility is that your parent forgets to bathe, doesn’t like the cold, or is afraid of falling due to cognitive impairment (possibly due to dementia).
  5. Driving problems. When you are home for a visit, ask to go for a drive with your parent. You will learn a lot about their abilities (or lack thereof) regarding safe driving. Look for dents and dings on the car. Sometimes older adults drive when they shouldn’t and other times, they stop driving out of fear. If you notice signs that your loved one shouldn’t be behind the wheel, you may want to consider encouraging your parent to turn in their car keys and find an alternate way of transportation for them, that they are comfortable and happy with.
  6. Wandering. Wandering behavior in seniors is common in people with dementia. This problem may start slowly with your parent leaving the house unattended either on foot or by car without telling anyone. Wandering can have serious consequences, especially if the weather is bad or your parent gets lost.
  7. Social isolation. Social isolation and loneliness affect many older adults, and the situation has worsened with quarantines. If your parent is no longer driving or visiting friends and family, social isolation can increase. Loneliness can contribute to mental health problems like depression and anxiety.

What to do When Your Parent Needs Home Care

Accepting that your parent needs home care and making it happen can be a huge transition for everyone involved. Patience and compassion are critical so that the process goes well and your parent feels heard and honored. Here are some suggestions on how to start the conversation about home care, and get home care started:

  1. Before talking with your parent, make a list of your concerns. You may have the conversation in person or over the phone, but you will want to talk about specific issues. Try to avoid making vague comments like, “I think you need some help.”
  2. Keep your comments positive and specific. An example is saying, “I have noticed you aren’t getting out much anymore since giving up driving. What do you think about a caregiver once a week to take you places you want to go?”
  3. Stay patient during these discussions. Your parent may be resistant to the idea of home care, so be prepared to have more than one talk. Respectfully listen and acknowledge their apprehensions about in-home care.
  4. Couch your concerns in the context of safety. Confirm that you are honoring your parent’s desire to stay in their home and that home care is the best way to ensure that.
  5. Negotiate a very light home care schedule to start. Your parent wants to feel they are in control and the best way to do that is to reach consensus. Getting “your foot in the door” with a home care provider is the most critical step. After that, things are likely to go smoothly, and you can increase hours as needed.

It can be hard to acknowledge that a parent needs home care, but starting the process early on can help prevent more problems later. Approach the idea of home care with respect, care, and compassion. Then, during your next visit, you can enjoy your time together and feel confident in your parent’s safety and well-being.


National Council on Aging

About the Author(s)

Amanda Lambert is the owner and president of Lambert Care Management, LLC which provides care management for older and disabled adults. She is the co-author of Choose Your Place: Rethinking Home as You Age (November 2020) and of Aging with Care: Your Guide to Hiring and Managing Caregivers at Home (Rowman and Littlefield, 2018). She has worked for over 20 years in the senior-related industry including mental health, marketing and guardianship. She has a passion for topics related to health, wellness and resilience as we age.

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