When a Loved One Needs Home Care

 

Watching your parents age and lose the ability to do things they once found easy is emotionally challenging. It forces you to confront the inevitability of change and decline in life. The people who once cared for and protected you now seem vulnerable, creating a role reversal that can be difficult to process. It’s painful to witness their frustration as they struggle with tasks that used to come naturally, and it can stir feelings of helplessness and grief. This shift in their independence often brings a deep sense of loss—not only for their capabilities but also for the way life used to be.

The fear an adult child might experience when talking to their aging parents about needing help often stems from a mix of emotions—guilt, concern, and the fear of hurting their pride. It can be difficult to acknowledge that the people who raised you and were once pillars of strength may no longer be able to manage everything on their own. You might worry that bringing up the need for assistance will make them feel weak or like a burden or that it could strain your relationship. There’s also the fear of resistance, as many older adults are reluctant to accept help, viewing it as a loss of independence. Navigating this sensitive conversation requires empathy and careful timing to ensure they feel supported rather than diminished.

Research indicates that nearly 6 out of 10 people over the age of 65 need assistance with at least two activities of daily living, which are essential for daily self-care and play a key role in determining the level of care a person might need.

Activities of Daily Living (ADLs) include:

• Bathing – The ability to clean oneself and maintain personal hygiene.
• Dressing – The ability to choose and put on appropriate clothing.
• Toileting – The ability to get to and from the toilet, use it properly, and clean oneself.
• Transferring – The ability to move from one position to another, such as from a bed to a chair or standing up.
• Eating – The ability to feed oneself.
• Continence – The ability to control bladder and bowel functions.

However, it can be a difficult conversation to share with a loved one that it is time to consider the help of a home care provider.  For the person who needs the care, the following concerns may be top of mind:

• Is this the first step to losing my independence?
• Will the next step be a move into a senior care facility?
• Is it safe to have a stranger in my home?
• I don’t need help.
• I’m embarrassed to have a stranger help me with personal care.
• Do my loved ones think I can’t make my own decisions now?
• Can I afford home care?  Will I run out of money if I start paying for care?
• Am I a burden to my family?

Meanwhile, the family of the person needing care may have concerns of their own, such as:

• Is my loved one safe at home alone?
• Is it safe for me or another family member to provide care?
• Will it affect our relationship if I am the caregiver?
• Do I have time to be the caregiver?
• Is it too stressful to be a caregiver for my loved one?
• Should my loved one still be driving?
• Is it safe to have a stranger in my loved one’s home?
• Can my loved one afford home care? Will we need to help financially?

With these examples, some concerns may be closely related for the person who needs care, as well as their loved ones, but other concerns may be very different.  Thus, it can be challenging to develop a plan for care that the whole family agrees on.  Ultimately, it is most important to begin with the agreement of the person who needs care that it is time to take that step. Below are some tips for engaging your loved one in discussion around considering a home care provider:

1. Manage your own expectations. Unless there is an urgent safety concern, prepare yourself for the possibility that decisions and progress may not be made after the first conversation.  Your loved one might need time to absorb the idea, and more than one conversation may be needed. 
2. Plan a time to discuss your concerns. It does not have to be formal and intimidating, but it sets the stage for a conversation.  For example, “Dad, I was very concerned when you fell in the shower last week. Can we talk more about it when I take you to lunch this weekend?” or “Mom, I’ve noticed that you have not been taking all of the doses from your pill boxes.   This allows your loved one to prepare for the conversation and gives you time to organize your thoughts and requests.  Knowing your loved one, determine whether the first conversation would be best as a one-on-one conversation or if a family meeting would be better.  This depends upon the family relationship and dynamics, as well as the personality of the person needing home care.  Avoid blindsiding or overwhelming the person by not giving them the opportunity to prepare or involving too many people in the first discussion.
3. Be prepared and organized.  Make a list of your concerns.  Ask your loved one for their ideas about solutions before immediately jumping to your recommendations or requests.
4. If the first conversation needs to be one-on-one, it may be helpful to include other family members or trusted advisors for subsequent conversations. Depending on the concerns, a member of a home care team, Financial Planner, physician, Geriatric Care Manager, or other resource may be helpful. If your loved one has a trusted friend who has/is using home care with positive results, this person may also be a valuable resource.
5. Involve your loved one in the decision on what home care company will be selected, when possible.  Most non-medical companies offer a complimentary initial assessment that can offer the potential client and family to ask questions and understand the approach of the home care.  Some companies even offer the potential client and family the opportunity to interview and select the caregiver(s).  These are important steps to ensure that the home care company you choose aligns with your expectations.  
6. If driving is a safety concern for your loved one, be sure to check that the home care companies you are considering offer assistance with transportation to errands and appointments.  Losing the ability to drive can be one of the most difficult transitions in terms of loss of independence. A caregiver who can assist with errands and appointments can ease some of the stress about driving and relieve the family of helping with errands and appointments when needed.
7. Once a home care provider has been selected, remember that this is a transition.  It is important to discuss in advance with your loved one that it will likely take some time to adjust to having caregivers in the home.  Give the home care company and caregiver(s) time to learn preferences and routines before determining that it is not a good fit. If you have concerns or issues, communicate these to the home care to provide the opportunity for making adjustments as needed. If there is a reluctance to receive home care, it can be easy to dismiss the care prematurely, before time has been given to realize the benefits.

Making the decision to use home care services for a loved one can present challenges, but home care can bring peace of mind and comfort to situations where there are concerns around safety and independence.  Using home care services can make it easier for seniors to age at home, which is where most people want to remain as they age.