Watching as our parents begin to struggle with the effects of old age can be devastating, and many of us help out as best we can by offering informal care in the home – cooking meals, shopping for groceries, and general housekeeping, for example. In fact, it’s estimated that there are around 3 million children providing care in the home for their elderly parents, without counting those in care homes.

Tea with my old mum in her Care home
For many of us, this is a system that works, but it’s important to remember that situations can and do change. If your parent’s needs change significantly, or your own situation changes, providing care in the home may no longer be a suitable option for either party. So just when should you consider alternative forms of care?

Your Parent’s Changing Needs

The needs of the elderly may change frequently in response to health events, side effects of conditions or medications, or simply as a result of ‘normal’ changes in both the body and mind as we begin to get older, such as reduced mobility, frailty, or mild confusion. Here are some reasons why your parent’s care needs may change, and why you may wish to explore other care options:

  • Degenerative Conditions – Conditions such as dementia, Alzheimer’s disease, and Parkinson’s disease are all degenerative, meaning that the symptoms often get gradually worse.

  • Health Events – Should your parent suffer a minor or major health event such as a fall or stroke, they may become more dependent and require a higher level of everyday care.

  • Confusion – Memory problems are a common complaint amongst the ageing population, and certain medications can also increase confusion. Confusion can increase risk for the elderly.

  • Medications – If your parent has been prescribed essential medications, they may not understand which pills to take – and when. This can increase their care needs, creating changes for you.

Her pills

For the health and safety of an elderly parent, it’s essential that we don’t overlook these changing needs in order to be able to continue providing care in the home. As their children, it’s important that we’re able to recognise these changes and ensure personal and medical needs are being met.

Your Changing Role as Carer

The changing needs of the elderly are not the only reasons to consider looking into alternative care arrangements. If you find that your role as carer is changing beyond what you anticipated, or beyond what you feel you can physically or emotionally handle, it can be very beneficial to explore other options. There’s no need to feel ashamed – sometimes parents require a level of care we’re unable to provide safely. Here are some ways in which your role as carer may change over time:

  • Increased Risks – Should your parent suffer a fall or be affected by mobility issues, you may be required to undertake manual handling as part of your role as carer, which can increase risk.

  • Personal Care – If your parent is unable to perform basic personal care tasks – bathing or using the toilet, for example – you may wish to explore other options if you’re not comfortable.

  • Extended Care – As a parent’s care needs become greater, you may find you’re required for much longer periods of time, which can significantly affect both work and family life.

Looking after her
Never be afraid to admit that your role as carer is changing beyond what you expected, or feel guilty for exploring alternative care options. Studies have found that, when the elderly receive a new form of care after being cared for by someone who is stressed or frustrated, they often demonstrate an improvement in functioning. New care arrangements can be a breath of fresh air – for both of you!

Signs that Suggest Changes Should be Made

Unfortunately, in many cases we may be simply too close to the situation to be able to recognise when our needs, or our parent’s needs, change beyond what we’re physically and emotionally capable of. That’s why it’s important to understand some of the most common signs that suggest that current care arrangements are failing to meet all needs, and be able to identify these signs in our parents.

  • Increased Falls – A higher prevalence of accidents or injury in the home may suggest that the current environment is proving to be too challenging for the elderly to navigate safely.

  • Feelings of Depression – Signs of depression amongst the elderly may be piles of unopened personal mail, poor housekeeping, or a drastic change in appearance such as unbrushed hair.

  • Signs of Risks – If you notice charred burners or burnt pan bottoms in the kitchen, it could suggest that your parent is becoming confused regularly, increasing their risk of injury.

  • Slow Recoveries – If your parent is taking a long time to recover from minor ailments, it could be a sign that they require higher levels of support and extended care to improve health.

  • ADL Performance – Activities of daily living (ADLs) include washing, going to the toilet, dressing, eating, and so on. If a parent is unable to perform these tasks, they may require more care.

If you identify any of these signs, you may wish to begin exploring alternative care home options. However – is this when you would put your parent into a care home? Perhaps not. These signs don’t always mean that a parent needs to move out of their home – in many situations is could simply mean that some changes need to be implemented in order to provide a safer living environment for the elderly.

Alternatives to Care Homes

If you feel that your parent’s needs can successfully be addressed without residential or nursing home care, then there are a number of ways that you can increase the level of support and assistance they receive without having to perform tasks that are beyond what you’re able to provide safely.

  • Home Adaptations – For parents who primarily struggle with mobility, including moving around the home, getting up and down stairs, or using the bathroom, a few minor home adaptations can have a significant impact and encourage independent living. Mobility aids such as stairlifts and walking frames can allow your parent to move freely throughout their home, while grab rails and hoists can assist with bathing and toilet needs. Pick up some brochures and printed literature for relevant companies to see what would suit your family.

  • Care in the Community – Community care can be as formal or as informal as required to meet individual needs. Community care is usually offered by the local authority, age-related charities, or independent providers, with carers undertaking personal care tasks, housekeeping, cooking, minor nursing tasks, and providing companionship at times when you’re unable to be present due to work or family commitments. The number of people receiving local authority care is actually dropping as more people opt for home adaptations.

  • Assisted Living Facilities – Sheltered accommodation for the elderly is considered to be a halfway point between remaining in the community and moving into a care home, and can be an excellent option for many families. Around 10 percent of the elderly in England live in sheltered or retirement housing. Here, residents either own or rent their own apartment and are encouraged to live independently, but have warden support in case of emergencies. There is always a member of staff on hand to call for medical assistance if required.

Residential or Nursing Homes

While the more informal care arrangements such as home adaptations and community care can be very beneficial, it’s important to recognise when these systems aren’t working, and are failing to meet both basic and more specific care needs. If you have a parent whose condition cannot be adequately managed in the community, a residential or care home can be the safest and most suitable option. So which type of care will your parent require? Residential or nursing?

In her wheelchair with the balloons at her Care home

There is a big difference between residential care homes and nursing homes. Residential homes are similar to sheltered accommodation, with the exception that your parent won’t own or rent an apartment – instead, they’ll be ‘residents’ in a large, communal building. Residents will often be encouraged to live as independently as possible, although basic care needs can be provided as required. In cases of ill health or emergencies, residential care homes will contact the relevant GP or emergency service for assistance, and residents may be moved to hospital if they require medical care.

On the other hand, nursing homes will always have at least one registered nurse on duty at all times, and can provide medical assistance and care in line with what nurses are permitted to do under their registration – changing dressings, taking blood, or managing specific conditions such as dementia, for example. Care is provided on a 24 hour basis, and the home may have the ability to treat certain conditions on site without the need to call a GP, or transfer a resident to hospital.

When contemplating sending your elderly parents into a care home, making sure all of the nurses have had the appropriate checks is absolutely essential. www.crbdirect.org.uk can help you through with this.

Choosing the Right Care Home

If you have determined that it’s the right time to transfer your parent into a care facility – either a residential home or a nursing home – don’t be tempted to rush the process. This is a major life event, and it’s vital that you work together with your parent and other family members, to locate the most suitable care home that will meet their needs, provide a safe environment, and encourage healthy living. One of the first tasks you should undertake is to read reports by the Care Quality Commission which oversees care home standards in England. Also take into account the location – you want the home to be easily accessible for visitation – and whether the home can meet medical, religious, and language requirements. You can also check out user reviews on the NHS website – it’s like TripAdvisor for care homes!

The Right Time

Grandad

When would you put your parent into a care home? Every person is different, and there’s no set age at which it’s best for a parent to receive higher levels of care. Some people may continue to live a healthy life in their own home, for example, while others may be struggling to perform day-to-day tasks without a little help and support. What’s important for us as relatives is to be able to recognise when our parents need more than what we can offer, and be prepared to consider alternative care options in order for them to live safely – and happily.

Article supplied by Harold Rigby, health writer with a special interest in issues faced by retired people in care homes.

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8 Comments

  1. brizcox says:

    Its not children’s responsibility to “put a parent in a care home”. Parents have rights and choices that are their own. This is a dreadful set of comments and attitudes.

    What happens when you become frail? What do you want to happen?

  2. Jackie Lowe says:

    The person who has capacity should make the decisions for themselves even if the carers feel that it is the wrong one. Quality of life is more important than quantity.

  3. Anya says:

    @Brizcox, when someone is a carer for an elderly relative for a majority of their life and has subsequently struggled to have very little outside contact with the world for years because of being a sole carer for that elderly relative – I’m talking missed out on educational and job opportunities because of that relatives needs and then the carer is spoken to and treated like dirt as the cared-for relative continues to deteriorate, losing their motor skills, unable to dress, cook, clean themselves, make a pot of tea, use the toilet, having a commode emptied, walk even small distance, so they need to be physically pushed in a wheelchair, fall in the night because they insist on turning night lights off, then that is the time for the carer, or child, in this instance to put the cared for relative in a home that meets their needs for the carer’s own sanity. If the cared for relative doesn’t wish to go into a home and the carer can no longer cope, then they have to agree on another of the options suggested in Mr Rigby’s article, above. It is just as much about the carer’s physical, mental and social needs as it is the cared-for’s.

  4. Martin Rathfelder says:

    If we want people to be cared for in their own homes – which is what most people want for themselves – then we need to support those that care for them more than we do now.

  5. Ann Seton says:

    Social services don’t want the elderly in their own home I get 52 hours a week to provide carers for mum 24 hours a day she is unable to walk dress herself toilet herself and suffers night terrors and confusion and doesn’t sleep and as an unpaid carer aged 64 with a heart condition 52 hours buys 5 nights waking care I do the rest and because 52 hours is the maximum VDA rate they took my 11 hours a week respite off me I am completely worn out and have no day time help so on three nights a week I am caring for 36 hours without a break. I don’t know at which point I give up trying to care but it will be the most guilt ridden decision I ever make .

    1. Mark says:

      Please don’t feel guilty, if your condition deteriorates you won’t be able to help anyone so you should think of your self first so that you can help others

  6. Sally says:

    Me and my husband have cared for my MIL 75 for 6 years we have 3 children 5.12.13 she lived in a granny flat opposite our home, she also as 3 carers 3 times a day,
    She is an alcoholic With suspected dementia will not take medication,
    and was recently in hospital for four weeks due to a fall Probably due to alcohol will not ring emergency buzzers is incontinent. She will not get any shopping she does not know how to drive she will let anybody in a home when she feels like it not knowing who they are we live very rural.
    Will not answer the phone she will not ring my husband for anything unless it’s alcohol .
    She recently came out of hospital even though me and my husband said she was not neady.
    after two days we were right she could not get out of a chair could not walk .
    But I was told by the doctor that this discharged her that my mother in law was told she was not capable of looking after a self and high chance she could fall into a self in danger ,
    Her response was she was prepared to take the chance they said she had capacity even though she had memory problems and suspected dementia are legally had to take her wish,

    So the way I see it She as no consideration for my husband her only son who is at braking point, and her grandchildren so although I can understand that elderly people want to stay in their home independently it gets to the stage that in my opinion They are not capable of making that decision and it’s their children and family that Suffer
    And the carer feels they are abandoned and they have to put up with it I’ve heard so many stories about people put their life on hold before the family members and the family members parents do not even want to meet half way That makes the situation even worse

  7. wendy hampton says:

    Such a difficult dilemma, ive cared for my mum for the past five years since she began having seizures, ive since nursed her in my own home for almost a year alongside looking after my family (4 children, the youngest is 15 and still dependent on me. My mother has deteriorated badly in the last six months to the point where she cannot walk or transfer without the assistance of two plus shes doubly incontinent. Ive really struggled emotionally with the personal care and she was admitted to hospital for rehab but they want to send her home with carers ×4 a day but what happens in between their visits? i was broken before and have been looking at care homes but i cant face putting her in them as i think she will go downhill more?

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