When to hire senior home care services

There is often a lot of resistance and hesitation when it comes to hiring senior home care services. Many people don’t like admitting that they need help with daily activities, and family members don’t always know how to broach the subject. Unfortunately, this means that a senior relative can go years without assistance, since it can be several years from first witnessing the need to acquiring aid. This can become burdensome for people in the family, who are not always well equipped to handle such needs and may not have the time to devote to home care. It’s important to be able to notice and acknowledge when it’s time to hire senior home care services.

Noticing the Signs

Loved ones might notice that there are missed doctor’s appointments or that medications are left untaken. You may have observed failing hygiene, household chores left undone, or house pets or plants that aren’t tended to as well as they should be. All of these can be initial indicators that home care assistance could be beneficial. More severe signs may be distracted driving, difficulty remembering names, dates, or addresses, or that already present safety and health concerns become more acute. Although discussing home health care might be uncomfortable or embarrassing, such assistance can help encourage a greater sense of independence, aid with transportation and mobility, and can help to ensure that health care needs are met promptly and with appropriate attentiveness and urgency. A single awkward conversation can be the first step to getting your loved one the help they need. Full or part-time services are often all that are necessary. Staffing agencies can often be the easiest approach, since they locate the caregivers, handle payroll taxes, and perform all administrative work and conduct background checks. This is a relatively easy way to find qualified and verified home health care professionals. Another option is that you would hire a nurse or other caregiver directly. This would place the burden of performing the background check, as well as verifying references and credentials, on you. You would also be responsible for payroll taxes, liability, and, more, which can be overwhelming. However, it’s possible that it could also save you money. It will ultimately be up to you to decide what’s best and to ensure that your loved one’s needs are met.

The signs that actually matter

Families tend to wait for something dramatic. In practice the reliable signals are quieter, and they show up in the house rather than in the person:

• The fridge. Expired food, or full containers of meals delivered by family and never eaten.
• The mail. Unopened letters, second notices, cheques not deposited. Managing correspondence is a complex task and it is often the first to go.
• Weight. Clothes looser, rings turning on the finger, a belt on a new notch. Unintentional weight loss is one of the strongest signals there is.
• The same clothes. Or the same clothes slept in. Washing and dressing take effort and privacy, and people stop rather than ask for help.
• Bruises with vague explanations. Most falls are never reported to anyone.
• Withdrawal. Stopping activities that were once fixed points in the week — church, cards, a walking group.
• The car. New scrapes on the bumper or the garage frame.
• The smell of the house. Uncomfortable to say, and often the clearest indicator of all.

How to raise it without a fight

The conversation goes badly when it is framed as an assessment of competence. A few things help:

• Pick a calm moment, not a crisis. The day after a fall is the worst possible time.
• Lead with the specific task, not the general decline. “Would it help if someone did the shopping and the heavy cleaning?” lands very differently from “you can’t manage on your own.”
• Offer it as something for you. “It would put my mind at rest” is easier to accept than “you need this.”
• Start small and time-limited. Two mornings a week for a month, then review. Most resistance is to the idea of permanence and lost independence, not to the help itself.
• Give them control over the details. Which days, which tasks, who comes. Handing back some decision-making is often what unlocks the whole thing.

Expect it to take more than one conversation. It is normal for the first answer to be no and the third to be yes.

Do not wait for the crisis

The most common pattern we see is a family that talks about it for a year, does nothing, and then arranges care in forty-eight hours from a hospital bedside — with no time to compare providers, meet anyone, or make a considered decision.

Arranging support early is also easier on the person receiving it. Someone who has met their caregiver while still relatively well, and had a say in choosing them, accepts help far more readily later on than someone who wakes up after a fracture with a stranger in the house.

If you are unsure whether it is time, it is worth requesting an assessment from Ontario Health atHome. It is free, you can call yourself without a doctor’s referral, and it commits you to nothing.