How do you know when your parents or relatives need more help or care at home? There may be obvious moments after a fall, a spell in hospital, or after the death of a spouse. But so often we are asked the question “I’m not sure they’re coping anymore. Should we get more help, and if so what kind and where from?”. The honest answer is – if you’re asking that question or even just thinking about it, then it’s time.
When it's time
It’s one thing getting to this point of realisation. It can be quite another to make it a reality. Individuals and couples who have muddled along very nicely thank you for decades will most likely continue to muddle along, often way past the point of no return.
A mixture of pride, anxiety as to the consequences of asking for help, worries about money, or actually they just don’t know, for whatever reason, that they need more help.
There’s a whole raft of emotional and practical things to navigate if you’re starting to think about more care at home.
Tell-tale signs
A community nurse said the most telling thing that confirmed someone needed more help was when they said they struggled with their morning routine, from making the bed, to buttoning a shirt. It may be more subtle than that such as a husband or wife who no longer goes out very much because they don’t like to leave their other half alone at home for long. Or less subtle, with carnage in the kitchen, unopened post or a home that feels different to how it used to. (Have a read of our guide to what to look for here.)
A lot less muddle
Having the conversation about more care at home is the next big hurdle. It will doubtless be more than one conversation, and it might take different approaches to reach the point of acceptance, however grudging. More care at home isn’t a capitulation or admission of failure. But god it can feel like it. It should be the passport to a bit less muddle and counter-intuitively to more independence and peace of mind.
Write a job description
You may well have Mary Poppins in mind as the ideal candidate to care. And that should be your starting point. What and who are you looking for? It may feel a bit like the ultimate match-making exercise. Make it so. Write a list of all the tasks and things you think need doing, day and night, week in and week out, from the smallest to the largest. This may include:
- Washing, dressing and going to the loo:
- Taking meds regularly;
- Getting out and about – shopping, visits, kite-flying and trips;
- Admin – cleaning the house, keeping the garden in good nick;
- Companionship – watching tv, playing bridge or doing puzzles etc
Write a person spec.
Then write a list of what you think would make the ideal candidate, not just the skills they need but their human qualities. Caring right at the top obvs., but should they need to like knitting/puzzles/cards; what should be on the menu? Will they need to like pets and so on. And whilst we’re on this subject, there is also possibly the slightly delicate matter of cultural/social fit that you may need to navigate.
Finding your own Mary Poppins may take a while, particularly if you have quite specific needs such as giving medication, or for example stoma expertise. Also, dare I say it, agencies and providers might be struggling to provide carers.
Do you want to be an employer?
You need to decide if you want to employ someone yourself, with all the fandango that involves in terms of contracts, employer responsibilities, organising holiday and sick cover; or you may decide that an agency is best which will take all that responsibility on for you. They will employ the carer, and should train them and provide the support to enable them to fulfil their role.
How much care - day care or live-in care?
Another consideration, which is both practical and financial as well as based on care needs, is do you need live-in care or day/visiting care. If it’s live-in care then someone needs accommodation on site of course, and the relationship with your parent will also need to sustain 24/7 together……
Our section on what care might be useful for you. Read more here.
Take your time and do it right
Finding, interviewing and hiring a carer/carers should be a detailed and thorough process. It’s a mixture of finding the right nanny, school, job x 20.
Try not to let it be anything less. Even if you’re feeling pressured to find a solution fast. Do talk to a number of different providers and agencies. Don’t just accept terms if they don’t suit you – breakfast at 10am is not generally what anyone wants. discuss the price and look at the detail of the contract – are bank holidays included, what about over-time or emergency situations?
Build a relationship with the agency/provider. Ask for reports and be, nicely, “in their face” to ensure the care your parent deserves, which you or they are paying for.
With any luck it will be a match made in heaven from day 1, or maybe from day 5, or even 22. It’s a big adjustmnent.
Mary Poppins may not just float in with her umbrella and carpet bag. But she’s out there somewhere. “spit spot” as she’d say, clapping her hands, ready to get busy.
Annabel James is founder of Agespace.org. Her views are her own.
