My Parent Needs Care: Where Do I Start?

Summary: If Mum or Dad is starting to need more help, you do not need to have care figured out before you take the first step. Start with what has changed, what they are still managing well and what matters to them. From there, you can explore support that could help them keep as much independence, choice and control as possible. If they have capacity to decide about their care, the final decision remains theirs, even when the family is worried.

More often than not, there isn’t a definitive moment that tells you a loved one needs care. While sometimes a fall, a hospital stay or a sudden change in health can make it obvious that something needs to change quickly, it’s often a lot less clear.

You might notice the fridge is looking a bit emptier. Dad is still getting dressed and making his own breakfast, but he has stopped going out unless somebody takes him. Mum is forgetting tablets now and then. You are popping in after work more often, doing the shopping, sorting appointments and ringing every evening to check everything is okay.

None of those things on their own necessarily mean your parent needs professional care. But when a few of them start happening together, it is completely understandable to wonder whether they need more help.

And this is usually where families get stuck. Who are you supposed to speak to? How do you know how much help is enough? Can they stay at home? What if they do not want care? Do you contact the council or a care company? How much is it all going to cost?

You do not need to know the answer to all of those questions before you start. If your elderly parent needs care, the first job is simply to get a clearer picture of what has changed, what they are still managing and where life is becoming harder.

Where should you start when an elderly parent needs care?

Start with one question: does something need dealing with now, or have things been gradually getting harder? Once you’ve got a clear idea of that, it can make everything else feel a little clearer.

It is very easy to jump several steps ahead. One minute you’re worried because Mum isn’t eating properly and the next you’re researching care homes, funding rules and whether the house might need to be sold. You don’t need to solve all of that yet.

If something has changed suddenly, deal with that first

If your parent has suddenly become unwell, much more confused, very weak, breathless or unable to manage in a way that is unusual for them, don’t assume it simply means they need more care.

A sudden change may need medical assessment. Use NHS 111 if you need urgent medical help and aren’t sure what to do, and call 999 in a life-threatening emergency.

A fall, illness or hospital stay can also bring care decisions forward very quickly. In that situation, the immediate question may simply be: what needs to be in place for Mum or Dad to be safe when they come home?

You can think about longer-term care once that immediate situation is clearer.

If things have changed gradually, look at the whole picture

Most commonly, there isn’t actually one specific moment. It might be that Mum is still getting washed and dressed but isn’t cooking proper meals anymore. Dad might still feel he’s managing, but somebody in the family is now doing his shopping, collecting prescriptions and checking in every evening.

While one of those things alone doesn’t tell you very much, what tells you more is the pattern.

Think back over the last few months:

• What has become harder?
• What has stopped happening altogether?
• What are family members now doing that your parent used to manage themselves?
• How often does somebody need to check in or step in?
• Are you starting to organise your own week around making sure they are okay?

That last point is easy to miss, as families can gradually take on more and more without ever sitting down and deciding, we’re now providing care. A weekly shop becomes meals and medication. One evening visit becomes every evening. Phone calls become checking that someone has eaten, taken their tablets or got safely to bed.

That is part of the picture too. If you’re not sure whether the changes you’re seeing suggest that more support may be needed, our guide to the signs an elderly parent may need care goes into those early changes in more detail.

Riley’s story: when lots of small things started adding up

Riley’s experience with his grandparents shows how this can happen in real life. One of the moments he remembers was noticing a bucket of water being used to keep his grandad’s freezer shut.

A broken freezer doesn’t mean somebody needs care. But for Riley, it was the start of noticing more. As he describes it, there was “another thing, there was another thing, there was another thing.” He began seeing changes in his grandad’s memory and energy too. At the same time, Riley was doing more and more himself.

Eventually, he says he had gone from being a grandson to almost a full-time carer. That is why looking at the whole picture matters. Sometimes it isn’t one dramatic event that tells a family something needs to change. It is lots of smaller things, alongside the amount of help the family is already having to provide.

Once you’ve got a clearer picture of what is changing, the next question is usually how to talk about it with your parent. And that conversation often matters just as much as the practical side of arranging care.

How can you tell what support your parent actually needs?

You probably already know more about this than you think. If you’re the person ringing Mum every night, doing Dad’s shopping or going round on Sundays to sort out the week ahead, you already have a good picture of where things are becoming difficult. What families sometimes have not done is put all those little jobs together.

Think through a normal day rather than making a list of everything your parent can no longer do.

What happens in the morning? Are they getting washed and dressed comfortably? Are they eating breakfast and taking medication at the right time? What about lunch, shopping, getting out of the house, using the stairs, making an evening meal and getting ready for bed?

Then think about the gaps in between. Are they happy and safe when nobody is there, or is somebody in the family constantly checking their phone because they are worried?

It is just as important to notice what is still going well. If Dad still makes his own lunch every day and enjoys doing it, there is no reason for a Caregiver to take that over. He might need help getting showered in the morning and getting to the shops once a week, but be perfectly independent for much of the day.

That is why the question is not simply, “What support does my parent need?” It can be more helpful to ask, “What matters to them, what do they want to keep doing and what support might make that possible?”

You can also ask your local council for a care needs assessment. It’s free, and it shouldn’t simply be a list of everything the person can no longer do. It should consider their needs, how those needs affect their wellbeing, the outcomes they want to achieve and what support, equipment or adaptations might help. That includes the strengths they still have, the routines and relationships that matter to them and how they can keep as much independence and control as possible. You can ask for an assessment even if you expect to pay privately for care.

If you are getting ready for one, our guide to preparing for a care needs assessment explains what usually happens and what is useful to think about beforehand.

How do you talk to a parent who may need care?

This can be harder than researching the care itself. You may be thinking about safety, medication or how much the family is doing, while your parent may hear the word care and think you are saying they can no longer manage their own life.

So try not to begin with a verdict. “You need a carer” is a very different conversation from “How are you finding the stairs at the moment?” or “You mentioned shopping is getting tiring. What would make that easier?”

Start with something real and specific. It gives your parent something they can respond to without feeling as though a whole care plan has already been decided for them.

It also helps to listen for what sits underneath a no. “I don’t want care” might mean “I don’t want strangers in my house”. It might mean “I don’t want somebody doing things I can still do myself”. Or it might simply mean “I am not ready to think about this yet”.

Those are different concerns and they need different conversations. Where there is time, you do not have to settle it in one sitting. In fact, that is one of the most useful things to remember.

Jo Cleary, our Learning and Development Manager, has spent more than 25 years supporting families through conversations like these. Her advice is not to treat it as one big talk that has to end in a decision. As she puts it, “It’s not one big conversation. It’s a series of smaller ones.”

That might mean bringing it up over a cup of tea, during a walk or in the car. Start with something you have noticed, ask how they are finding things and then listen. If they are not ready, you can pause and come back to it another day.

Our guide to starting a conversation about care with an elderly parent goes through this in more detail. If your parent is firmly refusing support, our article on what to do when an elderly parent refuses help looks at that situation in more depth.

What if Mum or Dad has capacity but still says no to care?

Sometimes, you can talk things through carefully and the answer is still no. That can be incredibly difficult when you’re worried and feel as though you should be doing more.

It’s worth knowing that Mum or Dad should be presumed to have capacity unless there is a clear reason to think otherwise. Put simply, if they can make this decision for themselves, the choice is theirs.

They may understand why you’re concerned and still decide that they don’t want care. Refusing help doesn’t automatically mean they lack capacity. Neither does their age, a diagnosis or a decision that you wouldn’t make yourself.

If they have capacity, you can’t make the decision for them. But that doesn’t mean there’s nothing you can do. You could:

• ask what it is about care that worries them;
• talk about the particular things you’ve noticed, rather than care in general;
• look at a smaller first step, such as help with shopping, meals or getting out;
• keep the conversation open and come back to it if things change; and
• seek professional advice if you’re genuinely worried that they may not be able to make this particular decision for themselves.

Sometimes there isn’t an answer that takes all the worry away. You may have to respect a choice you disagree with while continuing to offer help and keeping an eye on the situation.

If there is an immediate medical concern or you believe someone is at risk of abuse or neglect, seek professional help rather than trying to manage it alone.

The Mental Capacity Act Code of Practice explains more about capacity and how decisions should be made.

What care options are available for an elderly parent?

One thing that catches a lot of families out is thinking they have to choose between managing alone and moving into a care home, but there are usually more steps in between.

For smaller needs, the right answer might be something fairly simple. That could be a handrail, a medication prompt, help with shopping, a cleaner, a community group or more structured support from family.

If professional care is needed, hourly care can be built around particular parts of the day. That might mean help with getting up and dressed in the morning, preparing an evening meal, medication, shopping, companionship or getting out to appointments.

If somebody needs much more support across the day, live-in care may be worth considering. A Caregiver lives in the home and supports the person within an agreed care plan, while the wider care team remains involved in overseeing the service.

Residential care may be the right option for somebody who would prefer a more communal environment, wants staff nearby or has needs that are better met in an on-site environment. Nursing homes also provide residential care alongside registered nursing support for people who need it.

The right option is the one that fits the person’s needs, wishes, home situation and the amount of support they need. For some people, that will mean a little help at home. For others, it may mean more regular care or moving somewhere that can provide the right level of support.

You also don’t have to assume that the first type of support you arrange will be the one that stays in place long term. Care can change as someone’s needs change. A few visits each week may be enough at first, while somebody else may need more support after an illness, a fall or a change in their health.

If you are already comparing care at home, our hourly care versus live-in care guide explains when each option tends to work best.

Can your parent stay at home if they need more care?

Often, yes. Needing more help does not automatically mean your parent has to leave home. The more useful question is whether their needs can be met safely and realistically at home, and whether staying there is what they want.

For many older people, home is about far more than the building itself. It can mean familiar routines, neighbours, pets, memories and control over the small decisions that shape each day. Where your parent has capacity, their wishes about where and how they live must be central to the conversation, even when the family has concerns.

For some people, a couple of regular visits are enough. For others, the issue is that they are no longer comfortable being alone for long periods. Someone living with dementia may need more supervision and reassurance. Another person may need a lot of physical help but remain completely clear about how they want their day to run.

The home itself must also be safe and comfortable for them too. Stairs, bathroom access, space for equipment and whether somebody can move around safely can all affect what is realistic. An occupational therapist may be able to suggest equipment or adaptations if everyday tasks at home are becoming difficult.

And family capacity matters. If staying at home only works because a daughter is there every morning, a son is there every evening and somebody is on call overnight, that is not the same as the person managing independently.

That does not mean home care is automatically the answer. It just means the family’s contribution needs to be included honestly when you compare the options.

If you are weighing up staying at home against moving, our live-in care versus care home comparison looks at both options, including routines, social contact, one-to-one support and cost.

How much does care cost and what funding may be available?

At some point, somebody in the family is going to ask, “But how much is all this going to cost?” It is a completely reasonable question, and unfortunately there is not one useful figure for “elderly care”.

The cost depends on the type of support, how much of it is needed, where the person lives and what the provider includes in the service. Hourly care, live-in care, residential care and nursing care are also quite different things, so comparing weekly figures without looking at what sits behind them can be misleading.

When you do compare prices, ask what is actually included. Who employs the Caregivers? Who arranges cover if somebody is ill or on holiday? Who reviews the care? Are there extra charges? How much one-to-one support is the person actually receiving?

You can see Unique Senior Care’s current prices and get an initial estimate using our home care cost calculator.

It is also worth checking funding before assuming the family will need to pay for everything privately. Council support for social care is means-tested after a needs assessment, and some people may qualify for other help such as Attendance Allowance or NHS Continuing Healthcare depending on their circumstances.

Our guide to funding care at home explains the main routes and where to check the current rules. If you are making a major financial decision, use current NHS and GOV.UK information and take appropriate financial advice where needed.

How do you choose a care provider you can trust?

By the time families reach this point, they often have a spreadsheet open and three or four care companies starting to blur into one.

Price is of course important, as is the provider’s CQC rating, but it is also worth getting underneath what day-to-day care will actually look like.

Ask who will be coming into your parent’s home and how consistent that group is likely to be. Ask how Caregivers are recruited and trained, how they are matched, who stays involved once care starts and what happens when somebody is unavailable.

It is also worth asking a question that is easy to miss: who is actually responsible for managing the care? With a fully managed care provider, the organisation employs and supports the Caregivers, manages the care plan, arranges cover and remains involved if needs change.

Introductory agencies work differently. They usually introduce families to self-employed carers rather than employing and managing the care themselves, which can leave more of the ongoing arrangement with the family.

That does not automatically make one model right and the other wrong, but it does mean they should not be compared on headline price alone.

For regulated home care in England, you can check a provider’s registration and inspection information through the Care Quality Commission.

It can also help to have a few questions ready before you speak to a care provider, particularly around consistency, training, cover and what happens if needs change. And when you are comparing companies more broadly, look beyond the first impression and think about what makes a home care agency trustworthy in practice, from how Caregivers are recruited to how the care is overseen once it starts.

What should you do next if your parent needs care?

By this point, you may have a much clearer idea of what is happening. The next step depends on where things are right now. You don’t need to do everything at once. Pick the route that sounds closest to your situation and start there.

If you already feel ready to explore professional care, a first conversation should help make the options clearer rather than expect you to arrive with everything decided.

At Unique Senior Care, a home care consultation gives you time to talk through what is happening, what support may be needed and what matters most to the person receiving care. If you want to know what that involves before making contact, you can see what happens during a home care consultation.

Realising Mum or Dad needs more help can bring up a lot of decisions at once. You do not need to make all of them today. You only need to work out what needs attention now and what the next sensible step is from there.

If you would rather talk through the situation with somebody, our team can help you understand the options without expecting you to know what type of care you need first.

External references

• NHS: Getting a care needs assessment
• NHS 111 online
• NHS: When to call 999
• Care Quality Commission: Find and compare care services
• GOV.UK: Mental Capacity Act Code of Practice
• GOV.UK: Care and support statutory guidance

Unique Senior Care is a regulated provider of live-in and visiting care. This article is general information and does not replace medical, legal or financial advice.