How to Recognize When the Assistance of a Care Provider is Necessary


How to Recognize When the Assistance of a Care Provider is Necessary

Many families struggle with the dilemma of when to implement the assistance of a caregiver - whether the supervision of a friend or family member, the aid of a professional in-home caregiver, or moving to an assisted living community.  When hesitating to decide, patients and families offer many different reasons for not implementing care, from not wanting a stranger in the home, to being a burden to others, or bemoaning the cost of care.  In reality, the price tag of assisted care is often not much greater than the cost of living at home, especially when factoring in the added expenses of medical treatment and hospitalizations.  Can anyone really put a price tag on the safety and well-being of a loved one?  For many people needing care, financial resources are available to help balance out the cost of these care services.  Ultimately, if you are considering additional care for yourself or for your loved one, you likely have reached the point when the help of a caregiver should be established.  Listen to your instincts! 


The following are some signs and symptoms, listed in no particular order, that indicate you or your loved one would benefit from the assistance of an in-home caregiver or moving into a residential care community:

  1. “It is better to be safe than sorry.”  If you are even thinking about the possibility that you or your loved one may need the assistance of a caregiver, then you probably already do.  You should listen to your instincts!
  2. “Hope for the best and plan for the worst.”
  3. Does your loved one have a strong, reliable support network?  Does he/she live alone?  Are there neighbors or roommates who can check on him/her regularly?  If he/she has an accident, who is available to help?
  4. Forgetting to take medications.  Even though your loved one insists they are taking medications, you may need to check periodically to confirm the medications are being taken as prescribed.  Some patients go so far as to hide pills in their mouth, only to spit them out later.  There are way too many potential pitfalls to list in this article.
  5. Not taking medication as prescribed or other mistakes with medications.  In some instances, I have seen patients taking a prescribed medication, but after reviewing the label it became clear that the medication should have been taken and discontinued two years earlier such that there was no possible way the medication was taken correctly.
  6. Declining health and failure to thrive.  Is your loved losing weight, frequently ill, or falling?
  7. Frequent hospitalizations or visits to the doctor.  Beyond the obvious risks to personal safety, declining health and frequent hospitalizations often far outweigh the costs of assisted care.
  8. Forgetting medical appointments or other important meetings.
  9. Falling down.  The risks are even greater if falling occurs while taking a blood thinner or anti-coagulant.  Some adults may cover up bruises or injuries to hide declining health from friends and family.
  10. Loss of consciousness.  A lapse of consciousness is never normal and often can indicate a serious underlying disease, such as epilepsy or cardiac arrhythmia.  Loss of consciousness should never be ignored.  Some patients do not disclose episodes of loss of consciousness because they want to protect their driving privileges and independence.
  11. Dangerous behaviors.  Examples include leaving the stove on, leaving the car running and unattended, putting metal objects in the microwave, leaving the front door open.
  12. Getting lost in the neighborhood, or even worse, in the home.
  13. Wandering.
  14. Physical or verbal aggression or agitation.
  15. Unsafe driving.
  16. Diminished insight (lack of ability to recognize one’s own impairments).
  17. Diminished executive function (lack of ability to make informed, rational, and safe decisions).
  18. Forgetting to eat meals or not eating healthy meals.  Just because your loved one tells you they are eating does not guarantee that this is actually happening.  Check to see if your loved one is preparing fresh meals.  Is there spoiled food in the refrigerator?  Is the refrigerator adequately stocked?
  19. Neglecting personal hygiene.  I have seen a number of patients with dementia who neglect personal hygiene.  This can be dangerous, leading to urinary tract infections and other complications.  Is your loved one bathing regularly (preferably daily)?  Is she brushing her teeth at least once or twice a day?  Is she changing her clothes regularly?  Is she combing her hair and putting on makeup as she has in the past?  Is he shaving as often as he did in the past?  Does he miss patches of hair when shaving?
  20. Neglecting the upkeep of the home.  Does your loved one maintain their home as they always have?
  21. Can your loved one hear well-enough to live alone safely?  Can he hear a smoke detector or the telephone?
  22. Can your loved one see well-enough to live alone safely?  Can she see the writing on her prescriptions?  Can she see safely at night and in the dark?
  23. Can your loved one operate household appliances correctly?  Does she know how to use the telephone in case of emergency?  Would she know who to call in case of emergency?  Does he know how to use the oven, stove, and microwave?
  24. Have you and your loved one modified the home to ensure safety?  Does your loved one have a home safety system or personal safety system?  Does the home have smoke detectors and carbon monoxide detectors?  Would there be any dangers exiting the home during an emergency?  Does the home have a burglar alarm?  Are grab bars installed in the shower and next to the toilet?  Have loose area rugs been removed?  Are lights left on at night to prevent falls and injury?
  25. Is your loved one sleeping a lot more than usual?  Is your loved one alert and capable of self care?
  26. Is your loved one opening the mail and paying bills correctly?
  27. Is your loved one making mistakes with money?  Have they donated excessively to charity or gone on a spending spree that is out of character?
  28. Is your loved one feeling lonely, isolated, or depressed?  Depression can be a life-threatening disease and should be treated just as aggressively as stroke or heart disease.
  29. Is your loved one exhibiting symptoms of psychosis?  Generally, psychosis refers to an alteration of normal thought and may include paranoia, delusions, or hallucinations.  Psychosis can be dangerous for the patient and for other people who interact with the patient.


Some patients will undertake great efforts to hide the truth or mislead family members and doctors to avoid the possibility of losing independence.  At the end of the day, the best advice is to use your best judgment.  



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