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I THINK MY MUM NEEDS CARE BUT I'M NOT SURE WHAT? A 6-POINT CHECKLIST TO HELP YOU!

I'm at that age when many of my friends have parents who are developing a need for some sort of care.

Often, this need is identified by an increase in the number of telephone calls an adult child might receive or when - having not seen a parent for a while - the adult child notices a deterioration in their living situation. 'Care' to a senior means different things, there's normally a negative connotation and frequently a senior may see this as 'giving in'. "I don't need care. I am not that bad!" is a response I frequently hear as the result from a conversation between a senior and their adult child. When I talk to my friends (and seniors!) about the concept of senior care and what they think it is, they tend to jump straight to 'hands on' personal care - those aspects of looking after another person which can involve the most intimate details of their daily lives. 

In my experience, a need for care arises long before a need for personal care. By leaving a conversation with a parent to the point at which personal care is required makes the likelihood of a crisis arising increase (a fall requiring hospitalisation, for example) and an intervention with personal care more difficult. Moreover, the relationship between the adult child and their parent begins to change - negatively - as roles become reversed.  

Early intervention with 'light touch' care is key, so that a Caregiver and senior have the opportunity to develop the depth of relationship which makes the transition to receiving personal care easier. Early intervention also creates the conditions where a crisis is less likely to happen. So when my friends ask me 'do you think my mum needs care now', I ask them to consider 6 or possibly 7 factors. I believe that whatever a senior's situation, if they need care they will typically present with one or more of 6 areas of need which should be assessed and addressed. 

These are:

  • Needing support with the activities of daily living

(ADLs as professionals within the care sector would call them) – washing, dressing, personal care, mobility etc.  Have you noticed that mum's clothes aren't as clean as they normally are, with food stains on them? Have you noticed that dad is wearing the same clothes, day after day? Are you beginning to notice odours that would suggest mum isn't adhering to her usual personal hygiene regime?

  • Needing support with nutrition. 

Have you noticed that dad is losing weight? Have you checked the fridge and spotted out of date food? Have mum's eating habits changed and she's relying on tinned or prepackaged foods rather than cooking from scratch as she used to do?

  • Needing support with medication management. 

Have you noticed that dad gets confused with the quantity of medications that he has to take and is missing doses more frequently? Have you seen multiple boxes of medication in mum's home and you aren't sure what has to be taken and when?

  • Needing specialist dementia care.

Does dad have a diagnosis of dementia or cognitive impairment? Is mum becoming confused about time, places and people? Are you concerned for dad's safety at home - for example have you found the gas left on the kitchen? Do you struggle to cope with some of the behaviours your parent is displaying?

  • Needing socialisation/companionship. 

Are you aware that mum is going out less and less as her circle of friends is decreasing? Is the frequency of telephone calls from your parent beginning to have an adverse effect on your life and relationships? Has dad lost interest in the pastimes and pursuits that used to fill his life?

  • Needing support with continence management. 

Despite what many under the age of 60 might say, incontinence is not a part of natural ageing! Have you started to notice the odour of urine around your parent? Have you spotted clothes tucked away following 'accidents'? Do you think your parent would benefit from professional continence management? 

Some might argue that there is a seventh factor to consider - that of needing specialist nursing care/intervention (believe it or not, although there are lots of ‘Nursing Homes’, very few seniors actually need the routine intervention of a trained nurse as part of their care). This is a very individual-specific factor and your parent's medical history may mean that limited intervention by a trained nurse is necessary - in most cases a District Nurse can meet this need. For example, a dressing might need to be changed or an injection given. While these might be medically important, the foregoing other 6 factors will normally have a greater impact on the quality of life that a senior leads as they begin to need care and support.

So, if any of this resonates with you, I'd encourage you to use this simple six-point checklist to guide you to answer the question 'does my parent needs care, and if so, what type of care'? Let me know if it helps!

David Lloyd
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