10 Signs Your Loved One May Need a Care Home
Sometimes the need for a care home develops gradually. These ten signs can help you recognise when someone’s current care arrangements may no longer be meeting their needs safely or sustainably.
Knowing when a loved one may need a care home is one of the most difficult decisions a family can face.
There is rarely one dramatic moment that provides a clear answer. More often, several smaller changes begin to appear: increasing falls, missed medication, difficulty managing personal care, disturbed nights or a family carer who is simply running out of capacity.
None of these signs automatically means that someone needs residential care. They are reasons to stop and reassess the situation.
The strongest indication that a care arrangement needs to change is usually the combination of increasing needs, increasing risk and increasing pressure on those providing support.
1They are struggling with everyday personal care
Washing, dressing, toileting and maintaining personal hygiene can become increasingly difficult as someone becomes frailer or develops cognitive or physical problems.
If they now require substantial assistance with several aspects of personal care, it may be time to review whether their current support is enough.
2They are falling more often
Falls are not simply an inconvenience. Repeated falls can indicate that someone is no longer moving around safely in their current environment.
Look at what happens after a fall too. Can they get themselves up? Can they summon help? Are they becoming frightened about moving around?
3Medication is becoming difficult to manage
Missed doses, taking medication twice, confusion about what each medicine is for or difficulty administering medicines safely can all indicate that additional support is needed.
Medication problems should be discussed with the appropriate healthcare professional, but they can also be an important part of the wider care picture.
4They are becoming unsafe when left alone
Perhaps they leave doors unlocked, forget cooking appliances, wander outside, become confused about where they are or cannot respond appropriately to an emergency.
One event does not necessarily mean residential care is required. A pattern of unsafe incidents, however, should not be ignored.
5They need help throughout the night
Night-time needs are often a major turning point for families.
If someone needs repeated assistance with toileting, repositioning, medication, reassurance or supervision, the impact on the person and their carer can be considerable.
6They need more care than home visits can provide
Home care can be extremely effective, but it has limits.
If the person needs supervision or assistance between scheduled visits, the family may be filling those gaps. As needs increase, those gaps can become increasingly difficult to manage.
Read When Is Home Care No Longer Enough? for a more detailed look at this point.
7They are losing weight, becoming dehydrated or struggling to eat
Changes in eating and drinking can have many causes and should be discussed with healthcare professionals.
From a care perspective, however, needing prompting, assistance, supervision or specialist support with nutrition and hydration can significantly increase the level of care required.
8Dementia or confusion is making life at home harder
Someone living with dementia may remain physically capable while becoming increasingly unable to manage safely on their own.
Changes in memory, orientation, behaviour, communication, continence or ability to recognise danger can all affect whether the current home-care arrangement remains suitable.
Explore the wider Carentis dementia resources for more guidance.
9The family carer is exhausted
This is one of the most important signs and one of the easiest to overlook.
If a spouse, son, daughter or other relative is providing increasingly intensive care, sleeping badly, taking time away from work or becoming physically and emotionally exhausted, the sustainability of the arrangement needs to be considered.
Needing more support is not a failure by the family.
10The person repeatedly reaches a crisis point
Repeated falls, hospital admissions, emergency calls, carer breakdowns or sudden increases in care needs can indicate that the current arrangement is being stretched beyond what it can safely provide.
Ideally, decisions about care homes should be made before a crisis. But even after a crisis, it is important to step back and consider the underlying reasons rather than simply finding the quickest available placement.
Do these signs mean someone definitely needs a care home?
No.
There may be ways of increasing support at home, adapting the environment, introducing equipment or changing the care package.
The question is whether those alternatives can realistically meet the person’s needs.
You should also consider whether the person needs residential care or nursing care.
What should you do if several signs apply?
Start by documenting what is actually happening.
- What care does the person need each day?
- How often are they unsafe?
- How much care is the family providing?
- What happens overnight?
- How much professional care is already in place?
- What has changed recently?
- Could the current arrangement cope if needs increased further?
This information will help you have a more useful conversation with social care, healthcare professionals and potential care providers.
Not sure whether a care home is appropriate?
Use the free Carentis Care Home Finder to work through the person’s needs and identify the type of care setting worth exploring.
If a care home is becoming likely
Don’t wait until you have to choose a home in an emergency.
Start learning what to look for, what questions to ask and how different homes compare.
Our detailed guide explains how to choose a care home, while the Carentis care-home guide and checklist can help you compare homes objectively.
What about funding?
Funding depends on the person’s circumstances and the type of care they need.
Do not assume that having savings or owning a home automatically means the NHS cannot fund care. Where significant health needs exist, NHS Continuing Healthcare may be relevant.
Understanding funding early can prevent families from making expensive assumptions before an assessment has taken place.