Ask the Expert: The Care Decision

Ashley Seace, Care Management Associate –


I have noticed that my parent is starting to exhibit a noticeable decline both physically and cognitively. I’m not sure how to proceed. What are some things to look for while deciding what I should do about their care; can you advise?


This is an important question. It’s also a question that doesn’t have the same answer for everyone. Knowing how to proceed with a loved one’s care is a personalized decision that everyone involved with the care should discuss. The biggest thing to know is that you have options. This could mean that it is safer and more financially feasible to move your loved one into an assisted living or memory care facility. It could also mean that you keep your loved one at home and employ at-home care. There are some questions you could ask yourself when having these tough conversations to help clarify options and find the best answers for your family and situation. Let’s walk through them together!

How is your loved one managing self-care? Think about their hygiene, how they are dressing themselves, and what their outward appearance is. What is the state of their home, and how are they maintaining it? If you find them exhibiting poor self-care and the home is falling into disarray, then you may want to consider an increased amount of care.

Are there signs of memory loss? Is there a significant amount of confusion that can lead to them being in a position of danger? It is important to notice if they are having difficulty remembering well-known people or places, getting lost frequently, or struggling with following instructions. Has your loved one missed medication doses? This is another sign to look for to see how they are doing cognitively, particularly if they were great about taking their medications before. If you find that they are repeatedly getting lost in familiar places, then you need to also consider their safety behind the wheel of a car. As they decline physically and mentally, they are going to experience slowed reflexes, diminished vision and hearing, and increased confusion, making driving unsafe.

How is the home and living space set up? If the home is cluttered with loose rugs, exposed electrical cords, and poor lighting, the home is not safe for them to live in. Consider if there are challenges regarding the use of stairs, as well as if there are things out of reach for them. If they attempt to reach an upper shelf in a cabinet, this could put them at risk for a fall. When they are walking and moving about, do you notice they are stiffer, weaker, have balance problems, or joint pain? These things can affect someone’s gait making them at greater risk of a fall. Falling is the primary cause of disability in older adults, so if there are any concerns with their walking or increased difficulty, they should be addressed immediately. Helping loved ones prevent a fall is important.

What about mood and social participation? If there is a sudden change in mood, this could be an indicator for clinical depression. If they are not maintaining social activity, your loved one could be isolating themselves and experiencing depression as result. Check in on their social participation to see if they are maintaining hobbies and friendships.

Have you noticed any weight loss? Unexpected weight loss can be contributed to several things such as issues with cooking, loss of taste or smell, socioeconomic issues, or other health conditions causing loss of appetite. This can also relate to their memory loss where they think they have been eating but have actually missed several meals.

Navigating the aging process is a challenge, especially if you are doing it alone. Hiring a geriatric care manager can help to alleviate some of the stress. Care managers can provide you with guidance for making the best decision for your loved one. We look at things as an entirety, so we can help you understand what you can and cannot afford, as well as what does your loved one wants as they age.

Every family is different, so deciding how to care for your loved one will vary. This will be impacted by finances and social support. There is no magic reason for placement in a facility or for increased care in the home. Sometimes it takes a crisis to decide how to move forward, but planning is important and could prevent a future crisis. If your answer is yes to multiple questions above, then it is time to create a plan for their care.

Find peace of mind when it comes to the care of your loved one, contact our team at CaregiverNC online or call us directly at (910) 692-0683 today! 

Ask the Expert: The Care Decision was last modified: June 21st, 2023 by Sprout Media Lab Testing