Addressing the topic of in home care with an older friend or family member can be a sensitive matter. Frequently, there are hesitations and barriers that make these conversations challenging. Often the older person is embarrassed to admit they need help or may not be able to see that their quality of home life is in decline.

Recognise the signs

Recognising the signs that an older person may be struggling to care for themselves at home is crucial to protect their well-being. Here are some common signs to look for:

1. Physical Decline

  • Difficulty moving around, unsteady gait, or frequent falls.
  • Neglect of personal grooming, infrequent bathing, or issues with oral care.
  • Noticeable weight loss due to challenges with meal preparation or eating.

2. Cognitive Decline

  • Difficulty remembering important tasks, appointments, or medications.
  • Disorientation about time, place, or people.
  • Struggles with handling bills, managing accounts, or understanding financial matters.

3. Changes in Living Environment

  • Noticeable decline in housekeeping, including dirty dishes, laundry piling up, or clutter.
  • If there’s a garden, it might become overgrown or neglected.
  • Smells that indicate poor sanitation or spoiled food.

4. Social Withdrawal

  • A sudden or gradual withdrawal from social activities or contact with friends and family.
  • Disinterest in hobbies or activities they once enjoyed.

5. Medical Issues

  • Evidence of missed doses or mismanagement of medications.
  • Signs of falls or accidents that haven’t been addressed.

6. Communication Difficulties

  • Difficulty expressing basic needs or understanding instructions.
  • Slurred speech or difficulty forming sentences.

7. Emotional Changes

  • Unexplained shifts in mood or expressions of sadness, anxiety, or fear.
  • Withdrawal, changes in appetite, or disruptions in sleep patterns.

8. Inability to Perform Daily Tasks

  • Evidence of burned pots, uncooked food, or spoiled groceries.
  • Unopened mail, unpaid bills, or evidence of financial mismanagement.

Refer also: Stop and Watch Tool

So, what should you do if you notice these signs?

If you notice these signs, it’s important to approach the situation with sensitivity and discuss the possibility of in-home assistance or other forms of support. It’s important the older person feels supported during these conversations. Often it can take multiple discussions before a decision is made.

Approaching the home care discussion with empathy and understanding can open doors to valuable support that will ultimately improve their quality of life and keep them living at home for longer.

Understanding hesitations

Fear of Loss of Independence

For many older people the fear of losing independence is deeply rooted in the desire to lead a self-directed life. The concern often revolves around the perceived loss of control over personal decisions and lifestyle choices. It is important to note that accepting help also means accepting that they have moved into a new stage of their life.

This fear often stems from a lack of knowledge regarding the options available, with many older people associating home care with more traditional models of aged care (think live in aged care facilities or traditional home care providers who provide services based on what they have available, not what the person receiving assistance needs). Imagine a depressing nursing home, with boring food and nothing to do.

To the contrary a home care package (especially when the choice is made to self-manage) can enhance one’s independence and provide extensive choice and control over who comes into their home and what services are provided.

To help address fear of loss of independence:

  1. Express empathy: Acknowledge their independence and reassure them that a home care package is designed to enhance, not replace, their autonomy.
  2. Highlight control: Emphasise that they can remain in control of their decisions, choosing the services that align with their preferences and unique needs.

Stigma Surrounding Age-Related Support

The stigma surrounding age-related support stems from societal perceptions that seeking assistance implies a loss of capability or self-sufficiency. Overcoming this stigma involves normalising the idea that seeking support is a proactive and sensible choice that empowers individuals to age on their terms.

To help address stigma:

  1. Normalise the conversation: Discussing home care is a natural part of aging. Emphasise that many individuals opt for these services to maintain their lifestyle and ensure they’re able to live at home for as long as possible.
  2. Share positive stories: Provide examples of people who have benefited from a home care package, emphasising their increased sense of security, independence, and well-being.

Concerns About Affordability

Affordability concerns are grounded in uncertainties about the financial implications of in home care. Many fear that quality support might be financially out of reach.

To help address concerns about affordability:

  1. Clarify financial aspects: Explain in simple terms what financial assistance may be available. Encourage them to register for an ACAT assessment which is the first step in determining a) home care package eligibility b) any fees they may have to pay and c) how much the government will contribute. Let them know there is no harm in having an assessment, they can always decide not to proceed after assessing the pros and cons.
  2. Outline cost-effectiveness: Illustrate how a home care package can be more affordable than alternative options, such as residential care.

Tips for Initiating the Conversation

1. Choose the Right Setting

  • Opt for a comfortable environment where they feel secure and relaxed.
  • Ensure privacy to allow an open and honest discussion.
  • Consider who is best to ‘have the conversation’ – think about who the person respects or is likely to listen to most (perhaps a family member with a health background, a close friend, or their local GP who they like and trust).
  • If you are the conversation instigator rather than sitting down for a formal chat, raise the topic more informally when talking about something related or when doing an activity together.

2. Use Gentle Language

  • Frame the conversation positively, focusing on enhancing their current lifestyle.
  • Avoid ultimatums or language that may induce fear or anxiety.

3. Highlight the Benefits

  • Emphasise that home support and services will provide them with the opportunity to stay in their own home for longer, surrounded by familiar surroundings.
  • Discuss how tailored services can address specific needs, promoting a healthier and happier life.
  • Reiterate that they will not lose control over their independence.

4. Share Success Stories

  • Share real-life examples where home care packages have significantly improved the lives of others.
  • Highlight the positive outcomes, such as increased social engagement and improved health and general well-being.
  • Offer to connect them with someone receiving a home care package so that they can ask questions and hear firsthand how it can help.

Initiating a conversation about home care packages requires sensitivity, patience, and a commitment to understanding the unique concerns of your older loved one. Be sure to do your homework and understand how home care packages work and the steps to apply for one before talking with your loved one.

By approaching the discussion with empathy, providing clear information, and emphasising the positive impact on their lives, you pave the way for a smoother transition into a supported and independent future.