Deciding whether to intervene in a parent's life is difficult.

The emotional bonds of love and respect are immensely strong – the historic relationship of parent and child makes conversations about care and support complicated. Most conversations around help to stay at home end with "I'm fine; I'm coping very well thank you."

You may have had wonderful past discussions with your mum about options for the future including moving in with your family when she no longer feels safe at home. That may have been some time ago but now she's refusing to leave her home for your house or to move into an assisted living facility. She says to you, "I'm staying right here in my own home until something happens that proves I need to move". You're thinking something has already happened: she keeps losing weight, isn't always clean, and doesn't seem interested in activities with her friends anymore. How do you know if she's tired and eats less because she's 85 or because she needs help but won't ask for it?

Changes are expected and acceptable as we age; intervention is necessary when the changes are unexpected and unacceptable. The problem is, in most cases, that it is all left to the last minute. Conversations about the future and options to help manage aging are hard to have. The result is that most families only look for help when something bad happens. A fall, or a diagnosis, or the onset of dementia most often act as a trigger for the family to intervene – but by then it is often too late. When your mum is in hospital and medical advice is that she cannot return home, options become very limited – and expensive.

These guidelines can help judge if your parent is at risk or safe and enjoying their quality of life, even if their way of doing things differs from what you'd like/expect them to do:

• We would expect an 85-year-old to have less energy than a 75-year-old. However, losing interest in the family she loves would be unexpected.
• If mum's been ill or is frail, we would expect her social life to diminish. If she's been active and is suddenly too weak or tired to go out, that's unexpected and she's at risk for depression caused by isolation.
• If mum's weight has been steady for years, we would expect her to maintain a similar weight and appetite. A loss of 5+ kgs is unexpected and may be caused by depression, confusion (forgetting to eat); dental problems that cause pain when she eats, or other serious issues.
• If mum's personal hygiene patterns have remained the same for years, we would expect her to continue her grooming. An unexpected change signifies potential problems like cognitive impairment or fear of bathing with no one around to help if she falls.
• Aches and pains in joints may make mum less inclined to get up and about. Exercise may be painful and doing simple tasks like slipping on a jumper become major exercises.
• Reticence to go out shopping or visit a friend, or participate in a once favourite activity points to a lack of confidence. This may be caused by fear of being out alone unaided. Plus the difficulty of using public transport may be a major inhibitor.

These possibilities all point toward you mum or dad needing help. The reality is that these changes need a coordinated response which includes you, your family, the family GP, and your local home care company. Begin with a complete home and medical assessment to determine the cause of these "unexpected & unacceptable" changes.Talk about options to help your mum or Dad stay safely at home for as long as possible. Work at ways of putting back what is missing or things that have stopped happening. Companies like Right at Home can help coordinate all of this.

If your mum or dad is showing these sorts changes – don't leave it to the last minute. Be proactive. A little bit of help can keep people safe and independent in their home - pretty much for ever. Right at Home is a full service care company offering companionship, personal care and skilled nursing services. Call us for a free home care assessment by one of our Registered Nurses on 1300 363 802.