Even if you’ve been keeping up fairly well with your parents’ aging so far, bringing in whatever senior support services your mother or father has needed to stay at home, you may still worry that it just isn’t enough.

And you may be right.

Of course, you want your parents to be able to remain in their own home for as long as possible, but homemaker and personal care services can only do so much. There may come a time when it is simply no longer safe or prudent for a parent to live alone. Not even a visiting nurse can ensure that life-threatening incidents like falls, medication errors and significant medical events never occur.

So, take steps toward a healthier future for your parents and learn to identify the signs that the home may be becoming an unsafe or unhealthy environment.

Get into the habit of measuring your parent’s condition and needs against the level of care in-home services can provide. Discuss your parent’s abilities with others— such as doctors, neighbors, and other family members—who may be able to spot signs you cannot see. Collect a variety of perspectives to determine whether your parents need a higher level of professional medical care than can be received at home.

Big Picture Signs

There a number of red flags such as recent accidents or falls, worsening chronic health problems, and slow recovery from everyday illnesses that can be a good indicator that it’s time to consider skilled nursing care.

See if you can schedule a time to speak with your parents’ primary care physician about such red flags. Consult with in-home care providers to learn more about your parents’ ability to take medicine, participate in therapy, and seek help for a medical problem.

Be alert for signs that one of your parents has trouble managing the activities of daily living including dressing, cooking, and personal hygiene. Talk to your parent’s current in-home aides, registered nurses, or therapists to find out if your mother or father has had increasing trouble performing these daily duties even with the assistance of their in-home senior support services.

Personal Signs

When you give your mother or father a big hug the next time you see them, you may notice a few physical signs of declining health or poor in-home care.

1. Noticeable weight loss or weight gain otherwise hidden under clothing.

Mom may be losing weight if she has trouble cooking or eating. Conversely, unexplained weight gain may indicate malnutrition from poor food choices, medication problems or a worsening medical condition.

2. Strong or unusual body odors.

Strong body odor can indicate your parent is having trouble keeping up with personal hygiene. Hair, clothes, makeup and personal habits, like shaving, are good indicators of your parent’s ability to bathe and launder clothing.

3. Unsteadiness or trouble getting around.

Watch how your parent rises from a chair and compare her stability to the last time you saw her. Increasing unsteadiness can indicate a new or worsening medical condition. Unsteadiness can lead to falls and fractures, which makes it unsafe for your parent to be home alone for any length of time.

Medical Signs

Look for signs that one of your parents has a medical condition that may be an obstacle to safe aging-in-place—especially if the possibility of residential care is brought up by your parents’ physician. Even with skilled home health care, some medical conditions can make it all but impossible for your parent to stay at home safely.

The later stages of Alzheimer’s disease, for example, has life-impairing behavioral issues like angry outbursts and paranoia and can progress to the point where your parents will lash violently out at others or become unable to perform basic functions like feeding and dressing.

And a confused parent may wander off and get lost or injured.

Short of fortifying your parent’s house like a prison and hiring someone to watch your mother or father every minute of the day, in-home care cannot adequately protect your parent from wandering.

The senior support services at a retirement home or a skilled nursing facility will be able to offer a safer environment and more concentrated care, typically at a lower cost to you, so talk to your parent openly about the possibilities of residential care as soon as you determine that current in-home care is inadequate for her needs.