Why changes in care needs occur
Change is a natural part of life and growing older. A person’s physical health, such as their eyesight, hearing or mobility, may deteriorate over time. A person’s memory may also deteriorate as they get older, which could lead to them needing help.
Older people can also be more susceptible to illnesses and accidents, such as falls. Changes might be permanent or temporary. They might happen suddenly or very gradually over time. As your loved one’s health changes, they might need different levels of care and support.
A gradual decline
More often than not, changes in physical or mental health will happen very slowly. Your loved one’s mental health might deteriorate gradually due to old age or the slow onset of a condition such as Alzheimer’s (see our guide to the stages of dementia). In these cases, it can be difficult to spot that their care needs have changed, especially when you see them on a regular basis.
You might realise that the person you’re caring for is less mobile than they used to be, or that they are finding it more difficult to do everyday things. Because changes have happened gradually, it might take you both some time to identify there is a problem that needs addressing. However, this should give you more time to research and plan appropriate care.
A sudden decline
If your loved one suffers from an unexpected illness or injury – such as a stroke or a fall – the change in their mental or physical health might be sudden. They might struggle to carry out certain tasks that they managed without a problem the week before, or they might not be able to get around at all. For information on dealing with emergencies that result in your loved one going to hospital, see hospital admissions and discharge.
In these circumstances, it will be obvious that your loved one’s needs have changed and that they need a different level of help or support. You might need to take action quickly to get the right care in place.
Preparing for the future
As care needs often change over time, it’s a good idea to think about the future when making plans for a loved one’s care. Try to think ahead and keep your options open by choosing care options that can be changed without too much difficulty. For example, if considering a move into sheltered housing, you might choose a place that offers the option of extra care, so that it’s easier for personal care to be accessed in the event that it is needed in the future.
Alternatively, if you’re choosing a care home that offers personal care, consider one that also offers a higher level of nursing care, so that this option is available later on without them having to move. Of course, this level of choice won’t always be available, but it’s worth bearing in mind.
But don’t forget that the local authority will only fund current and eligible needs, so if there are any additional costs associated with these choices, your loved one would have to fund them privately.
Advance care planning
Your friend or relative might find it helpful to put their wishes for future care in writing. This can give them the peace of mind of knowing their wishes will be recognised and respected, even if they lose the capacity to make decisions about their own care in the future.
Advance care planning is the process of deciding how you would like to be cared for at the end of your life, and communicating those plans to others around you. There are a number of ways that you can record your wishes.
For example, you can record general preferences about how you’d like to be cared for in an advance statement. This can include information about where you would like to be cared for, who should be consulted about your care, or other personal preferences, such as religious or dietary choices.
An advance decision to refuse treatment (often known as a living will) is a legally binding way to tell people about specific medical treatments that you don’t want to receive in the future. It will be used if you’re unable to make or communicate decisions for yourself.
Read more about planning ahead for the final stages of life in our guide to End of life care planning.
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A needs assessment is key to getting the support you need. You have a right to this assessment and it's free of charge.