How Do I Know It's Time for In-Home Healthcare? (Part 2) - Elder Care Channel

How Do I Know It’s Time for In-Home Healthcare? (Part 2)

Preceded by Part 1

Memory/Cognition Deficit

The assessment of memory/cognition considers the ability

  • to plan,
  • to adjust to new and familiar routines (including medication regimes),
  • to make safe decisions, and
  • to make basic needs known.

You might want to score the following:

Yes or No Memory Deficiency of Elder Parent
Y Requires consistent and ongoing reminding and assistance with planning
N Requires regular assistance with adjusting to new and/or familiar routines, including medication regimens
Y Requires ongoing supervision to make safe decisions
N Cannot make their needs known.

With regard to your elder parents’ memory, do one of them have any of the following:

If you are not certain but are suspicious of your parent’s appearance of having failing memory, your physician would be the first person to contact so an appropriate assessment could be done.

Nevertheless, these conditions are bound to begin with a “score” of 2 or more, meaning they could likely to require supervision or in-home health care depending on their stage of the disease.

Functional Assessment

  • bathing
  • eating
  • dressing
  • toilet use
  • personal hygiene
  • transferring & mobility

The items on the list above comprise the “Activities of Daily Living”, (or ADL’s). Some of these ADLs involve not just physical disabilities, but impaired judgment or impaired decision-making skills that require constant or frequent direction to them.

Eight IADLs (instrumental activities of daily living) also are frequently cited including:

  • heavy chores
  • light housekeeping
  • phone use
  • money management
  • meal preparation
  • shopping
  • taking medication, and
  • transportation use

Though the decision to get home health care assistance for your elder parents can be very subjective, there could be more objective ways to help your decision.

You can now make a scorecard by tallying the number ADLs and qualifying them by the level of assistance you feel they would need in each deficiency, and how often.

The level of assistance could be graded by:
(1) for supervision only
(2) for some help
(3) for total help

And the frequency by:
(1) rarely
(2) sometimes
(3) always


Yor N

ADL Level of Assistance Needed Frequency Assistance Needed Comments
Y bathing 2 3
Y toilet use 3 1
personal hygiene
Y transferring & mobility (see mobility test below)
heavy chores
light housekeeping
phone use
Y money management 1 1
meal preparation
taking medication
Y transportation use 3 Vision impaired

(Example of functional assessment scorecard)

The above example leaves a total score of 3. But it also points out that the parent considered is especially in need of help with toileting. Continue to learn more about the process of in-home health care.

Continued in Part 3