Signals To Look For

The following are signs that it is time to discuss long-term care.

Isolation/Depression

  • Is your loved one isolated from social contact? 
  • Are his or her sleeping habits, eating habits or activity levels changing?

Daily Activities/Eating Habits

  • Is your loved one having a difficult time walking, dressing or eating?

Bruises/Falls

  • Has there been an increased susceptibility to falling and bruising?

Cognitive Ability

  • Is your loved one’s mental reasoning ability at a level where his or her personal safety and the safety of others is at risk?

Increasing Medical Needs

  • Does your loved one need medical care that you or he or she cannot provide?
  • Does your loved one’s medication needs to be increased?
  • Does he or she need more and more help taking medications?
  • Does he or she use medical equipment like an oxygen tank or need daily or weekly treatments like dialysis? 
  • Is your loved one in need of rehabilitative care?

Caregiver Burnout

  • Is a family caregiver exhausted due to the amount of care your loved one needs?

Medication Errors/Missed Doctor’s Appointments

  • Is your loved one mixing up medications, taking them incorrectly or not taking them at all?
  • Is your loved one keeping his or her doctor’s appointments?

Household Management

  • Can your loved one still manage the components of running a household, such as keeping a checkbook or paying bills?
  • Is there a dramatic change in how the house is kept?

The following questions can guide you in making the decision. If the answer to any question is "no," it may no longer be possible for the senior to be left alone, even for a short period of time. Instead, moving into an assisted living facility may be appropriate.

  • Do they understand how to leave the home if necessary? Do they know where the door is located and how to exit the building? 
  • Will they stay home or near the house rather than wander off? 
  • If they go outside, do they know where they live and how to get back inside? 
  • Can they identify signals, such as smoke from the kitchen or fire alarms, that would alert them to potential dangers? 
  • Do they know how to access emergency services? Do they know how and when to dial 911? Would they be able to communicate over the phone? Can they physically get to a phone no matter where they are? 
  • Do they have frequent life-threatening medical emergencies that require immediate intervention? Do they know where any medication they might need is located? Can they reach it? Do they have the capacity to select the right medicines in the correct amounts? 
  • Do they have the judgment to identify who they should and should not let into the home? Will they know to allow family, friends and emergency personnel into the home? 
  • Can they prepare themselves something to eat if they get hungry? Do they know how to use the stove, and will they remember to turn it off? 
  • Can they get to the bathroom and use the toilet on their own? If not, have alternatives been worked out? 
  • Are they afraid to be alone for an hour or more? Do they become clingy when caregivers depart and make frequent telephone calls if they are alone?


If you decide that it is still safe to leave your senior at home alone, you should regularly reassess the situation. Caregiving is a dynamic process, you need to be aware of any and all changes in the elderly person's condition and abilities. Even if you think they can be left home by themselves, if they fear being alone, it could be a sign that at some level they know they are not capable of coping with any emergencies that might arise.