One week things may seem manageable, and the next week there is a hospital stay, missed medications, unpaid bills, meals not being eaten, a discharge plan, or a phone call that changes everything.
Suddenly, they may feel ill-prepared, unsure, maybe even angry at this sudden escalation of required care.
Maybe there was a fall. Maybe the hospital has announced discharge “tomorrow before 11 AM”. Maybe you opened the refrigerator door and realized your parent has not been eating the way you thought.
The first step is not to solve the next 6 months.
The first step is to slow the situation down enough to understand what is urgent, what can wait, and what kind of help your loved one actually needs.
In an attempt to bring it back, I would ask you to center to today, “What exactly are you seeing that made you call?”….
First, Is Everyone Safe?
If part of you is wondering whether this is an emergency, do not use this article as the deciding factor. Get medical help first and call 911 or your local emergency number.
Safe can be any physical, cognitive or psychiatric emergency.
Don’t second-guess yourself. If you feel it “could be an emergency”, treat it as it is and call 911.
If the situation is a medical question, clarification on medications or dressings, or care, contact the Doctor’s office or clinic, or another appropriate medical contact, such as the patient’s Primary Care Physician or specialist for the respective need in question.
Again, if your gut is telling you this is not just a planning problem, treat it as urgent.
When “Something Changed” Becomes a Caregiving Crisis
Sometimes the first sign is a phone call from a sibling, neighbor, or spouse saying, “Hey, your Mom hasn’t been taking her medicine out of the pill box”, or someone calls and you hear… “something is not right.”
Maybe your parent has been calling you more often – or less. Maybe they are missing appointments, forgetting bills, or sounding confused about things they usually manage well.
The family may not have a name for it yet, but everyone can feel that something has shifted.
It is these subtleties of behavior that can signal to the caregiver that more help is needed.
Most older persons won’t tell you – either they can’t identify what they need, describe it, or will overtly or covertly cover it up.
You may never know if the shift is intentional or not, and it probably really does not matter. You need to recognize it, identify it, and deal with it before it gets worse.
Write Down What Changed
You may not know yet whether your parent needs home care, medical follow-up, transportation, meals, or more family support. That is okay. Start by naming what has changed. I will help you turn these questions into a usable description.
When everything feels urgent, it helps to get the facts out of your head and onto paper.
Start with what you have noticed, even if it feels small. Those details can help you explain the situation more clearly when you call for help.
Let’s look at some examples – but again, you write down in plain words what you observe…
- Are medications being missed or not taken?
- Have there been falls or slips? If there was a fall, especially if you suspect the person may have hit their head, or if there is a deformity or pain, please still seek emergency care to rule out any acute needs.
- Is there a change in the person’s eating or drinking?
- Are bills unpaid or missed?
- Is there new confusion or loss of memory?
- Is the home unsafe, cluttered, or not conducive to preventing falls?
- Are they refusing help, such as aides or home care?
- Is the change sudden, gradual, or both?
- Can the spouse no longer manage care in the home alone?
- Do you feel the person has limited their movement in the home, such as not taking stairs or bathing, due to a possible fear of falls?
- They may have prolonged sitting in a recliner, chair, or couch.
- Is ther person becoming incontinent of bowel or bladder?
You do not need perfect medical words or a diagnosis. Leave that to the professionals. You only need a clear picture of what is different now, how the person is acting, so the medical professional can understand the situation faster and help guide you.
Families often just know something is wrong before they know what to call it. The goal here is not to diagnose the problem. The goal is to describe what you are seeing in plain language.
Gather the Information You Will Be Asked For
The goal here is to make the phone calls easier and reduce repeated scrambling.
If reaching out to any type of medical office or community resource, you will probably need the following:
- Full name and date of birth (most medical clinics can find the patient with these two identifiers)
- Address
- Insurance cards or plan names
- Primary doctor and specialists
- Most Recent Medication List
- Diagnoses or recent changes or hospitalizations, Urgent or Emergency visits
- Emergency contacts – yourself and other family or friends willing to pitch in
- Recent hospital, rehab, or home health information – especially if they were recently discharged.
- Mobility needs – such as canes, walkers, wheelchairs, scooters.
- Memory or communication concern.
This is not busywork. It prevents you from having to recall all the details with each call. You think you will not forget, but you are under a lot of stress, you will. Write it down.
When everything feels urgent, it helps to get the facts out of your head and onto paper. Start with what you have noticed, even if it feels small. Those details can help you explain the situation more clearly when you call for help.
I would recommend keeping a notebook and a folder to keep yourself organized before, during, and after the calls.
Figure Out What Kind of Help Is Actually Needed
The purpose here is to understand that different senior care services and resources solve different problems.
Not every senior service or resource solves the same problem. There are few hole in ones. And, this is where families often feel stuck, especially in our fragmented system.
Often, “we need help” can mean ten different things.
Some examples you might find yourself writing down:
- Do they need help bathing, dressing, meals, errands, or supervision: this points to Home care and personal care and aide services.
- Nursing, therapy, or medical follow-up after illness or hospitalization: Skilled short-term Home Health Care
- Meals, socialization, routine, and daytime structure: senior center or adult day program, Meals on Wheels, companionship care.
- Caregiver relief: respite care
- Unsafe home setup: home modification, care management, or higher level-of-care conversation: Skilled Home Care, Nursing and/or Social Work Case Management
- Insurance, benefits, or legal confusion: benefits and insurance counseling, elder law, or advocacy resource.
Families often confuse home care and skilled home health because, again, the healthcare system does not make it easy!
Home care is usually non-medical help at home. That may mean help with bathing, dressing, meals, light housekeeping, errands, companionship, or supervision.
Home health (skilled) is medical care at home. It is usually ordered by a doctor after an illness, injury, surgery, hospital stay, or rehab stay. It may include nursing, physical therapy, occupational therapy, or speech therapy.
A simple way to think about it is this: home care helps with daily life. Home health helps with medical recovery or skilled medical needs.
Make the First Three Calls
Let’s make a manageable action list!
These are suggested calls based on your observations above. I will kindly warn you that there may be more calls, as you may be referred to another resource or contact person, and that is okay. You will gather information along the way.
- Doctor, nurse line, hospital discharge planner, or rehab social worker if there was a medical event.
- Ask your loved one’s PCP has a Nurse or Social Worker Case Manager that works either in or outside the office. Sometimes these case manager services can be either via the:
- PCPs or specialists’ offices, especially Cancer and Oncology clinics.
- ACO Accountable Care Organization attached through the PCP office
- Case Managers through your loved one’s Insurer. Nurses and Social Workers usually work with all Insurance carriers.
- Local aging services organization or community resource. I would suggest you look up the Local Area on Aging in your county or city. State Elderly resources usually case workers and contact information, can be found on State Websites with a Google search.
- One service category that matches the need, such as home care, adult day, transportation, benefits counseling, or caregiver support.
For Philadelphia services, this may include Philadelphia Corporation for Aging, Senior Centers, Adult Day Programs, Transportation Resources, legal/benefits support, or local directory resources, depending on the situation.
You do not need to call everyone today. Start with the calls most likely to clarify the next step.
Don’t shy away from calling anyone or a service. It is a process, and you never know what resource you may trip over by making those first and subsequent calls!
Do Not Make These Decisions in Panic
Protect yourself from rushed decisions. Panic may push you into decisions that you may not fully understand yet.
You may be rushing if you find yourself:
- Signing with the first provider, especially home care (non-skilled) services, without asking questions.
- Assuming insurance or Medicare covers everything.
- Waiting until discharge day to ask for help, ask questions or express feelings of uncertainty.
- Not asking about backup coverage from other family members.
- Not involving siblings or other family early – let’s get a calendar of shifts and responsibilities!
- Ignoring caregiver burnout. Caregivers need regular breaks and extended respite.
- Choosing any provider based only on who answers the phone first.
Create a 72 Hour Plan
This is when we make the next few days feel more doable, and you as a caregiver more confident
The 72-hour plan should answer:
- Is the person safe tonight?
- Who is checking in?
- Are meals handled?
- Are medications handled? Will someone need to queue the person when and what to take?
- Are appointments or follow-ups scheduled?
- Is transportation arranged?
- Which calls need to happen first?
- What documents need to be gathered for the upcoming calls or follow-up?
- What can wait?
Remember the Caregiver:
Let’s make caregiver support part of the plan, not an afterthought.
The person needing care matters, and so does the person trying to hold the care together. It is very easy for the caregiver to disappear into the list of tasks.
Appointments, medications, meals, phone calls, paperwork, transportation, family updates — it can all start living in one person’s head.
If that person is you, pause for a moment and name that. You are not just “helping out.” You are carrying real responsibility, and the care plan needs to include support for you, too!
Include:
- Caregiving should not become one person’s invisible job.
- Ask for specific help, not general help.
- Keep notes.
- Schedule breaks early.
- Watch for burnout.
- Use checklists or shared calendars.
The person needing care matters, and so does the person trying to hold the care together!
Next Steps
If you are in Philadelphia and trying to understand what kind of senior support may fit your situation, The Caregivers Directory can help you start with local resources, senior centers, home care options, caregiver support, and practical next steps.
*Important Note: The Caregivers Directory provides caregiver-focused information and resource navigation. We do not provide emergency medical services, clinical diagnosis, legal advice, or guaranteed provider matching. Always contact qualified professionals and providers directly to confirm services, eligibility, availability, insurance, pricing, and care needs.
FAQ
Who should I call first when my parent suddenly needs help?
If there is immediate danger, call 911. If the issue is medical but not an emergency, start with their doctor, nurse line, hospital discharge planner, rehab social worker, or urgent care. If the need is ongoing support, contact your local aging services organization and begin identifying the type of help that fits the situation.
What is the difference between home care and home health care?
Home care usually helps with non-medical support such as bathing, dressing, meals, errands, companionship, and supervision. Home health care is skilled care or medical or therapy-based care ordered by a doctor, often after an illness, injury, surgery, or hospitalization.
What if my parent refuses help?
Start with safety and one specific concern instead of trying to solve everything at once. It may help to frame support around independence, recovery, routines, or temporary help after a recent event. If safety is at risk, contact the appropriate medical, legal, or local support resource for guidance.
How do I know if my parent is unsafe at home?
Warning signs can include falls, missed medications, confusion, wandering, poor nutrition, unsafe cooking, unpaid bills, poor hygiene, or difficulty managing bathing, dressing, or mobility. A doctor, discharge planner, care manager, or local aging services organization may help you think through the next step.
What should I do if a hospital discharge is coming soon?
Ask what care is needed at home, what equipment is required, whether home health has been ordered, what medications have changed, who to call if symptoms worsen, and what follow-up appointments are needed. Do not wait until discharge day to ask these questions if you can avoid it.