When is it time to introduce caregiving services to older adults who need help to remain at home? The easiest answer is when caregiving becomes a burden and a disruptive force rather than an expression of love.

One of the biggest challenges facing adult children who need relief from their caregiving role is the opposition of their parents. Older adults want to remain independent as long as possible, do not want to be a burden to their children, and do not want their dignity compromised. Normally, older adults cannot admit the need for caregiving services and frequently cannot comprehend the far-reaching implications for their caregiver children. What is required is advocacy, whereby adult children explain to their parent that caregiving services help maintain independence while providing peace of mind for them. If a parent remains opposed, adult children can offer the prospect of caregiving being an experiment for one month, after which the family will collectively evaluate the benefits of care. Almost invariably, older adults who experience professional caregiving quickly recognize the benefits and are delighted with the results.

Importantly, caregiving services are not restricted to the home. While over 80% of older adults want to remain at home, where the bulk of service is delivered, caregiving is also appropriate to hospitals, independent living facilities, assisted living communities, and nursing homes. Families should understand that even in the best facilities, there is no dedicated one-on-one care unless an external caregiver is introduced. In hospitals there should always be a caregiver at night if the patient is compromised physically or cognitively. Caregiving services are often a requisite to older adults remaining in independent and assisted living communities when personal care needs such as bathing, toileting, and incontinence are in play. In nursing homes caregivers are introduced for companionship, feeding, and to serve as a liaison with staff. In all cases where caregiving is delivered outside the home, it is complementary to, and not independent of, the care responsibility of the facility or senior community.