Caring for an Aging Parent at Home: Safety Checks and Support

Helping an aging parent or loved one stay in their home is incredibly rewarding, but it’s also a challenging undertaking. To assist you with this journey, Ceren Durer, MD, a geriatrician with UnityPoint Health, shares the best strategies for keeping the home safe and preventing unexpected falls. A good first step is understanding the different kinds of professional in-home senior care available to support you and your loved one.

What Is Home Health Care?

Home health care is skilled medical care provided in the home by a licensed professional. To know who qualifies for home health care services, you typically need a doctor’s order and must be considered homebound. If criteria are met, Medicare Part A or B covers home health care, which is a major financial relief for families seeking in-home senior care.

Skilled home health care also includes:

• Durable medical equipment (DME): This can include covering a percentage of the cost for items like wheelchairs, walkers and hospital beds, if ordered by a physician.
• Home health aide services: If the patient is already receiving a skilled service, a home health aide may be covered to assist with personal care, such as bathing, getting dressed and grooming.
• Medical social services: Professionals provide counseling, locate community resources and assist with complex social or emotional concerns related to the patient's condition.
• Occupational therapy (OT): Helps patients regain the ability to perform daily tasks like dressing, bathing and cooking, often involving training on adaptive equipment.
• Patient and caregiver education: Teaching the family and patient how to manage medications, identify signs of a worsening condition and perform necessary care tasks.
• Skilled nursing services: This encompasses many advanced tasks like medication management, giving injections or IV antibiotics, monitoring vital signs for serious conditions (like heart failure or COPD) and changing catheters.
• Speech-language pathology (ST): Assists patients with speech, language, communication and swallowing difficulties, which is often crucial after a stroke.

Program of All-Inclusive Care for the Elderly (PACE)

If a senior wants to remain safely and independently at home for as long as possible, our Program of All-Inclusive Care for the Elderly (PACE) offers a full range of coordinated care. Provided in select communities, PACE offers peace of mind through a dedicated team who manages everything, including primary medical care, medications, in-home support and transportation. To qualify, participants must be age 55 or older and require a nursing facility level of care.

Common Conditions that Need Care at Home

Some conditions require specialized training. One of the most demanding is dementia. Caring for a parent with dementia at home requires patience, specialized safety planning and techniques to manage confusion and agitation. While maintaining the home environment is usually the priority, families often struggle with the difficult decision of when someone with dementia should go into a care home.

"This is usually discussed with a provider when the person's safety or care needs become too great for the family to manage safely at home," Dr. Durer says.

Beyond dementia, many other complex chronic conditions frequently require professional in-home senior care:

• Arthritis and mobility issues: Conditions like severe arthritis can cause chronic pain and stiffness, making basic activities difficult. Home care aides can assist with bathing, dressing and mobility, while physical therapists can provide gentle, targeted exercises.
• Cancer: Seniors undergoing chemotherapy or radiation often need specialized skilled nursing care at home to manage medication side effects, infections, pain and complex wound care.
• Diabetes: Effective management involves consistent blood sugar monitoring, insulin administration and specialized wound care for potential slow-healing sores. Home care professionals help ensure correct medication and diet adherence.
• Heart disease and heart failure: These require careful monitoring of vital signs, medication adherence and lifestyle adjustments. Home health nurses can check for early warning signs of complications, helping prevent hospital readmissions.
• Post-stroke recovery: A stroke can impair mobility, speech and daily function. Home health often includes physical, occupational and speech therapy to help the senior regain function and independence.
• Respiratory conditions: Chronic breathing issues, like chronic obstructive pulmonary disease, require specialized support. Caregivers help manage symptoms, administer oxygen therapy and teach techniques to conserve energy.

Fall Prevention at Home

A sudden trip or stumble is a major concern, making proactive fall prevention essential. To accurately pinpoint risks in your loved one's environment, a formal fall risk assessment is often conducted. Healthcare teams use tools like the Morse Fall Scale — a quick, six-item clinical assessment — to evaluate risks such as a history of falls, balance and mental status. This tool assigns a score (low, moderate or high) that allows caregivers to implement the most effective, targeted safety measures.

Fall prevention for seniors requires practical steps, such as:

• Ensuring stairways are well-lit
• Installing grab bars
• Keeping clutter off the floor
• Removing loose rugs

"This proactive approach saves unnecessary trips to the emergency room," Dr. Durer says.

Exercises for Seniors at Home

Maintaining strong balance and coordination is one of the best ways seniors can prevent falls and stay independent at home. These gentle, evidence-based movements require no special equipment and are excellent for improving leg strength — essential skills for navigating steps and uneven surfaces.

Top 10 Balance Exercises for Seniors at Home

• Ankle circles: Gently rotating the ankles to improve joint mobility and stability, which is essential for quick recovery from a trip.
• Balance walk: Walking along a straight line (like a crack in the floor or a piece of tape) focusing on smooth, deliberate movements.
• Grapevine/crossover steps: Stepping one foot in front of the other, then crossing the back foot behind to improve lateral (side-to-side) stability and coordination.
• Heel raises: Standing and lifting up onto the balls of the feet to strengthen the calves and improve ankle stability.
• Heel-to-toe walk: Placing the heel of the front foot directly in front of the toes of the back foot, which simulates walking on a narrow path and challenges balance.
• Side leg raises: Lifting one leg out to the side while standing straight (often done with support) to strengthen hip and thigh muscles vital for stability.
• Single-leg stance: Standing on one foot while holding onto a chair or wall for support, increasing the time held as balance improves.
• Stand up/sit down: Rising from a chair without using hands to strengthen the leg muscles needed for getting up after a fall.
• Tai chi: Performing slow, gentle, flowing movements that smoothly shift weight from one leg to the other, which is excellent for dynamic balance.
• Toe taps: Tapping the toes of one foot in front and to the side while keeping weight on the standing foot, improving ankle control.

"You don't need a gym — simple, consistent routines can make a huge difference," Dr. Durer says.

Home Maintenance Assistance

Home ownership gets harder with age. Seeking help for seniors in need of home repairs can solve major safety issues like wobbly railings or broken steps before they cause an injury.

"If possible, arranging home cleaning for seniors is also helpful, because it reduces their effort and fatigue while keeping the environment clutter-free to eliminate trip hazards," Dr. Durer says.

"Successfully caring for a senior at home requires a mix of good strategy and external help. You can make a difference right now by focusing on home safety and helping with those gentle balance exercises. But the most important step is always to talk to your doctor. They can determine the right level of support, from home health coverage to a formal fall risk assessment, ensuring your loved one stays safe, healthy and independent," Dr. Durer adds.