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7 Signs It Might Be Time for a Nursing Home

NHC

Nursing Home Care

February 9, 20268 min read

Nobody wants to have this conversation. The thought of moving your mom or dad to a nursing home feels like you're giving up, like you're failing them somehow. I get it.

But here's the thing: ignoring the warning signs doesn't make them go away. It just makes things more dangerous—for them and for you.

So let's talk honestly about when home care stops being enough.

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1. They're Falling. A Lot.

One fall? That happens. Two falls in a month? Concerning. Three or more? That's a pattern, and patterns mean something's seriously wrong.

Falls are the leading cause of injury and death in older adults. If your loved one is falling frequently, their environment isn't safe anymore—or their body can't handle daily activities.

Red flags:

  • Multiple falls in a short time
  • They can't get up on their own
  • They're falling during simple activities (getting out of bed, walking to the bathroom)
  • Previous falls resulted in injury (broken bones, head trauma)
  • You can't watch them 24/7. And even if you could, that's not sustainable for either of you.

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    2. They're Not Taking Their Medications Correctly

    Missed doses. Double doses. Taking the wrong pills. Finding medications scattered around the house or weeks-old pill bottles still full.

    When someone can't manage their medications, bad things happen—hospitalizations, worsening conditions, dangerous drug interactions.

    What to look for:

  • Pill organizers are wrong or haven't been touched
  • They can't tell you what their medications are for
  • They've been hospitalized for medication-related issues
  • They're confused about when or how to take pills
  • If medications aren't being managed properly, they need 24/7 supervision from someone who knows what they're doing.

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    3. Personal Hygiene Has Completely Fallen Apart

    We're not talking about wearing the same shirt two days in a row. We're talking about:

  • Not bathing for weeks
  • Wearing dirty or urine-soaked clothes
  • Severe body odor
  • Unwashed hair that's matted
  • Long, dirty nails
  • Not brushing teeth (or losing dentures entirely)
  • This isn't laziness or stubbornness. It's usually a sign of cognitive decline, depression, or physical inability to complete these tasks.

    If they can't (or won't) stay clean, they're at risk for infections, skin breakdown, and social isolation.

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    4. The House is Dangerous or Filthy

    Walk into their home. Really look around.

    Are there:

  • Piles of mail, newspapers, or trash?
  • Spoiled food in the fridge?
  • Dirty dishes piled up for days or weeks?
  • Unopened bills and late payment notices?
  • A smell of urine or feces?
  • Clutter creating tripping hazards?
  • When someone can't maintain their living space, it's not about being a bad housekeeper. It's a cognitive or physical decline issue.

    Warning signs of self-neglect:

  • Severe hoarding behavior
  • No working heat or AC
  • Pest infestations (rodents, roaches)
  • Utilities being shut off for non-payment
  • Animal neglect (if they have pets)
  • ---

    5. You (The Caregiver) Are Completely Burned Out

    Let's talk about you for a second.

    Are you:

  • Exhausted all the time?
  • Skipping your own doctor appointments?
  • Losing your temper more easily?
  • Feeling resentful toward your loved one?
  • Neglecting your spouse, kids, or job?
  • Thinking "I can't do this anymore"?
  • Caregiver burnout is real, and it's dangerous. You can't pour from an empty cup. If you collapse, who takes care of them?

    There's no shame in admitting you need help. In fact, recognizing your limits is one of the most responsible things you can do.

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    6. They're Wandering or Getting Lost

    For people with dementia, wandering is terrifying—for them and for you.

    Serious warning signs:

  • They've left the house and gotten lost
  • They don't recognize their own neighborhood
  • Police have brought them home
  • They've been found wandering at night
  • They try to "go home" even though they're already home
  • Wandering isn't just inconvenient—it's deadly. People with dementia can die from exposure, dehydration, or getting hit by cars.

    If they're wandering, they need a secure environment with staff who are trained to manage it.

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    7. Medical Needs Have Become Too Complex

    Some people reach a point where their care needs exceed what family or home health aides can provide.

    Signs medical care is too complex for home:

  • They need wound care for bedsores or surgical wounds
  • They have a feeding tube, catheter, or other medical equipment
  • They need frequent monitoring (blood sugar, blood pressure, oxygen levels)
  • They've been hospitalized multiple times in recent months
  • Their doctor has recommended 24/7 nursing care
  • Skilled nursing facilities have nurses on staff around the clock. They can handle complex medical needs that families simply can't manage at home.

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    What to Do If You See These Signs

    1. Talk to their doctor. Be honest about what's happening at home. Doctors can assess whether nursing home care is medically necessary.

    2. Tour facilities now. Don't wait for a crisis. Visit 3-5 nursing homes and get a feel for them. Have the conversation before you're forced to make a decision under pressure.

    3. Understand the financials. Talk to an elder law attorney or Medicaid planner. Know what you can afford and what help is available.

    4. Have the conversation. Yes, it'll be hard. But avoiding it doesn't make it easier—it just delays the inevitable. Be honest, compassionate, and firm.

    5. Stop feeling guilty. You're not abandoning them. You're making sure they're safe, clean, and getting the care they need. That's love, not failure.

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    The Bottom Line

    Nursing homes exist for a reason—because sometimes, love and good intentions aren't enough.

    If you're seeing multiple signs on this list, it's time to have the hard conversation. Waiting until there's a crisis (a bad fall, a hospitalization, a fire) doesn't make it easier. It makes it worse.

    You're not giving up. You're doing what's best for them—and for you.

    Tags
    #Decision Making#Safety#Family Caregiving
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