Phase 4: When It Takes OverYour parent is struggling to live safely at home. And the weight of that is falling mostly on you.
There may have been a single turning point. Or it may have felt like lurching from one crisis to the next until, somewhere along the way, you looked up and realised this had become the shape of your life.
Skip to resources for this phaseYour parent is no longer managing at home the way they were.
Whether it is staying safe, taking their medicines or organising meals, the gap between what they need and what they can do independently has widened. They need a lot more help. And you, whether you planned for this or not, are the person providing much of it.
By this phase, you are no longer simply a daughter or a son doing what you can. You are a carent - or perhaps you now identify as a carer - managing a level of care
This is Phase 4 of the Carenting Journey. It is typically shorter than Phase 3, somewhere in the range of one to three years, though every situation is different, and it can be one of the most intensive. You may also be weighing up additional care options, wondering whether staying at home is still the right setting.
The weight of all of this tends to be invisible to the people around you, even as it becomes the organising principle of everything.
What this stage looks like
Your parent's needs have grown significantly, so much so that they would not be safe or well without your help. They may need:
Help with meal preparation: shopping and cooking may no longer be manageable alone and unintended weight loss can be a problem
Assistance with correspondence, bills, phone calls and communications. By Phase 4, managing their own affairs in this way can be challenging even if they keep up appearances
Reminders or even supervision around medication
Help navigating the home safely: stairs might be almost impossible, stepping in and out of the bath is getting dangerous, grab rails, raised seats or even commodes are needed
Falls can be more common at this stage and hospital admissions for accidents, infections and other illnesses may happen. Managing finances has become too complex or too risky to do independently. Technology, including phones, banking apps and any digital process, may become a significant barrier. Scams remain a real risk.
If dementia is part of the picture
By Phase 4, it is less likely to be just memory loss that defines the day-to-day, and there might be some behavioural or psychological symptoms such as paranoia, strange or suspicious ideas, unusual behaviours, wandering, sleep disturbance, agitation and anxiety.
Supporting someone experiencing these symptoms can be exhausting in a particular way, and can be difficult to describe to people who have not seen it.
Practically at home
- The majority of outside activities are no longer possible without help, they might be relatively housebound without helpful drivers, public transport is no longer feasible
- Household tasks, including laundry, cleaning, cooking, can be difficult to manage alone
- Cold homes and winter safety carry real risk as do heatwaves and seasonal changes
- Loneliness and isolation can be a problem
What is happening for you
This is the phase that is hardest to explain to people who are not living it.
What many carents describe is that it can feel like lurching from one difficult thing to the next, without time to settle in between, and without anyone on the outside quite seeing the scale of it.
This is also the always on phase.
Always wondering. Always checking and always braced for the next phone call.
Getting away, holidays, work can become more challenging to fit in.
If you are managing children as well as your carenting, often called sandwich carenting, you may be feeling the full weight of that now. Torn between your parent and your family, and possibly a job that is becoming harder to sustain. Your bandwidth is most likely depleting and there may be less time for self-care (and not much appetite for it either).
The identity loss that many carents describe in Phase 4 is real. It tends to happen gradually, without a clear moment of change. Plans are cancelled. Friendships require more effort than you have. The things you used to do for yourself move to the bottom of a list that never gets short enough to reach them.
Carent loneliness is part of this too, even for carents who are surrounded by people. Friends might not understand the scale of your problems. Siblings may not be sharing the load equally, or at all. If you are an only child, or doing this without a partner, the isolation can be acute.
Some carents find themselves drinking more than they would like, or carrying thoughts they feel guilty about having.
That does not make you a bad person. It makes you someone who has been carrying too much for too long.
Almost everyone in Phase 4 feels invisible, unsupported, and as though the people around them do not understand what they are managing. Many feel guilty. You may also be carrying significant decisions about your parent's future, and the sadness and weight that comes with them.
Whether the current arrangement is sustainable.
Whether care at home is still the right setting.
Whether raising the question of a care home means you are giving up on them.
Perhaps they should move in with you?
What tends to help at this stage
Formal care, not as a last resort
Home care, live-in care and respite care are not admissions of failure. At Phase 4, the level of support needed is more than most family carents can or should sustain alone. A care agency, even for a few hours a week, changes what is possible for everyone and being safe at home is priceless.
Getting a formal assessment
A social care needs assessment for your parent, a financial assessment for them, and a carer's assessment for you are all worth requesting if they have not happened already. These can open doors to funded support. If you are employed and work is becoming difficult, an employment support package may be available - it is worth speaking to your manager or HR if you have not done so already.
Respite care
You are allowed to rest. Respite care, whether a day service, a short residential stay or regular sitting, is part of how this remains sustainable. Many carents in Phase 4 feel guilt about taking it. It is worth taking anyway.
Thinking seriously about the care home question
If it has started to feel like a question, it is worth exploring the options - not because a decision has to be made, but because having the information makes any future decision less fraught.
Safety at home
At this stage, the right equipment and home modifications can reduce risk and change the daily reality significantly. Falls alarms, monitors, stairlifts, key safes, locking cooker valves and cameras are all worth considering if they are not already in place.
Connection for your parent
Befriending services, day centres and anything that creates social contact outside the home matters more at this stage, not less. Loneliness is a health risk as well as an emotional one.
If dementia is a factor
Contacting the Admiral Nurses for advice and support can be invaluable, alongside modifying the home to make it safer and easier to navigate.
The Carents Lounge
Phase 4 is the phase where connection with other carents matters most. The people in the Lounge understand this phase from the inside.
Resources for where you are right now
Care and support
Safety at home
Personal care and daily living
Health
Legal and financial
For you
- BurnoutRecognising the signs and taking action
- Understanding Loneliness as a Carent
- Still You PackFor carents who have lost track of themselves underneath everything
- What to Do When Siblings Won't Help
- Carents LoungePeer support from carents who understand this phase
- Support at work
- Support from the NHS
- Support from your council
Free download
The Still You Pack
For carents who have lost track of themselves underneath everything.
Did you find this information helpful? Let us know what you think or pass on some advice to other carents by emailing us at hello@thecarentsroom.com