Stages of Caregiving

According to statistics Canada, there are 8 million people who are family Caregivers and 80% of those in need of care are suffering from severe Chronic health issues or disability. Most caregivers provide care to Parents. In particular, about half (48%) reported caring for their own Parents or parents-in-law in 2012.

The financial and emotional stress of caring for an ailing parent or loved one is not well-understood even though more family caregivers provide care for a chronically ill, disabled or aged family member or friend during any given year and spend an average of 25 hours per week providing care for their loved one. Would you know enough about your parent or loved one’s situation to determine what level of care they require? This article provides a framework to help you determine the level of care required for an ailing parent.

Stage 1: Independence

Depending on their circumstance, many parents may be able to live on their own and only require occasional help from family and friends. Your parents may indeed be experiencing some of the chronic ailments associated with ageing, but are able to generally take care of themselves. This is a good time to make sure their documentation such as a will, powers of attorney, financial plan, insurance are all up-todate. Encourage them to meet with their financial and legal advisors to make sure that there is sufficient money for the care they may need and to discuss the provisions they have made for funding care.

Stage Circumstance Hours/week Suggested Care Options
Stage 1:
Capable of taking care of themselves, mobile, chronic pain associated with aging, occasional assistance required from caregiver 1 - 10 hrs Informal caregiver (Family/friend)

Stage 2: Interdependence

At the stage of interdependence, your parents may still be living on their own, but requiring more help. They require family or friends to check in on them every day to assist in the many aspects of daily living, including meal preparation, house cleaning, laundry, transportation to doctors’ appointments and grocery shopping. As caring becomes more demanding – a formal caregiver could be considered to alleviate the daily visits depending on your parents’ needs and willingness to hire outside help as well as financial considerations. At this time, it would also be in your parents’ interest to have a capacity assessment to determine their mental health and how capable they are at making decisions regarding their own health and well-being. Reach out to their family doctor to assist in getting a capacity assessment completed for your parent. 

Stage Circumstance Hours/week Suggested Care Options
Stage 2:
Assistance needed for household chores, meal prep, experiencing further pain from health conditions 10 - 20 hrs Formal/informal caregiver

Stage 3: Supportive living

By stage 3, your parent(s) or loved one may be trying to cope with multiple ailments and may be willing to accept outside caregivers who can help with personal care and/or healthcare. Family members are also often heavily involved in helping to find, hire and coordinate formal caregivers (personal support workers, nurses, therapists), while continuing to assist their ailing parent with daily activities. The involvement of formal caregivers, nurses, etc. will open up opportunities for further service care providers in the community that can make daily living easier and less of a challenge.

Your parent(s) may still have a very strong desire to remain on their own and possibly accept the alternative of assisted living residences or retirement homes. Assisted living facilities, options of both private and publically funded, typically offer private or semi-private bedroom accommodations, a dining room, a full activity and recreational program and trained staff who provide direct assistance to residents needing help with basic activities of daily living.

Stage Circumstance Hours/week Suggested
Care Options
Stage 3:
Supportive living
Beginning to have mobility issues, relying on caregiver for assistance, transportation, etc. 20 - 30 hrs Formal/informal caregiver

Stage 4: Complex care

Even with formal caregivers in the home, the level of care needed in stage 4 may be inadequate or too expensive, leading to one crisis after another. Ailing parents at this stage may have difficulty speaking, have poor mobility, and are unable to dress or feed themselves and they could even have signs of Alzheimer’s or dementia. If there are cognitive problems – thinking, memory, impulse control – then close supervision is required, and an assisted long-term care facility may be a safer option for your ailing parent. 

Stage Circumstance Hours/week Suggested Care Options
Stage 4:
Complex care
Having difficulty speaking, poor balance when walking, not eating, physical and mental health diminishing, requiring a variety of treatments and therapies 30 - 40 hrs Formal/informal caregiver

Stage 5: Dependence

Many families are able to recognize when the well-being of both their ailing parent and that of the extended family would be better served by a healthcare facility. With 24-hour institutional health and personal care, most patients often feel safer knowing they have the assistance they need at all hours.

Stage Circumstance Hours/week Suggested Care Options
Stage 5:
Requires constant assistance for daily living; preparing meals, eating, bathing, hygiene, activities, transportation for medical appointments, medical supervision, loss of cognitive ability 40 hrs+ or
24 hrs
Formal caregiver

Given the demands of caregiving – especially at the later stages – the family may not be able to provide the quality and/or quantity of care needed. They may not have the time and space required to incorporate the parent into their home life. Many families will choose not to provide direct care but to use professional services, in or out of the home. Not all aging individuals and their families pass through these five stages. Nor do they pass through all stages at the same pace. But the five family caregiving stages provide a framework for understanding the main needs and issues for parents and their families.