Mum, Dad or Someone I Care for Needs More Care, What Do I Do Next?
Sometimes there is no neat moment when somebody “needs care”.
Sometimes there is no neat moment when somebody “needs care”.
You may notice Mum is no longer eating properly. Dad has fallen again. A partner with Parkinson’s now needs help at night. Someone with dementia is becoming unsafe alone. A hospital is talking about discharge, or you have simply reached the point where the family cannot keep filling every gap.
When several things are changing at once, it can be difficult to know whether to call the GP, the council, the NHS Continuing Healthcare team, a benefits adviser or somebody else.
The best next step depends on what has changed. You do not need to solve the whole care system today. You need to identify the most urgent problem and open the right door.
If their health has suddenly changed
Start with healthcare.
New confusion, sudden weakness, repeated falls, severe pain, breathing problems, difficulty swallowing, a significant change in mobility or any other new or concerning deterioration may need clinical assessment.
Do not assume that every change is “just old age”, dementia or Parkinson’s.
Depending on severity, the appropriate route may be the GP, NHS 111, the person’s existing clinical team or emergency services. Once an immediate health problem has been assessed, you can then consider what ongoing care needs have changed.
If everyday life is no longer safe or manageable
Contact the local council’s Adult Social Care service and ask for a needs assessment.
This is the route when somebody is struggling with things such as washing, dressing, preparing food, using the toilet, moving around safely, managing at home or being left without supervision.
Describe what actually happens rather than only giving the diagnosis.
“Mum has dementia” is useful background. “Mum has left the gas hob on twice, no longer remembers to eat unless somebody sits with her and is frightened when left alone” tells the assessor why more support may now be needed.
A needs assessment is not an agreement to move into a care home. It is the process for understanding the person’s care and support needs and planning how they might be met.
If you are the person holding everything together
Ask for a carer’s assessment as well.
This is separate from the assessment of the person you care for and is about the effect caring has on your own life.
If you are awake several times a night, reducing work, cancelling your own appointments, physically struggling with lifting, unable to leave the house or simply reaching the point where you cannot continue at the current level, say so.
The NHS describes carer’s assessments as a route to consider support such as breaks from caring, practical help, training and access to local support.
Do not describe yourself as “managing” without explaining what managing currently costs you.
If the person is leaving hospital
Ask what care is expected after discharge before agreeing that the family will simply provide it.
Who will administer medication? Can the person get to the toilet safely? Who is dealing with wounds, mobility, equipment, meals or nighttime needs? Is rehabilitation required? Has Adult Social Care been involved where appropriate?
If the person’s ongoing needs may be primarily health-related, ask whether NHS Continuing Healthcare has been considered.
A discharge date should not turn an unclear care plan into an unpaid family responsibility by default.
If the needs look complex and heavily health-related
Ask whether NHS Continuing Healthcare should be considered.
NHS CHC is a package arranged and funded solely by the NHS for adults assessed as having a primary health need. It is not means-tested.
For most people, consideration begins with the NHS Continuing Healthcare Checklist. A positive Checklist leads to a full assessment; it is not an automatic award.
The useful question is not “Does Dad have dementia?” or “Is Mum ill enough?” It is what care the person actually needs, how intense and complex those needs are, how they interact and how predictable they are.
If you are unsure how to raise CHC, ask a health or social-care professional involved in the person’s care or contact the local Integrated Care Board.
If the person is deteriorating very quickly
Ask specifically about Fast Track NHS Continuing Healthcare.
Fast Track is for somebody with a rapidly deteriorating condition who may be entering a terminal phase.
It is different from the ordinary CHC pathway. The official Fast Track guidance says there is no requirement to complete the normal Checklist or Decision Support Tool where the Fast Track criteria are met.
Do not assume it is restricted to somebody expected to live only a fixed number of days or weeks. The national test is based on rapid deterioration and possible entry into a terminal phase, not an arbitrary life-expectancy cut-off.
A suitable clinician has to complete the Fast Track Pathway Tool, but a family member can ask the clinical team whether it should be considered.
If money is becoming the immediate worry
Separate the funding question from the care question.
For social care in England, a financial assessment determines what somebody may need to contribute towards council-arranged support. If a person has been self-funding and savings are running down, contact the council before the money reaches the relevant capital threshold so there is time to assess needs and finances.
At the same time, check whether NHS funding should be considered if health needs have become more complex.
Also review benefit entitlement. MH360 Entitled can help people explore potential benefits and statutory support, while official benefits services or an adviser can confirm individual entitlement.
Do not sell, transfer or give away major assets simply because you are frightened about care fees. Property, deprivation-of-assets rules and care funding can be legally and financially complex.
If the person is becoming less able to make decisions
Do not assume that a diagnosis automatically means somebody has lost mental capacity.
Capacity is decision-specific. A person may be unable to make one complex decision while still making many others.
Where capacity is in question, professionals should follow the Mental Capacity Act framework. If somebody has a valid Health and Welfare Lasting Power of Attorney, or a court-appointed deputy where relevant, their legal role may also need to be understood.
For significant disputes about capacity, best interests, attorneys or major welfare decisions, specialist legal advice may be appropriate.
If the family is arguing about what should happen
Bring the conversation back to three things: the person’s wishes, the evidence of current need and what care is realistically sustainable.
A relative who visits for an hour may see a very different person from the carer who is awake with them at 3am.
Equally, exhausted carers need support and should not be expected to make every decision alone.
A needs assessment, clinical review or other professional assessment can help replace family argument with a clearer picture. If the disagreement is about legal authority or mental capacity rather than simply preference, appropriate legal advice may be needed.
A simple way to decide which door to open first
If you are overwhelmed, use this order:
Health suddenly worse or medically concerning → contact the appropriate NHS service.
Everyday care no longer safe or manageable → ask Adult Social Care for a needs assessment.
You cannot keep providing the same level of unpaid care → ask for a carer’s assessment.
Complex or predominantly health-related ongoing needs → ask whether NHS Continuing Healthcare should be considered.
Rapid deterioration and possible terminal phase → ask the clinical team about Fast Track CHC.
Savings falling or care fees becoming unaffordable → contact Adult Social Care for financial assessment and check benefits and NHS-funding routes.
Family disagreement or questions about capacity → clarify the person’s wishes, obtain appropriate assessment and seek specialist advice where necessary.
You do not have to wait for every problem to be solved before asking for help with the next one.
Do not forget the person doing the caring
When somebody’s needs increase, the family’s attention naturally moves towards them.
The carer can disappear from the conversation.
Carers Mind exists for the person who is frightened, exhausted, guilty, grieving for how life used to be, angry about being left to manage everything or simply unsure how much longer they can continue.
Counselling cannot arrange a care package or decide CHC eligibility. It can give the carer somewhere to process what the situation is doing to them while practical and professional support is put in place.
Last reviewed
5 September 2026
Important informationThis guide provides general information about care, support and NHS Continuing Healthcare in England and is not intended to provide legal, financial, medical or other professional advice. Rules and processes differ elsewhere in the UK and individual circumstances can be different. You may wish to check current official information and seek advice from an appropriately qualified professional before making important decisions.