Most families don't see it coming all at once.
It starts with small things. A parent who used to manage everything now seems a bit more tired. The house isn't quite as tidy as it used to be. Phone calls that used to be chatty are getting shorter. A fall, or a stint in hospital, can suddenly make everything feel more urgent.
Whenever it happens, the moment you realise your parent might need some help at home can feel overwhelming. There's a lot of information out there, most of it confusing, and it's hard to know where to start.
This guide is meant to make that first step feel a bit more manageable. It covers what to think about, how to have the conversation with your parent, and the different ways support can actually be arranged in the UK.
Start by getting a feel for what daily life actually looks like
Before exploring any options, it helps to just take stock of where things are right now.
Not in a clinical way, just honestly. Is your parent managing meals and shopping? Are they getting out much? Have they mentioned feeling less steady on their feet, or more tired than usual? Are they keeping on top of the everyday admin of life (appointments, prescriptions, bills)?
You don't need a formal assessment to answer these questions. Often a visit, or a longer phone call than usual, tells you most of what you need to know.
Support at home usually starts with practical, everyday things rather than medical care. Help with meals. Getting to appointments. Having someone familiar around for company a few times a week. It's less dramatic than most people imagine, and that's worth keeping in mind when you're thinking about how to raise it.
Having the conversation with your parent
This is the part most families find hardest, and it's worth taking seriously.
A lot of older people hear "we think you need some help" and immediately worry it means losing their independence, or that a bigger decision is coming. That fear is completely understandable, and it shapes how these conversations go.
The conversations that tend to go better are the ones that start from a place of curiosity rather than concern. Not "we're worried about you" but "what would make day-to-day life feel a bit easier right now?" Not a list of things you've noticed going wrong, but a genuine question about what they'd find helpful.
It also tends to help to start small. Suggesting a few hours of help each week feels very different from suggesting a wholesale change. Most people are much more open to a small, practical step than they are to anything that sounds like a big decision.
And it might take more than one conversation. That's fine. The goal isn't to get a decision, it's to open the door.
The different ways support can be arranged in the UK
Once you're ready to explore options, there are broadly three routes families take.
Through the local council
If your parent has significant support needs, they may be entitled to a needs assessment from their local council's adult social care team. Depending on the outcome, the council might fund some or all of their support, either by arranging services directly or through a direct payment, which lets your parent choose and arrange their own support.
In practice, eligibility thresholds are often high, and a lot of families don't qualify for council funding or find the process slow. But it's always worth asking, especially if your parent's needs are substantial. Your local council's website is the starting point, or you can call their adult social care team directly.
Through a traditional home care agency
Domiciliary care agencies employ care workers and send them to visit people at home on a scheduled rota. For families where regulated personal care is involved (help with washing, dressing, or medication) an agency providing regulated services may be the right choice.
The main limitations families tend to find are the same as we covered in our guide to alternatives: different people showing up each visit, short time slots, and less flexibility around routines. For some families that structure works well. For others, it's what they're trying to move away from.
Working directly with an independent Personal Assistant
The third option, and one that's become significantly more common in recent years, is working directly with a self-employed Personal Assistant who provides support independently.
Because there's no agency in the middle, you and your parent agree everything directly with the Personal Assistant: what support looks like, when it happens, and how much it costs. The same person comes each time, relationships develop naturally, and the arrangement can flex as needs change.
Platforms like ilarna make this easier to navigate. You can browse profiles of ilarna Personal Assistants in your area, get a sense of who might be a good fit, and have a conversation before anything is agreed. Nothing is set up without your parent saying yes first.
What does a typical arrangement actually look like?
Support at home doesn't have to mean someone there every day. A lot of families start with just a few hours a week and build from there.
Some people want help with meals and household tasks a couple of times a week. Others value having someone to go out with, to appointments, to the shops, or just for a walk. Some families want daily contact for reassurance, or someone staying overnight. Others need more continuous support and explore live-in arrangements.
The right starting point is whatever feels manageable and useful right now. It can always change.
Understanding the funding options
Support at home can be funded in a few different ways, and it's worth understanding what might be available before assuming everything has to be paid for privately.
Private funding is the most straightforward — families pay directly for the support they arrange, either through an agency or directly with a Personal Assistant. Independent arrangements often work out more cost-effective than agency care because there's no agency margin built in.
Local authority funding is available to those who qualify following a needs assessment. If your parent is eligible, they may receive a personal budget or direct payments (money they can use to arrange their own support rather than having services chosen for them). It's worth exploring even if you're not sure they'll qualify.
NHS-funded support is sometimes available following a hospital discharge or for people with significant health needs. If your parent has recently been in hospital, the discharge team should be able to advise on what might be available.
It doesn't have to be figured out all at once
Arranging support is rarely a single decision. It's usually a process — starting somewhere, seeing how it goes, and adjusting over time.
Most families look back and wish they'd started the conversation a bit earlier, not because things were urgent, but because having some support in place made everything feel calmer. For the person being supported, and for the family around them.
If you're not sure where to start, a conversation with our team costs nothing and doesn't commit you to anything. We can talk through what's available in your area and what arranging support through ilarna actually involves in practice.
If you'd like to find out more or talk things through, get in touch using the form below, or call us on 0208 050 4805.
