Winston-Salem Senior AdvisorHow do we know a parent can no longer live alone safely?
Watch for falls, missed or doubled medications, spoiled food, unpaid bills, getting lost while driving, weight loss and unexplained bruises; any one can be managed, but several together usually mean the current arrangement is not safe.
Write down what you see, with dates, and share it with your parent's doctor. A physician can assess memory and function and complete the FL-2 that North Carolina uses to document care needs. That record will matter whether the next step is more help at home or a move.
What help can keep a parent at home longer around Winston-Salem?
A mix of paid aide hours from a licensed home care agency, adult day care on weekdays, Meals-on-Wheels, a personal emergency button and, for Medicaid members who qualify, CAP/DA services can extend time at home considerably.
In Forsyth County, Senior Services Inc. (336-725-0907) runs Meals-on-Wheels, a home care program and the Williams Adult Day Center. In Davidson and Davie counties, PACE through Carolina SeniorCare in Lexington combines medical care, a day center and home care for people who meet nursing home level of care. The county department of social services can tell you about in-home aide services and Special Assistance In-Home.
When is a move to assisted living the safer choice?
When help is needed at unpredictable times, especially at night, when a parent cannot call for help, or when the cost of enough paid hours passes the cost of a licensed home, which at North Carolina's 2025 medians happens around 48 hours of help a week.
A move is also worth considering when isolation is the main problem. Some parents improve noticeably once they have meals with others and staff nearby. Visit two or three homes with your parent if you can, and let them choose between options rather than face a single decision made for them.
How do we raise the subject with a parent who wants to stay home?
Start with their goals rather than your worries: what they want their days to look like and what they are afraid of losing, then talk about the specific risks you have seen and the options that protect what matters to them.
A doctor, a pastor or a trusted friend can sometimes say what a son or daughter cannot. Offer a trial, such as a respite stay at an adult care home, which many homes in the five counties offer when they have an empty room. Respect the parent's right to make their own choices if they have capacity, and keep the conversation going.
What if a parent refuses help and is at real risk?
If an adult with a disability is being neglected or is neglecting themselves to the point of danger, you can report it to Adult Protective Services at the county department of social services, which will evaluate whether protective services are needed.
APS numbers: Forsyth 336-703-3503 (911 after hours), Davidson 336-242-2500, Davie 336-753-6250, Stokes 336-593-2861 and Yadkin 336-849-7910. APS respects the rights of adults who can make their own decisions; its role is to protect those who cannot. If someone is in immediate danger, call 911.
What it is, and what it is not
| Staying home can still work when | A move is usually safer when | |
|---|---|---|
| Nights | Your parent sleeps through and can call for help | Night wandering, falls or confusion occur |
| Hours | Fewer than about 48 hours a week of help needed | Help is needed around the clock |
| Medications | A dispenser and checks are enough | Doses are missed or doubled regularly |
| Company | Visitors, church or adult day fill the week | Days pass with no one at all |
Based on N.C.G.S. Chapter 131D, 10A NCAC 13F and 13G, DHSR and NCDHHS documents, NC Medicaid, CMS, the VA, CareScout and the local agencies named above; see our editorial standards for how each is checked.
