How to Assess Whether an Elderly Parent Is Safe Living Alone
This is one of the most difficult assessments families face — and one of the most important. This guide provides a practical framework for thinking it through, and guidance on when to get professional input.
Why this assessment is hard
Assessing whether a parent is safe at home is complicated by the fact that you are probably not there most of the time, your parent will often present their best self when family visits, and there is no single definitive threshold at which ‘safe’ becomes ‘unsafe’. It is a judgment about risk — and risk is a spectrum.
A framework for assessment — what to look at
Personal care and hygiene
Is your parent managing bathing, dressing, and grooming adequately?
Do they appear to be wearing clean clothing?
Is there any evidence of significant change in personal hygiene?
Nutrition and hydration
Is the fridge stocked with food that is fresh and appropriate?
Is your parent eating regular, adequate meals?
Have they lost significant weight?
Are there signs of dehydration — dry skin, confusion, dark urine?
Medication management
Are medications being taken correctly and on schedule?
Are prescriptions being renewed when needed?
Is there evidence of confusion about medications — stockpiling, missed doses?
Mobility and falls risk
Is your parent moving around safely — no significant unsteadiness or difficulty?
Have there been any falls — reported or unreported?
Is the home environment safe — clear walkways, no loose rugs, adequate lighting?
Are there modifications needed — grab rails, raised toilet seat, shower chair?
Cognitive function
Is your parent oriented to time, place, and current events at their usual level?
Are there signs of increasing confusion, memory lapses, or unusual behaviour?
Are they managing their finances appropriately?
Have you noticed any significant personality changes?
Social connection and mood
Is your parent maintaining contact with friends, family, and community?
Are there signs of depression, withdrawal, or persistent low mood?
Do they have people they can call on if something goes wrong?
The home itself
Is the home adequately heated?
Is there evidence of deteriorating maintenance that poses a risk?
Is the home clean and orderly, or have standards changed significantly?
Signs that suggest increasing risk
Any of the following warrant prompt attention and a conversation with the GP:
A fall — even one that seems minor
Significant unexplained weight loss
Evidence of a fire risk — burnt pots, forgotten appliances
Medication errors or confusion
Evidence of financial exploitation or unusual transactions
Significant cognitive change over a short period
Your parent telling you they don’t feel safe — even indirectly
Getting a professional assessment
The GP is the right starting point. An occupational therapist (OT) can carry out a formal home safety assessment — available through Health New Zealand or privately. A NASC needs assessment evaluates whether funded support services are appropriate — if your parent’s level of need has changed, requesting a new assessment is appropriate.
→ See our guide: What happens when an elderly parent refuses help
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