What are the signs an older parent living alone needs more help? A checklist for families abroad

How many older parents in Nigeria and Ghana live alone?

In the 2024 Nigeria Demographic and Health Survey, 11.0% of urban-dwelling people aged 60 and over lived alone, and 62.6% of them lived in poor conditions.

Those figures come from a study of 5,106 weighted older people in the survey, published in BMC Geriatrics in July 2026. It found the risk of living alone in poor conditions was higher for widows than for married people.

In Ghana, the Ghana Statistical Service reported from the 2021 census that 341,960 people aged 60 and over were living alone, including 62,480 aged 80 and older, out of 1,991,736 people aged 60 and over.

Which signs matter most?

Age UK groups the signs into three levels: early changes, changes to daily routine, and changes that affect health or wellbeing and usually need support.

Early signs, often noticed by people who know the person well, include not doing their hair or being less house-proud than before. Signs affecting the daily routine include no longer washing regularly, not getting dressed during the day, refusing to go out and trouble sleeping. Higher-level concerns include not eating properly, drinking a lot of alcohol, not taking medicines and living in unsanitary conditions.

The World Health Organization's ICOPE handbook asks health workers to screen older people for decline in six areas: memory and orientation, mobility, nutrition, eyesight, hearing and mood. It also asks them to look at the social environment, including living conditions, financial security, loneliness and freedom from abuse.

From abroad, much of this has to be noticed on calls and visits by other people, so the checklists below are written to be used by a relative, neighbour or visitor on the ground as well as on video calls.

What should you look for in the home?

Look for change compared with how the home used to be kept: Age Scotland names an overgrown garden that used to be tended and a suddenly empty store cupboard.

• Check whether the home is as clean and tidy as it used to be.
• Look in the kitchen for fresh food, and for food past its date.
• Check for unwashed dishes, laundry or rubbish building up.
• Notice whether the compound or garden has been left to go.
• Look for clutter, loose wires or poor lighting on the way to the toilet.
• Check for signs of a fall, such as moved furniture or bruises they cannot explain.
• Check that power, water and the phone are working.

What should you look for in their body and health?

Weight loss is one of the clearest signs: the WHO screening question is whether the person has unintentionally lost more than 3 kg over the last 3 months.

The ICOPE handbook also uses a chair-rise test: whether the person can stand up from a chair five times without using their arms within 14 seconds. NICE guidance on falls (NG249, April 2025) says people should be asked whether they have fallen in the last year.

• Ask whether they have lost weight or lost their appetite.
• Notice whether clothes look looser than before.
• Ask whether they have fallen in the past year, even without injury.
• Watch how they get up from a chair and walk across a room.
• Ask whether they are still washing and getting dressed each day.
• Check their medicines are being taken and are not running out.
• Ask how much they drink; the NHS lists dark yellow pee and peeing less as signs of dehydration.
• Ask whether they can see and hear as well as before.

What should you notice about memory and mood?

The NHS lists memory loss, difficulty concentrating, confusion about time and place, trouble following a conversation and mood changes among the common early symptoms of dementia.

The NHS adds that these symptoms are often mild and may get worse only very gradually, and that it is important to talk to a doctor sooner rather than later about memory worries. Sudden confusion is different: the NHS says to get medical help immediately.

The ICOPE mood questions ask whether, over the past two weeks, the person has been bothered by feeling down, depressed or hopeless, or by having little interest or pleasure in doing things.

• Notice whether they repeat the same questions or stories in one call.
• Ask what day it is in passing, and whether they know their plans for the week.
• Notice whether they struggle to find words or follow the conversation.
• Ask whether they have felt down or lost interest in things in the past two weeks.
• Notice whether they have stopped going out, to church, mosque or the market.
• Treat sudden confusion as an emergency and get medical help straight away.

What about money and keeping in touch?

Age UK lists unusual transactions, being unable to access cash, pressure to give money to others, and unexplained losses among the signs of financial abuse.

Age UK also lists feeling pressured to change a will or other financial plans. The ICOPE handbook includes financial security and loneliness in the social needs a health worker should ask about.

• Check whether bills are being paid and power and water are on.
• Ask whether anyone has asked them for money or bank details.
• Notice money disappearing faster than usual, or new people asking for help.
• Check their phone is charged and they can make and answer calls.
• Ask who they have seen this week, and when they last went out.
• Note if calls are going unanswered more often than before.

What does each sign mean, and what can you do next?

The table below sets each sign against what UK guidance says it can mean and what it advises; it is general information, and a doctor decides what any sign means for your parent.

Age UK says one of the best things you can do is talk it over together, and that if you have raised concerns clearly and calmly you must try to accept that it is their decision, unless there is immediate risk.

In England, a council needs assessment looks at how someone manages everyday tasks such as washing, dressing and cooking, and the NHS says anyone can ask for one. The same everyday tasks are one way to describe what has changed when you speak to your parent's doctor.

Kinship Visits are care visits at home in Lagos by qualified nurses, with the same nurse each visit and a written report to the family after every visit.

Questions people ask

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• Loneliness in an older parent in Nigeria
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