What should a home visit to an older parent check? A checklist for families abroad

What should a home visit look for first?

Look at the person before the house: the WHO screens older people for decline in memory, mobility, nutrition, eyesight, hearing and mood.

The World Health Organization's Integrated Care for Older People (ICOPE) handbook, second edition 2024, gives health workers simple tests for each area. They include remembering three words, standing up from a chair five times without using the arms within 14 seconds, and asking about unplanned weight loss of more than 3 kg in three months.

A family visit is not a clinical assessment, and only a doctor can diagnose. What a visitor can do is notice change since the last visit and pass specific observations to the person's doctor.

The person does not need to be tested to be observed. Watching them get up, walk to the door, find their glasses and talk about their week covers much of the same ground.

How is the person doing?

Ask the same questions each visit so that changes stand out; the ICOPE screening questions are a good model.

• Ask if they have felt down, depressed or hopeless in the past two weeks.
• Ask if they have had little interest or pleasure in doing things.
• Ask about appetite, and whether they have lost weight without trying.
• Look in the kitchen for fresh food, and for signs it is being eaten.
• Ask how they are sleeping, and whether they are up in the night.
• Ask about pain, including in the feet, and whether it stops them moving.
• Notice memory: repeated questions, confusion about the day or date.
• Check they can see and hear you clearly, with glasses or hearing aids if they use them.
• Watch them stand up from a chair and walk across the room.
• Ask if they have had a fall since the last visit, even with no injury.
• Ask how much they drink; dark yellow pee and peeing less are signs of dehydration.

What should you check about their medicines?

Check every medicine they take, not only the prescribed ones, because NICE says a medication review should include over-the-counter and complementary medicines.

NICE guidance on medicines optimisation (NG5, 2015) names older people and people taking several medicines among those who may benefit from a structured medication review. NICE's falls guideline (NG249, April 2025) adds that medicines which raise the risk of falling should be reviewed.

The ICOPE handbook suggests pill cards and pill organisers, and stresses checking expiry dates. In Nigeria, many medicine packs carry a NAFDAC Mobile Authentication Service scratch panel: scratch it to reveal a PIN and text the PIN free to the short code on the pack, and a reply says whether the product is genuine.

• Write a list of every medicine, including herbal, over-the-counter and complementary ones.
• Check each one against the prescription: name, dose and times.
• Count what is left and work out when each will run out.
• Check expiry dates and set aside anything out of date.
• Use the NAFDAC scratch code on any pack that has one.
• Ask whether a pill organiser or a written pill card would help.
• Note any new dizziness, drowsiness or confusion since a medicine changed.
• Ask their doctor or pharmacist for a medicines review if anything is unclear.

What should you check in the home?

Home safety checks are mostly about falls; the NHS suggests clearing clutter and loose wires, using a non-slip mat in the bath or shower, and fitting grab rails.

The WHO lists unsafe stairs, lighting and walking surfaces among the risk factors for falls. Our guide to preventing falls at home in Nigeria goes through the home room by room.

• Clear clutter, loose rugs and trailing wires from walkways.
• Check there is a light by the bed and on the route to the toilet at night.
• Check there is a light that still works in a power cut.
• Check the bathroom has a non-slip mat and something firm to hold.
• Check stairs and outside steps have a rail.
• Keep generator and extension cables out of walkways.
• Check there is drinking water within easy reach.
• Check their shoes fit well, stay on and have a good grip.

What about money, paperwork and keeping in touch?

A visit is also the time to check practical arrangements that can fail quietly between calls, such as a phone left uncharged or an unpaid bill.

In Nigeria, 112 is the national emergency number, free from all major networks. In Lagos, 767 and 112 both reach the state's emergency control centre, which coordinates the ambulance, fire and emergency services.

• Check their phone is charged and has credit or data.
• Check 112 is saved in their phone, and 767 too if they live in Lagos.
• Check their doctor, a neighbour and the nearest hospital are saved and written down.
• Check there is money or a working way to pay for food, medicines and transport.
• Check bills such as power and water are paid.
• Check where their ID, health plan or HMO card and hospital records are kept.
• Ask whether anyone has been asking them for money or bank details.
• Agree the date of the next visit or call.

Which warning signs need action, and how fast?

NHS guidance sorts warning signs into three levels: an emergency, urgent same-day help, or a doctor's appointment soon. The table uses the NHS level and the Nigerian number to call.

What should happen after the visit?

Write down what was seen, with the date, so the next visit can be compared with this one and the family is working from the same notes.

Pass anything new to the person's doctor in specific terms, such as weight loss, a fall, new confusion or a medicine running out, rather than a general sense that they seem less well.

Kinship Visits in Lagos are care visits 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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