The short answer
- Personal care is a harder subject than help in generalIt means someone helping with washing, dressing or the toilet, so it touches on privacy that shopping or cleaning help never does.
- Lead with dignity and choice, not a list of what has changedWhat your relative gets to decide, such as who helps and how, matters as much as what you say.
- Build up to the most private tasks rather than starting thereStarting with help that involves no touching or undressing lets a carer become a familiar face before anything more personal is asked of your relative.
- A carer can protect a hobby as much as a routineHanding over the parts of the day that have become hard often buys back the time and energy for gardening, reading or a hobby group.
If your relative has never discussed needing any help at all, this page assumes that first conversation has already started, or is about to. How do you tell someone they need care? covers that opening conversation in general.
Why this feels different
Why talking about personal care is harder than talking about other help
Some kinds of help are much easier to raise than others. Somebody doing the shopping or the hoovering rarely touches on how a person feels about their own body. Personal care almost always does, and it is worth naming that difference before working out what to say.
| What it usually involves | What it touches on | |
|---|---|---|
| Help around them | Shopping, cleaning, laundry, a lift to an appointment | Very little. The carer is in the house, not on the person. |
| Personal care | Washing, bathing, dressing, continence care, help using the toilet | A great deal. It means being seen and touched by someone who is not family, often for the first time since childhood. |
Help around them
- What it usually involves
- Shopping, cleaning, laundry, a lift to an appointment
- What it touches on
- Very little. The carer is in the house, not on the person.
Personal care
- What it usually involves
- Washing, bathing, dressing, continence care, help using the toilet
- What it touches on
- A great deal. It means being seen and touched by someone who is not family, often for the first time since childhood.
Both are real help, and most families end up needing some of each. Only the second usually needs a conversation of its own.
If you have not yet worked out whether it is personal care your relative needs, rather than help around the house, what is personal care? sets out the fuller range of tasks it covers, and evaluating the need for a personal carer covers the signs that it is time to look at it. This page assumes you already have a reasonably clear idea that personal care, specifically, is what is needed.
Starting well
Raising it around dignity and choice, not what has changed
How the conversation is framed matters more here than in most family conversations, because the subject itself, someone else washing or dressing your relative, can sound like a loss of dignity even when it is offered with love. The framing that tends to land is one that hands control back rather than taking it away.
Tends to help
- Saying plainly that a carer would help with the parts of the day that have become tiring or difficult, not that your relative can no longer manage
- Offering a choice of carer, including whether they would prefer a man or a woman, rather than presenting someone already chosen
- Mentioning that a carer only does as much as is wanted, and that your relative can do what they are able to for themselves
- Keeping the detail of any specific incident, such as an accident or a fall, between the two of you rather than raising it in front of others
- Treating a first no as a pause rather than a final answer, and returning to it gently later
Tends to make it harder
- Describing an embarrassing moment, such as an accident, in front of other family members
- Assuming your relative will accept whichever carer is available, without being asked
- Framing the whole of personal care as one change, when starting with a smaller part of it is possible
- Treating an initial refusal as the end of the conversation
- Making the arrangements and introducing them as already decided
If your relative has already agreed in principle that some help is needed, but has not yet faced what personal care specifically involves, it can help to separate the two conversations: one about accepting help in general, and a second, later one about what that help covers. How do you get someone to accept care? covers what to try if the answer to help in general is still no.
Starting small
Building up to the most private tasks, rather than starting there
Personal care does not have to begin with washing and bathing. Many families introduce it in stages, starting with tasks that involve no touching or undressing and moving towards the more private ones once the carer is a familiar face rather than a stranger.
Stage one
Help that stays around them
- Shopping
- Cooking
- A lift to an appointment
- Company over a cup of tea
Nothing here involves the carer touching or undressing your relative, so it is the easiest first booking to agree to. It also lets your relative get used to a stranger in the house before anything more personal is asked of them.
Stage two
Dressing and light personal tasks
- Choosing and helping with clothes
- Prompting with medication
- Help getting to the bathroom
These involve some contact but not full washing or bathing. A carer who has already visited a few times for stage one tasks is no longer a complete stranger by the time this stage starts.
Stage three
Washing, bathing and continence care
- Washing or showering
- Bathing
- Continence care
- Full dressing and grooming
The most private tasks, usually introduced once trust is established. Some carers offer to let your relative do part of the task themselves for as long as they are able, rather than taking it over completely.
There is no rule that every family has to move through all three stages, and some start at stage three because that is what is needed straight away. Where there is a choice, though, a carer who has already been in the house a few times for shopping or company is a far easier person to be washed by than someone who walked in that morning, and whether that person is a woman or a man is worth asking your relative before you start looking. A day in the life of a personal carer walks through what a visit at each of these stages involves, so your relative can see what to expect before agreeing to it.
What stays theirs
Showing what a carer protects, not only what it changes
A conversation about personal care easily turns into a list of things your relative can no longer do. It helps just as much to talk about what a carer frees up time and energy for, particularly the things they still enjoy doing themselves.
Gardening
Painting or another craft
A hobby group or knitting circle
Reading
None of this needs to be said as a sales pitch. It works better as a genuine question: what does your relative do now that has become harder because of the time other tasks take up, and would getting some of that time back matter to them. Building a good relationship with your carer has more on keeping a visit personal rather than purely functional once care has started.
Before the first visit
Decisions specific to personal care, before the first visit
Once your relative is willing to try it, a few decisions specific to personal care are worth making before the first visit rather than during it. The daily routine, medication and general preferences are covered in the settling-in guide; these are the ones that matter because of what personal care specifically involves.
What to decide before a personal care visit
0 of 5 ticked
The carer
Privacy and pace
What to tell the carer
Once these are settled, the settling-in guide picks up from here with the daily routine, medication and what to agree before day one, and what to do in the weeks that follow.
Questions
Questions families ask about this conversation
Personal care means help with washing, dressing, continence and going to the toilet, so the conversation touches on privacy and the body in a way that arranging a cleaner or a shopping trip does not. Separating the two conversations, agreeing to help in general first and discussing what that help covers afterwards, often makes both easier.
Yes. When searching for a carer on PrimeCarers you can filter by preferred gender, and it is worth asking your relative which they would find more comfortable rather than assuming.
No. Many families start with help that involves no touching or undressing, such as shopping, cooking or company, and move towards washing, dressing and continence care once the carer is familiar. Some start with the more private tasks straight away because that is what is needed, and that is fine too.
Give it time rather than pressing for an answer immediately, and try raising it again once a carer is already a familiar face from less personal visits. How do you get someone to accept care? covers what to try if the resistance continues.
Carers on PrimeCarers charge £18 to £25 an hour with our fee included, against £28 to £35 an hour through an agency, with a one-hour minimum visit. How many visits a week does my parent need? helps work out what a typical week costs.
Usually not for the first conversation. A subject this private is easier for your relative to discuss with one person they trust than with several relatives at once, and any specific detail, such as an accident or a fall, is best kept between the two of you rather than raised in front of others.
Every carer on PrimeCarers has their identity, right to work and an enhanced DBS check on the Update Service confirmed, and an online interview, before they appear in a search. How we vet every carer has the full list.