You have read the books. You did Fly Lady. You built the bullet journal system. You found the workarounds that got you through your thirties and into a demanding career with three kids and no partner beside you. And now perimenopause has come along and quietly pulled every single coping mechanism out from under you, and you are sitting in the same leggings you wore three days ago, staring at the laundry, unable to move.

That is not laziness. That is not failure. That is a neurological system that was already working twice as hard as most people's, now stripped of the oestrogen that was quietly helping it compensate. The NHS has published guidance noting that oestrogen plays a role in dopamine regulation, which means for women with ADHD, the hormonal shift of perimenopause can make executive function significantly worse. What was hard becomes impossible. What was manageable becomes chaos.

You are not imagining it. And you are not alone in not knowing what to ask for.

The right job title matters more than you think

Most people in your situation type 'cleaner' into Google and feel vaguely wrong about it, because cleaning is not really the problem. The problem is the deciding, the sequencing, the starting. You know what needs doing. You cannot make your brain fire the starting signal.

What you are actually looking for sits somewhere between three job titles that the care sector uses inconsistently. A PA (personal assistant in the care sense, not the office sense) supports someone with a disability or health condition with daily tasks including planning, errands, and household management. A support worker does similar work, often with more formal training. A household manager tends to mean someone who runs the logistics of a home without the personal care component. In practice, the right person will do a mixture of all three: walk in, look at the week ahead with you, make a decision about dinner, start the laundry, and sit with you while you make a list you can actually act on.

Skills for Care, the workforce development body for adult social care in England, notes that personal assistants employed directly by individuals are one of the fastest-growing parts of the care workforce, precisely because families and individuals want someone who fits their specific situation rather than a generic service.

How to fund it

If you are paying for everything yourself right now, that is the most common route but not the only one.

First, ask your GP for a referral to an adult social care needs assessment from your local council. Under the Care Act 2014, adults whose ability to manage daily life is substantially affected by a disability or health condition, and ADHD absolutely counts, have the right to a free assessment. If you meet the eligibility threshold, the council must fund or contribute to care. Citizens Advice has a plain-language guide to how this works and what to say in the assessment.

If you are assessed as eligible, you can ask to receive the funding as a direct payment rather than a council-arranged service. That means the money comes to you, and you choose and employ your own PA. Gov.uk has a short guide on how direct payments work in practice.

If you are funding privately for now, knowing what to call the role helps you find the right person. Search for 'personal assistant for ADHD' or 'support worker for executive dysfunction' rather than 'cleaner' or 'PA' (which will return office PAs). Some introductory care agencies in London have carers and support workers whose background includes neurodivergent adults, not just elderly care.

What to say when you make contact

When you do speak to someone, whether a council social worker or someone you are hiring privately, these are the things worth saying out loud:

You should not have to justify this at length to the right person. The right person will have heard it before.

Tonight, or this week

If everything above felt like too many steps, do one thing. Call your GP and say: 'I have ADHD and I am struggling significantly with daily functioning since perimenopause. I would like a referral for an adult social care needs assessment.' That sentence is the thread to pull. You can also contact ADHD UK, who offer peer support and can help you understand what you are entitled to ask for.

If you want to talk through what kind of support worker or PA might actually fit your household before you go anywhere near a council assessment, we at Hibant are a London introductory care agency. Every carer and support worker we introduce has been DBS-checked, insurance-verified, and had their references checked by us before we introduce them to a family. You meet the person yourself before any arrangement begins, and you choose who you want. If you are paying privately or looking to use direct payments once your assessment comes through, we can help you find someone whose background fits neurodivergent adult support, not just elderly care. You can email hello@hibantcare.com or have a look at hibantcare.com.

Hibant

Useful links to keep handy

Looking for care or thinking of joining Hibant?

Whether you are a family navigating care for a loved one or a carer looking for fairer, more meaningful work, we would love to hear from you.

Find a carer Join as a carer
← Back to Understanding Care Questions? Get in touch