Seniors who have been self-managed all their lives frequently resist help. But some do not realize that they need it. How do you (or they) know?
The following is a list of indicators that are signals that help is needed – and ideas about how to provide that help. The list is organized in the order of the least to most serious.
7. A decline in personal hygiene. It may be subtle at first. Your Dad who has always presented as well-groomed starts skipping baths, shaving or tooth brushing. This may be a sign he needs help with personal care. Other indicators are that he may have more trouble getting in and out of the bathtub or shower. Scheduling a visit two or three times a week to assist in some of the basic hygiene activities may be appropriate. This assistance may also be provided by a scheduled visit with a professional home care aide.
6. Social engagements are declining. Your loved one seems to stop making the effort to see friends or do the social things he or she used to enjoy. You might notice that you are not getting the regular calls you used to get, and you need to initiate most of the communication. That behavior may extend to his or her other acquaintances, as well. Such behavior may indicate a decline in hearing which is more easily resolved, but it could be a hint an the early onset of dementia or depression. A conversation with a doctor is an important next step.
5. Giving away money to strangers. Financial exploitation is a sad, common fact of life for seniors. They are more vulnerable to the various requests that may come in over the phone. Sometimes it is not a stranger, but a family member, friend or caregiver that is the thief. If you believe that your parent is being financially abused you can contact the police. A whole list of strategies are neatly described in a six-page document from the U.S. Administration on Aging called Eldercare Locator. It may also be appropriate to contact an Elder Law Attorney to create a Power of Attorney or a Trust to protect your loved one.
4. Driving skills seem to be declining. You may observe this first-hand as a passenger. You can also inquire of neighbors or friends whether they have observed any odd or dangerous driving behavior. Seniors have slower reaction times and reflexes. They may have physical or mental limitations they did not have before. These conditions can include cataracts which limit the ability to see clearly (particularly at night) or arthritis that can limit the motions necessary to properly control the vehicle. If your loved one is developing dementia or Alzheimer’s they may not be as able to make the split-second decisions driving requires. You can ask that they take a senior driving skills test that is often provided by the DMV or an occupational therapy specialist.
3. Significant weight loss. Weight loss can portend any number of situations that can be serious if not addressed. When your parent looks like his or her clothes do not fit any more or you notice a reduction in body mass, it is time to be proactive. It may be that your loved one is no longer comfortable with or capable of cooking. Snack foods may be substituted for nutrition, or your senior may skip meals completely. Poorly fitting dentures may discourage eating solid foods. Alternatively, it is possible that eating patterns are a hint of early also dementia and the senior is simply forgetting to eat. Depression may be suppressing appetite.
Action steps are varied. If it is an issue with dentures, a visit to the dentist is the obvious answer. If your parent is not able to cook anymore, you could sign him or her up for a meal delivery service like Meals-on-Wheels. Hiring an in-home aide to do the cooking (and other key tasks) may be another answer. This is also a good first step if dementia turns out to be the diagnosis.
2. Forgetting medications. This is one of the more critical issues seniors face. Missing medications can lead to dramatic complications – particularly if the pattern goes on for some extended time. The simplest resolution is instituting the use of an organizational pill box. While this may help it may not be enough, so regular visits to observe compliance may be necessary. Ultimately, in-home supervised care to monitor medications as well as other basic needs may be appropriate.
1. Falling. The most serious indication of a need for more active engagement with a vulnerable senior is falling. Seniors who live alone are at a greater risk of a life-threatening injury from a fall. Technology is a great help here. There are several tools that allow for a person who is in trouble to push a button on a transmitter to get help. There are also passive observation devices that allow for monitoring movements of a senior in his or her home without violating individual privacy. The best human contact resolution is to have a personal care assistant present for risky activities like bathing or if the senior has a habit of night wandering.