When Visiting Aging Loved Ones, Be on the Lookout for Signs of Difficulty
Written by Bogutz and Gordon
Many of us live great distances from our parents, and we take advantage of summer vacations to reconnect with them. We might notice a change in ability since our last visit. Perhaps the change is so subtle that family members right in town may not be aware of it. Are your parents experiencing “normal” aging, or are they on the slippery slope to decline?
It is important to be an observer and not an advice giver. Look for clues in the household that may indicate difficulties:
- Is your parent rumpled, disheveled, or not completely clean when the standard has always been good (or at least appropriate) hygiene? Look for a marked difference in bathing, tooth brushing and hair care. This may indicate a physical impairment (such as poor eye sight ) or declining mental capacity.
- Has their physical strength changed? Perhaps there is difficulty getting up from a chair, or an avid walker now shuffles instead of strides. A change in gait leads to a greater incidence of falls, often the game changer in a person’s quest to live at home.
- Is cognitive processing growing more difficult? Sometimes a person with diminishing abilities will talk less, search for common words, get lost, use uncharacteristic poor judgement or be disoriented to person, place or time.
- Lax housekeeping in the home of a previously neat person may indicate an interfering physical or cognitive condition.
- Look for expired foods in the refrigerator or a freezer full of unused microwave meals. Is there edible food in the cupboard? Any evidence of recent shopping?
- Are there multiples of many items? Let’s talk MULTIPLES. A closet full of paper towels and bath tissue, a case or two of soup, enough garbage bags to supply the entire neighborhood. Hoarding behavior may be the result of memory loss, fear of not being able to get to the store, an underlying psychiatric issue or other undiagnosed problems.
- Look at pots, pans and stove top. Are there any indications of fire or neglected cooking?
- Are there multiple vials of the same medication, or outdated and clearly unused full bottles? It’s possible the pharmacy may be calling to remind of an automatic refill and the person picks up but does not take the prescribed pills.
- Is the bathroom filthy, lacking toothpaste, soap or clean towels? Any sign of recent use?
- How does the outside of the house look? It takes great effort to get rid of weeds, keep the paint from peeling, fix cracked windows, and clean up clutter. Is it overwhelming because of physical limitations or the inability to prioritize necessary tasks?
- Are there piles of paper everywhere, bills mixed in with junk mail, waiting for the time your parent can sit down and open everything? Anything grossly overdue?
- Watch for multiple sweepstakes entries, heartfelt thank you’s from charities and other organizations, as well as stacks and stacks of magazines. Memory loss may affect judgement and your parents may be targeted for their generosity.
- Is the mailbox full? Are there flyers in the bushes? The cause may simply be lack of mobility to pick these things up in a timely manner, or it may be completely forgetting to get them.
- If possible, ask to see the checkbook register. Do the numbers (if there are any) make sense? Are entries being recorded, or is the register an absolute mess? Are your parents still able to keep track of what’s coming in and what’s going out?
Keep in mind that just your very presence may cause enormous stress to your parents, especially if they are aware of changes they are experiencing. You may face denial, resentment and outright fear of loss if you misjudge their capacity to live independently. However, if there are multiple signs of difficulty, it is time to open the conversation.
- Share your concerns with your parents in a non-judgmental manner. If possible, have other caring people involved in the conversation. Focus on strengths, not weaknesses, and collaborate on solutions.
- Initiate medical appointments. A baseline medical exam and plan of care can address many treatable medical conditions, and offer hope for overcoming health obstacles. Some older people avoid doctor’s visits for fear of what may be found, when in fact, quality of life may be enhanced by care and the time staying at home may be extended. Send a “note taker” along if you cannot go with them.
- Check to be certain estate planning documents are up to date. If a parent should become incapacitated, it is difficult for family members to act on their behalf without the proper documents.
- Do what you can. Arrange for assistance with cooking, bathing and transportation if your parents will accept it. Consider having the home assessed for adaptive equipment. Also, some non profit agencies will clean yards of older homeowners for free. Contact the local office on aging for referrals.
There are no easy answers, no magic solutions, no set intervention period on the continuum of aging. There is no way of knowing if a change in condition will be fast or slow. As children we can only do our best to gather information and resources to support our aging parents to the best of our abilities.