Decline in mental and physical capabilities is inevitable as we age. People are living longer and healthier now, so changes are likely to be slower and more subtle than they were for our grandparents. In some ways, this increased longevity and health makes adjusting to the normal process of aging easier; in others, it makes it more difficult. You may be wondering what you can do if a senior you know needs additional care or support.
Ask without being patronizing. You're likely to notice a general slow down - a cue to ask general questions. If you see specific things that worry you, talk them over. Explain your concern. Listen! Propose solutions- if needed. Better yet, ask your loved one what he or she thinks the solution might be. It may not be appropriate to insist on your approach unless there is a threat to his or her safety or to the safetyof others.
Observe carefully. If you notice her clothes are not as clean as they used to be, you might ask,"Mom, can I help with the laundry? I'm usually here on the weekend. How about I throw in a couple of loads for you?"
Many seniors dread losing their independence. If you notice your Dad's refrigerator is often empty, your instinct might be to tell him you'll be doing the shopping from now on. He may, reasonably, see that as an intrusion. Instead, talk with him. Try to determine why the fridge is empty. There are dozens of possible reasons. Perhap she has little appetite. Maybe he is uncomfortable driving because he needs new glasses.
Pay Attention. Your loved one might tell you about a problem or concern. Although it's not always the case, someseniors are comfortable telling their family when they need help. If your Mom tells you the grocery bags are too heavy for her to carry, you can offer to shop for her. You may feel you know just how to help if your Dad asks,"These eyes aren't what they used to be. Would you look over my checkbook and bills before I mail them?" Perhaps helping with the bills and scheduling an eye exam is appropriate. Possibly, however, your Dad is not concerned about his vision; maybe he is worried that his mental alertness is deteriorating. Listening sometimes means reading between the lines.
As you focus on the issues, you can speak with other family members and friends about your concerns. They maybe a good source of insight, especially if they see your aging loved one regularly.
Look and Listen
If you regularly visit a friend or relative, you may notice any changes in mental and physical capabilities. You may notice changes in behavior, or you might see signs of a physical problem. For example, depression, a common condition for many older people, can appear as a physical problem (e.g., tiredness or insomnia) or a cognitive problem (e.g., forgetfulness) or both. Remember, if an older adult seems forgetful or takes longer to do some tasks, it may be a normal part of the aging process. Paying a bill a week later is not the same as forgetting to pay bills for three consecutive months. The most important consideration is whether or not the changes you see pose a threat to your loved one's medical or physical safety. Some changes that may signal the need for help are:
Behavior changes
- Changes in personal hygiene
- Change in tidiness or cleanliness of the home or yard
- Laundry piled up
- Mail and bills unopened or unpaid
- Odors (e.g. from spoiling food)
- Missed appointments
- Getting lost in familiar places
- Evidence of safety risks (e.g., burned pots in cabinet)
- Evidence that medications are not being taken properly
Physical symptoms
- Weight gain or loss
- Unsteadiness when walking or getting up / down from chair
- Evidence of incontinence (e.g.,odor of urine in the home)
- Unusual thirst
- Unusual fatigue
Symptoms of depression
- Darkened house with the shades drawn when you arrive
- Decreased contact with family and friends
- More withdrawn, less conversational
It may be tempting, when you have a concern, to rush to intercede. It's better, however, to avoid taking over. If your loved one is competent to participate, don't make unilateral decisions and don't go over his or her head. Instead, discuss the issues you've noticed and, if you have difficulty resolving problems, consider involving the professional community - a primary care physician, a gerontologist, or a senior care specialist. They are likely to ask you about your loved one's behavior. They may also ask about his or her cognitive status. Questions you are likely to hear include:
- Is there difficulty with Activities of Daily Living (ADL) tasks such as bathing, dressing, toileting, eating, and transferring from place to place (e.g., bed to chair)?
- Are support tasks such as shopping, laundry, meal preparation, managing finances, housekeeping, and transportation being adequately managed?
- Are you noticing significant changes in memory, judgment, or ability to make decisions?
The objective is to jointly figure out the cause of the problem(s) and possible interventions. If a senior has an acute event, such as an illness or accident requiring hospitalization, the social worker or discharge planner may offer helpful guidance. You can begin to develop a care plan based on insights and considerations from your lovedone, the medical community, friends and relatives.
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