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14 signs your loved one might benefit from home care

by Visiting Angels on May 27, 2010

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Signs Your Elderly Loved One Might Need Help

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Signs Your Elderly Loved One Might Need Help

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What are the signs that your loved one may be starting to fail? How do you know who to trust? Who do you listen to? Where do you start? There are times when decisions are forced upon us because of a crisis – a loved one’s fall or stroke, for example. Usually these situations provide an element of clarity about our choices. But there are many other situations that may be subtle, the onslaught may be slow and more difficult to recognize. When that’s the case, determining when a loved one may need more help than the family can provide may be quite difficult. Every day, families are forced with making those tough decisions when they feel that they now have to parent their parent. How do we know when an older loved one requires additional care? The signs can be physical, emotional, and cognitive.
There are many reasons why an elder may experience sudden and dramatic weight loss, and it’s a condition that should raise an immediate red flag for family members. Some of the reasons may be physical. For example, an individual with severe arthritis may have increasing difficulty holding a knife and fork, making him unable to cut some foods into bite-sized pieces. Even holding on to finger-food may be a problem. And, consider a Parkinson’s victim, whose tremors may make it almost impossible to get food from plate to mouth. Perhaps someone with Macular Degeneration simply can not see well enough to either prepare food or feed themselves sufficiently. Perhaps the loss of appetite may be due to a medication change or a change in metabolism due to another factor. And, we know that, as people age, they lose many of their taste buds. By age 80, 4 out of 5 people show a decrease in sensitivity to both taste and smell.
Many elders battle depression and loneliness, although they may be able to put up a good front with family and friends. Many seniors become quite good at covering up because of the fear of losing their independence or appearing needy, or sometimes not wanting to bother their loved ones for help. We probably have all known someone whose anxiety or stress has caused them to lose their appetite. Suspicion of such emotional issues should be the trigger to get a professional evaluation, perhaps by a geriatric psychiatrist. Many of these conditions can be treated with proper diagnosis and medication.
Dementia can cause someone to lose the ability to remember how to perform simple tasks, which the elder has known how to do for years. For example, I have known elders who could no longer remember how to get a spoon full of food to their mouths, or how to swallow a pill. Some forget how to use a knife and fork or how to pour a cup of coffee. Others may suffer from a loss of time or spatial orientation, getting confused about what time of day it is or even here where the dining room is in their building. Weight loss is an indicator that something is going on that needs to be identified. The best suggestion is to make an appointment for an examination by a geriatric physician or your loved one’s regular doctor.
Most of us, regardless of age, sometimes forget things – like where we left our keys or glasses. While dementia is not a normal part of aging, some common cognitive changes occur as a normal part of growing older. For example, the ability to take in and process information generally declines with age, but, given additional time on a test, a senior could probably do just as well. It may also take seniors a little longer to take in and recall information than younger people. And, reaction time generally slows as one ages – that may be noticeable in activities such as driving a car.
Dementia, on the other hand, is the progressive deterioration of intellectual ability over an extended period of time, and memory loss is generally the first noticeable cognitive change. Some also lose the ability to understand or use language, or can no longer identify objects or recognize people they have known for years. One of my family’s greatest fears was that our mother, who suffered from Alzheimer’s, would at some point no longer know who we were. Luckily she never reached that point.
Dementia also affects an individual’s orientation to place and time, ability to think abstractly and solve problems, to make good judgments, and can cause significant personality changes. Dementia also affects the ability to walk normally, and makes many other physical movements difficult. Some individuals may, at times, experience hallucinations and become delirious.
Proper medication management is perhaps one of the most significant and critical issues for seniors. An observation of your loved one and their environment might reveal the following clues that there may be a problem: Are medication bottles organized or are bottles of current and past medications scatterered throughout the house? Are random pills left on the countertops or tables? Does your loved one know which pills are for what? Can the person show you which medications he or she takes and tell you his or her routines? Can the person remember which medications are taken when, and describe the routine accurately?
Are bills and papers organized, or is the house clutterred with stacks of papers? Have there been reports that utilities or other services have been discontinued or threatened to be shut off because of nonpayment? Are there signs of mail “contests” present and in abundance? If the person will let you see his or her checkbook, is it in order or does it show signs of frequent errors, double payments, transposed numbers, etc.?
Unusual gait or walking difficulties can indicate changes that should be addressed. Is the gait too slow or too fast? Does the person need to grab on to furniture to prevent a fall? Can he or she walk up a flight of steps to get to the bedroom or down to get to a basement laundry? Do they wear proper and safe footwear? Unexplained bruising, cuts, or even a broken table leg may indicate a recent series of falls. And falls are a major concern because of the life change a fracture or disability can bring.
Individuals may withdraw from social settings or interactions for a variety of reasons. It is helpful to do a little detective work to try to find out why this is happening. Often, individuals withdraw because they are depressed, anxious, hard of hearing, or even embarrassed that they can not carry on a conversation as they used to. They may choose not to participate in card games in an assisted living facility, for example, because they can not quite remember the rules or sequence of various games and it’s easier to refrain than show vulnerability or weakness. Sometimes, individuals seem aloof or shy if they can not hear and participate in conversations because their hearing aid is not adjusted properly.
It may be that your loved one is not Mr. or Mrs. Clean, but if you see changes in the way the house looks, there may be something you should be concerned about. Pay attention to whether the laundry is done, linens are changed regularly, garbage is not piled up, etc. If there are pets in the house, check to see that they are being taken care of – fed regularly, messes cleaned up, etc.
Families often worry that their loved one does not eat well, or even often enough. It’s not unusual that someone living alone may not be motivated to prepare nutritious meals regularly, but evidence of expired foods in the refrigerator or burned and scorched pots and pans, melted Tupperware, etc., probably indicate some areas of concern. Sometimes, appliances are not working properly and the individual may not recognize what is wrong. We probably all know of instances where the improper usage of the microwave has lead to serious hazards. Sometimes chewing or swallowing problems may be the cause of changes in eating habits, with evidence of weight loss or malnourishment.
If your loved one shows signs of these conditions, that may just be the way they are – or it may indicate some signs of depression or dementia. But other conditions such as hypothyroidism and vitamin deficiencies may produce similar symptoms. An individual who does not brush his or her teeth, comb their hair, or bath regularly may not remember to do those things, or may have little motivation or interest due to depression. And soiled clothing or bed linens may indicate an incontinence condition.
Sudden and frequent mood changes are indicators that something is going on that should be investigated. Often, families will notice and comment that their loved one “just isn’t himself.” They may sleep too much or tool little, be extraordinarily anxious or crabby with little indication as to why this has happened. It may be worth a visit to the doctor for a series of lab tests, which just might identify the problem. It came as a great surprise to me a few years ago to learn that one of the causes of sudden confusion in older adults is often a bladder infection, which is diagnosed easily, and once the proper medication is prescribed, the symptoms clear up rapidly, and the person rapidly returns to normal.
Often those with dementia display behaviors that may seem unusual or not typical. Sometimes families say things like “he never used to be like that” or “she never hit anyone before.” It may very well be that their old ways of communicating aren’t working for them like they used to and these are some of the ways they are exhibiting their frustration. Imagine how it would feel if you couldn’t express yourself the way you wanted to or couldn’t find the words to tell someone what you’re thinking. What might you do?
My father was a nursing home administrator. Even though it was many years ago, I can remember him waking me one night saying, “Pearl wandered outside, we have to help the police find her.” This was in the middle of a Minnesota winter, and one of the residents had left the building in her pajamas, headed for who knows where. Luckily we found her soon, but such a situation is not as rare as you might think with someone with dementia. They may wander because they don’t know where they are, are looking for their old home, for a long-lost relative, or any number of other reasons. If your loved one is prone to wander, you need to be concerned for their safety and take measures to address the issue.
Abuse of alcohol and prescription drugs are not that uncommon with seniors. There are a whole variety of reasons why someone may become addicted to them. If you notice empty bottles around the house or prescription bottles laying around on counters or tables, there may be substantial reason to be concerned.
Do you remember an instance when you were driving and saw an elderly driver either driving extremely slowly, weaving in the lanes, or not noticing an emergency vehicle approaching? There may be a number of physical reasons why seniors aren’t as capable of driving as when they were younger. Their hearing or eyesight may not be good, and their reaction time most likely is slower as they age. And, on more than one occasion, we have had clients who have driven to the store or shopping mall, and not remembered where they left the car or how to get home.
As we noted at the beginning of our session, changes in your loved one’s condition may be easy to spot if they occur because of an accident, fall, or stroke. In these instances, your response may be more clearly obvious than if the changes you notice are gradual or subtle over a lengthy period of time. Your keen sense of perception and observation may be the key to helping your loved one maintain their quality of life and safety. Please take your responsibility seriously and use the signs that we’ve talked about to maintain at least a mental checklist whenever you are with your elderly loved one.
The key is to be continuously alert, but not alarmist, and utilize trusted professionals to help identify and problem-solve solutions to potential issues. And when you approach your loved one about observations you’ve made that are cause for concern, remember to do it with a sense of dignity and respect, for it’s most likely that their biggest fear is losing their independence. All kinds of studies have shown that the overwhelming desire of seniors is to age in place, which means staying in their own home as long as possible. And for the majority, that’s possible with some extra help, sometimes even just a little. If you have questions or need a little advice or suggestions about concerns you have for your elderly loved one, please feel free to call. We’re here to help.

14 signs your loved one might benefit from home care — Presentation Transcript

- 14 Signs That
- Your Loved One Might Benefit From Home Care Services
1. Sudden & Dramatic Weight Loss
- PHYSICAL FACTORS
- * Grasp
- * Arthritis
- * Tremors
- * Vision
- * Inability to Shop
- * Loss of Taste/Appetite
- * Changes in Metabolism
Sudden & Dramatic Weight Loss
- EMOTIONAL FACTORS
- * Depression
- * Loneliness
- * Anxiety
Sudden & Dramatic Weight Loss
- COGNITIVE FACTORS
- * Memory Loss – Sequencing Difficulty
- * Memory Loss – Use of Utensils and Tools
- * Time and Space Orientation
2. Memory Lapses, Increased Forgetfulness, Decreased Judgment
- AGE-RELATED MEMORY LOSS
- * Decline in Speed of Mental Processing
- * Less Able to Store New Material
- * Slower Reaction Time
Memory Lapses, Increased Forgetfulness, Decreased Judgment
- DEMENTIA
- * Deficits in Short-Term and Long-Term Memory
- * Aphasia – inability to understand or use language
- * Agnosia – inability to recognize and identify objects or persons
Memory Lapses, Increased Forgetfulness, Decreased Judgment
- DEMENTIA
- * Apraxia – Difficulty with Physical Movement (Walking, Gait)
- * Executive Functioning – Problem- Solving, Abstract Reasoning
- * Hallucinations, Delusions
3. Medication Problems
- * Not Taking Prescription Medication as Prescribed
- * Combining Medications
- * Unwanted Side Effects
- * Forgetting to Take Medications or Taking Them at the Wrong Time
4. Avoiding/Forgetting/Ignoring Responsibilities
- * Unopened Bills
- * Unpaid Taxes
- * Utilities Cancelled
- * Missed or Cancelled Appointments
5. Balance & Walking Problems
- * Stiffness
- * Posture
- * Gait (Walking)
- * Unexplained and/or Consistent & Multiple Bruising
- * Cuts, Burns
- * Broken Furniture
6. Withdrawal from Social Activities
- * Lack of Participation in Group/Social Settings
- * Disinterest in Previously Enjoyed Activities
- * Not wanting to Visit Friends or Relatives
- * Forgetting Rules of Games, Cards
- * Withdrawal From Conversations, Interaction – Often Due to Embarrassment, Hearing Difficulties
7. Neglecting Household Duties
- * Home Falling Into Disrepair
- * Laundry Not Done, Linens Not Changed
- * House Messy, Not Picked Up, Trash Not Taken Out
- * Dirty Dishes Piled Up
- * Pets Not Taken Care Of or Cleaned Up After
8. Changes in Eating, Cooking, and Shopping Habits
- * Not Eating Regularly and Nutritiously
- * Expired Foods in Refrigerator
- * Evidence of Burned Foods, Scorched Pans
- * Oven, Stove, or Other Kitchen Appliances Not Working Properly
- * Swallowing or Chewing Problems
9. Poor Hygiene or Appearance
- * Smelly, Wrinkled, Dirty Clothing
- * Inappropriate Dress
- * Body Odor
- * Hair Unkempt
- * Not Shaving or Brushing Teeth
- * Soiled Clothing or Bed Linens
10. Mood Changes
- * Sudden and Frequent Mood Changes
- * Changes in Appetite
- * Difficulty in Concentrating
- * Sleeping Too Much or Too Little
- * Hopelessness, Despair
- * Anxiety
- * Listlessness
11. Unsuitable or Inappropriate Behavior or Speech
- * Sudden Outbursts
- * Inappropriate Sexual or Racial Comments
- * Change in Language Usage (ie., Swearing)
- * Physical Aggression
- * Throwing Objects
12. Wandering, Difficulty Orienting to People or Places
- * May Feel Lost, Disoriented
- * Looking for Someone or Something They Think is Lost
- * Medication Side Effects
- * Curiosity
- * Boredom
13. Alcohol or Medication Abuse
- * Empty Liquor Bottles
- * Liquor Hidden or in “Unusual” Places
- * Prescriptions Depleted Before Refill Date
- * Medications Reported “Lost”
14. Driving Difficulties
- * Impaired Vision
- * Hearing Loss
- * Slow Reaction Time
- * Diminished Depth Perception
- * Getting Lost
Conclusion
- * Sudden Changes, Crises
- I.e., Fall, Stroke
- * Gradual Changes
- Tangible
- Intangible
Conclusion, contin.
Contact
- Prepared and Presented by:

14 signs your loved one might benefit from home care

by Visiting Angels on May 27, 2010

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14 signs your loved one might benefit from home care — Presentation Transcript