In our work as Aging Life Care Managers®, a common story we hear around the holidays goes something like this: Debbie first noticed a difference in her mom at Thanksgiving. The traditional holiday family foods that Debbie’s mom always created from memory, not recipe cards, tasted and looked different. The usual care she took with place settings and decorations was noticeably different too. She also observed her mom struggling with day-to-day tasks and activities that used to be second nature to her. It was obvious something had changed, but Debbie wasn’t sure if she should be concerned or what she should do.
The holidays are busy, filled with activities, traditions, distractions, and visits with family and friends. It’s often the time when those who live apart geographically can spend extended, precious time together. If you haven’t seen the older adults in your life over several months or years, it’s not unusual to notice changes when you are together for a few hours or days. You may observe uncharacteristic behavior, lifestyle changes, and routines, just as Debbie did with her mother.
The following are common signs that may signal a cause for concern and action. Use this Cause for Concern checklist for clues or changes that warrant attention:
| Areas of Concern | Cause for Concern | Yes | No |
| Concerned friends/
neighbors |
They notice worrisome changes, step in to help when they can, but when the changes are such that they’re concerned for your loved one’s safety, it’s time to step in. | ||
| Their Home | It’s not as clean or sanitary as you remember growing up. Routine maintenance, inside and outside, are neglected. You may notice hoarding tendencies; the trash not being taken out or the fridge filled with spoiled food. | ||
| Finances | Bills are unpaid or paid more than once; an unusual number of payments to telemarketers, charities, and television advertisements; utilities are at risk of being shut off; money is hidden; and/or the mail or newspapers are piling up. | ||
| Eating Habits | Is there weight loss? No appetite or missing meals? You discover moldy, rotten food in the kitchen, or a burnt pan on the stove that your loved one can’t explain. Your parent says they just ate lunch but there is no evidence to support this. | ||
| Medications/Health Care | Medications are being taken incorrectly. Your parent doesn’t know why they are taking certain medications. They’re confused about their doctor’s advice, not filling their prescriptions, or missing medical appointments. | ||
| Safety | Your love one has difficulty using the stairs. They have had repeated falls. They seem less cautious about strangers and you are worried they may be vulnerable to abuse. They lack the safety awareness they once had, and you wonder what they would do in an emergency. | ||
| Hygiene | Your parent’s clothing may not coordinate, it may be soiled, worn for days, or not appropriate for the weather. Are they bathing infrequently and not attending to oral hygiene? You may notice body odor, bad breath, neglected nails and teeth, and sores on their skin. | ||
| Driving | The car has new scratches or dents that can’t be explained. Regular car maintenance is being ignored. Your parent may mention they got lost while driving or ran out of gas. Or, they may seem too nervous to drive or don’t have insight that it’s time to give up the keys. | ||
| “Mom Is Fine” | So your father says. Mom agrees, though your gut tells you otherwise. They’ve learned to compensate for one another and may be afraid or embarrassed to share that they are struggling. | ||
| Uncharacteristic behaviors | Your parent is unusually loud or quiet, paranoid, agitated, making phone calls at all hours. Your loved one no longer initiates activities, is more withdrawn and isolated, and you wonder if sleeping all day is now the norm. |
The more items you answered YES to in the Cause for Concern checklist, the higher the likelihood your older loved one needs support. Even if you responded YES to just one question, you will benefit from being proactive and planning ahead.
What Next? Be Proactive.
Whether you live near or far, there are steps you can take to ensure your loved one’s health and well-being and give yourself some peace of mind:
- Talk with your parents/older loved ones. Start with a conversation and talk about your concerns. Consider including other people who care about your parent/s in the conversation, such as other loved ones, close friends, or clergy who may be able to come alongside your parents as they make these changes.
- Regular checkups. If you’re worried about weight loss, depressed mood, memory loss or other signs and symptoms, such as those described above, encourage your older loved one to schedule a doctor’s visit. This can help to identify and address any possible causes of changes. Ask about follow-up visits as well. Offer to go with them and take notes. Remind them how nice it is to have an advocate.
- Take care of safety issues. We can’t cover our parents in bubble wrap, but we can review any potential safety concerns with them. Start by prioritizing what needs to be addressed first. Then suggest small, manageable changes so they don’t become overwhelmed. Include your parent in the discussion and decisions. Go at a pace they can accept. Be patient.
- Engage an Aging Life Care™ expert. Also known as a geriatric care manager, an Aging Life Care expert is a health and human services specialist who acts as a guide and advocate for families who are caring for older relatives or disabled adults. Visit the Aging Life Care Association website to locate an expert near you and/or your loved one.
- Seek help from local agencies. The Eldercare Locator, a public service of the U.S. Administration on Aging, connects you to services for older adults and their families. You can also reach them at 1-800-677-1116.
It’s not always easy or comfortable talking with parents or other aging loved ones about concerns, as sometimes they won’t admit they need help, and other times they don’t realize they need support. Assure your parents that their health and well-being are a priority for you and that you are in this together. Fortunately, there are many options and resources for supporting them and you. You are not in this alone!
Amanda Lewis, BA, CMC
Categories: Care Managing