40 Signs An Elder Loved One Needs Help
Admitting that they need help and accepting assistance is not easy for people as they age.
Generally, this is due to a fear that they will lose their independence if they admit they need help.
The responsibility often falls on family members to recognize the signs that an elderly loved one needs support with their Activities of Daily Living (ADLs).
When elders have difficulties living on their own the issue is usually caused by one of four things:
• Cognitive Decline
• Functional Decline
An injury, such as a broken hip, can be so debilitating at any age that caring for oneself is impossible during the early stages of recovery.
Illnesses such as glaucoma causing vision issues, or health problems such as diabetes, can make it difficult to manage life alone.
Cognitive decline from dementia or other memory loss results in confusion which can lead to greater health issues from medication mismanagement, accidents, and can become dangerous, such as leaving the stove on.
Common Signs Help is Needed
If your loved one shows one or more of these signs, you should be concerned, monitor the situation and take action.
Changes in Physical Function
• Difficulty getting up from a seated position
• Difficulty with walking, balance and mobility
• Unexplained bruises or injuries
• Marks or wear on walls, door jams, furniture and other items is a sign they are using for stability while walking through the home
Changes in Mental Status
• Reports from friends and neighbors of strange behavior
• Difficulty keeping track of time
• Sleeping for most of the day
• Tasks that seem to have begun but are not completed, such as clothes left in the washing machine to mold
• Difficulty communicating, such as rambling conversation, inability to find words to express themselves
• Repetitive questioning and not being able to your frequent answer
• Persistent confusion about the day of the week
• Poor diet or they are losing weight
• Loss of interest in their hobbies and everyday activities
• Changes in mood or extreme mood swings
• Uncertainty and confusion when performing once-familiar simple tasks such as opening a bottle of pills or how to use familiar implements such as a key
• Forgetfulness, including forgetting to take medications or taking incorrect dosages
• Inappropriate clothing choices, such as a heavy coat in hot weather or shorts/t-shirt in winter
• Missing important appointments
• Consistent use of poor judgment such as falling for scams or sales pitches, and giving money away
• Uncharacteristic changes in their normal spending habits such as making many purchases or not purchasing anything at all
• Signs of unsafe driving such as unexplained dents and scratches on their car
• Instances of getting lost, especially the inability to find the way home from a familiar place
Poor Personal Hygiene
• An unpleasant body odor
• Infrequent showering or bathing
• The smell or stains from of urine or feces in the house, on their clothing, or on furniture including wet spots
• A noticeable decline in grooming habits and personal care such as unkempt hair, untrimmed nails, lack of oral care, wearing dirty or stained clothing, sloppy or not shaving at all, bizarre makeup
Neglecting Household Responsibilities
• An inability to independently complete Instrumental Activities of Daily Living (IADLs).
• Little or no fresh, or healthy food in the fridge
• Spoiled food that doesn’t get thrown away
• Improperly stored food
• Evidence that food has not been properly prepared such as burnt or uncooked meat, or burnt pots and pans.
• A dirty house and/or extreme clutter
• Piles of dirty dishes in the sink or around the house
• Garbage is piling up and not taken out.
• Dirty laundry piling up
• Food and other stains on furniture or carpet
• A pile of unopened mail or an overflowing mailbox
• Late payment notices, bounced checks and calls from bill collectors
• Utilities being turned off due to missed payments
• Evidence that a pet is not being cared for such as an empty water dish, filthy litter box, animal urine and feces in the house
These red flags do indicate that supportive care is needed for the Activities of Daily Living (ADLS) and Instrumental Activities of Daily Living (IADLs) on either a short term or long term basis.
Additionally, these red flags and the situation need to be discussed with your loved one’s doctor.
Factors Contributing to Functional Decline
Functional decline in elders can usually be traced to one or more of the following factors:
As we age we lose physical strength, stamina, balance, and muscle control.
These changes can make the Activities of Daily Living (ADLs and IADls) a challenge.
• Laundry baskets begin to feel like they weigh a ton, especially carrying them up on down the steps.
• Trips to the bathroom happen more often, take longer than they use to and an accident may result.
• It becomes more difficult to get up from a chair or the toilet.
• Balance can make using the steps or the shower scary.
• Slower reflexes making driving more difficult and even dangerous.
• Arthritic joints, shortness of breath from lung or heart problems, pain that is not being managed properly, the side effects of medication, can all make movement difficult and independent living unmanageable.
Illness and diseases can produce similar changes, even in younger people.
Our perception ability deteriorates as we age and contributes to functional decline:
Vision: As we age we become farsighted and lose the ability to focus on small details.
• It is difficult to shave or apply makeup if we cannot see our face clearly.
• The house and the kitchen may look clean when you cannot see the dirt.
• It is harder to write a check when you cannot see the numbers.
Hearing: We lose hearing as we age making us less aware of what is happening around us.
• Decreased hearing can make telephone conversation impossible and even face to face communication difficult.
• All sorts of buzzers, alarms, and sound warnings, even people entering the room, can be missed.
Smell and Taste: Our sense of smell and taste decreases as we age.
• Reduced smell and taste may cause a person to miss that food has soiled.
• The reduced ability to smell may cause a people not to noticed that a pot has boiled over of food burned in the stove.
Touch: Poor circulation and illness decrease our temperature sensitivity and tactile feeling.
• Decreased temperature sensitivity can lead to burns from scalding water in the shower or kitchen sink.
• Decreased “feel” may cause scrapes and cuts to go unnoticed and lead to infections.
The way we process information does not really change as we age, however, the speed of processing and the ability to multitask does:
Speed: The rate at which we can process information and think declines with age, especially when a rapid response is required.
• Banking or shopping during peak hours and may lead to confusion, miscalculations and errors.
• Driving during rush hour may have too many inputs happening too quickly and all at once.
Multitasking: We lose the ability to divide our attention and carry out two or more tasks simultaneously
• Holding a conversation and driving at the same time can become dangerous.
• Tasks that must be done in a certain precise sequence such as cooking can become a challenge.
Some age-related decline in cognitive processing is normal as we age.
However Alzheimer’s and other forms of dementia affect on memory, problem-solving, language processing, and the ability to perform the activities of daily living (ADLs/IADLs) can deteriorate rapidly.
As we age, we continue to use the same coping strategies that worked for us in the past, when we were younger, even if these strategies are no longer effective.
Lifelong personality traits become more exaggerated:
• A person who always relied on others can become unbearably clingy, pestering friends and family constantly
• A once effective take charge person can deteriorate into an argumentative my way or the highway person
Some age-related personality trait exaggeration is normal. However, the more scared or upset a person is the stronger the exaggeration becomes as they cling to their old and familiar ways.
Depression and anxiety are common in elders and can lead to functional decline.
Distinguishing Temporary Decline From Long-Term Deterioration
If your loved one is recovering from an injury, surgery or an illness, it may be easy to tell the functional decline is temporary and care is only needed for the short-term.
One single incident from the list above may not be enough to confirm that there is functional decline.
Look for a pattern of repeated incidents.
When incidents repeat themselves or there are incidents in a variety of categories, something is wrong and it is time to act:
• Seek a diagnosis and begin treatment
• Learn more about the medical condition and plan ahead
• Consider psychological issues
Seek A Diagnosis And Begin Treatment
First, check to see if the issue is caused by a misdiagnosed illness or disease.
This requires a thorough assessment and diagnosis from a physician.
If a medical problem is detected, in many cases the problematic behavior will disappear once the cause in under control.
Learn More About The Medical Condition And Plan Ahead
If the problem is due to an untreatable medical condition, research the illness to learn as much as possible.
Usually, your doctor can predict the course of the illness which can help you plan for the future.
Consider Psychological Issues
If there is no medical basis found or the problematic behavior goes beyond the normal medical cause, consider that there may also be a psychological factor.
If this is the situation, the issue needs to be addressed by psychotherapy, medication, and other behavioral intervention.
The doctor should refer the patient to a psychologist or psychiatrist who is experienced with the elderly.
Whether the issue results in temporary or permanent decline, a care plan must be made to address your loved one’s immediate and future needs.
If these signs are present, it doesn’t necessarily mean a move to assisted living or nursing home is required. However, these red flags do indicate that daily supportive care is needed.
In-Home care can provide this care and also supplement family caregivers.
Our extensive directory of Online Resources has additional information and tips for families and caregivers.
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