Family who live too far away to visit regularly miss the subtle changes that happen right before someone’s eyes. A parent sounds good on the other end of the phone each week. They are fine; they are managing; they are coping. Then, one day, a well-meaning neighbor or friend of the elder stops by and is confronted with a home full of unmailed mail, spoiled groceries and a medication routine that has turned into a free-for-all. Suddenly, it’s not a matter of whether or not they need help. The questions are how long has this been going on and when did it all begin?
There’s no instantaneous progression from living alone to needing assistance with activities of daily living. It happens gradually over time through myriad little changes that they can no longer cope with on their own. Thankfully, families can spot these changes early enough to get them the help they need before it manifests into something more serious.
The Condition of the Home is a Good Indicator
One of the most telling signs that someone needs more help than they are currently getting is in the condition of the home. Someone who has always kept a tidy and clean household starts to see clutter in the home. Dishes stack up. The laundry piles up. The bathrooms don’t seem to get cleaned anymore.
A messy home isn’t a one-off occurrence but a continual manifestation of a home that is falling apart because the person who lives there can’t keep up with the home any longer. Most often, age-related physical challenges are the cause. Picking things up off the floor becomes difficult. Carrying the vacuum cleaner becomes heavy. Bending down to clean the tub is impossible. Other times, it’s cognitive challenges that stop someone from completing these routine tasks. They can no longer remember or create a plan of action to get these small tasks completed.
Spoiled food in the fridge is another clear sign that someone needs more help than they can manage. So are stacks of unopened mail or unpaid bills when someone has always paid their bills on time. Piles of newspapers or unopened mail can indicate cognitive decline or so much fatigue that someone no longer has the energy to tackle the small mundane tasks of life.
Physical Issues Become Obvious Over Time
When someone stops taking care of themselves, they likely need hands-on assistance that they are not getting. Someone who has always practiced good hygiene suddenly stops. Wearing the same clothes for multiple days, not showering or bathing regularly, developing body odor and unkempt hair all seem to happen at once when someone can no longer take care of themselves to the level they have always maintained.
The bathroom routine is usually the first thing someone struggles with in the home. Seniors often have difficulty negotiating the tub or shower safely. Standing up for long periods becomes challenging. Instead of asking for help with what many feel is an embarrassing task, many people stop showering altogether.
For families looking for options for help, Philadelphia Home Care has trained care workers who can step in and provide assistance as necessary.
Poor dental care also signals someone who needs more help than they can ask for. Someone who has always taken good care of their teeth suddenly has bad breath, plaque build-up in their mouth and who avoids the dentist. These all happen at the same time when there’s a reason they can no longer keep up with their regular dental routine.
Managing Medications Has Multiple Steps That Are All Essential
Medication management also has several steps seniors must complete to take multiple medications each day. There are multiple opportunities to fail in these steps, and failing to take medications as directed can have adverse effects. Missing doses, for example, all have harmful outcomes. Taking medications at the wrong time (like a medication that should be taken on an empty stomach after eating) also has complications.
Signs that someone needs help managing their medications include pill bottles that are way too full (which can indicate missing doses) or one that’s empty before it should be (which indicates double dosing). Asking for the same information regarding what medication to take and at what time can signal someone’s memory is failing them.
There are several reasons why people may stop taking their medications when left to their own devices, but it usually goes unnoticed until someone ends up in the hospital with a complication that could have been avoided.
Cognitive Needs Become Obvious with Isolation
Someone who suddenly stops going out after having an active social life needs cognitive stimulation as much as they need assistance with activities of daily living. Someone who attends church each Sunday, plays cards every Friday or volunteers at an organization where they have spent years of their lives contributing suddenly, out of nowhere, becomes a hermit is not natural and needs addressing.
This often happens because getting ready and going out becomes too much for many seniors. Or they become embarrassed about their decline (physical or cognitive) to be seen by those who once relied on them to run the organization or who participates in social activities with them. The decline in mood often also contributes to the declining desire to leave the house.
The impact on mental well-being from isolation occurs almost instantly. Seniors who stop engaging cognitively with someone else often decline far quicker than those who do not. The same goes for their physical well-being.
A little companionship from professional caregivers becomes as essential as help with activities of daily living, hence, caregivers are encouraged to spend time with those they care for after completing their tasks.
Nutrition Needs Attention Before Malnutrition Sets In
There are physical signs that someone may need assistance caring for themselves rather than just living in a clean and tidy home. Noticeable weight loss and changes in eating habits long before unwanted pounds start falling off the scale. Rather than keeping a well-stocked refrigerator, someone who stops cooking for themselves fill the fridge with easy grab-and-go items that require no preparation at all—slices of cheese; slices of lunch meat, crackers but missing fresh produce that spoils before it gets eaten.
The skills of cooking and nutrition know no bounds. Someone who has always loved cooking for themselves suddenly can’t manage this task anymore because bending down at the stove or washing vegetables has become an impossible task. They can no longer remember how to prep a recipe (even those they know by heart) to make a meal. They don’t feel safe around knives anymore (doesn’t anyone ever think about cutting off old fingers?) for chopping and cutting; They cannot reach pots and pans in lower cabinets (My fingers hurt; Bending hurts).
The ritual that was once an enjoyable endeavor turns into boredom where eating cereal for dinner becomes okay; skipping meals is a possibility.
Malnutrition causes several adverse but avoidable conditions over time so before it gets noticed as a thing that needs addressing; it needs addressing already.
Someone Shouldn’t Drive If They Can’t Drive Safely
Someone who suddenly stops driving in certain situations and conditions where they had no issues driving through before is an indication that an elder may need assistance before something bad happens (like crashing). Unexplained scratches on the car is one thing but a refusal to drive at night or when it’s raining outside shows some self-regulation skills
What’s hard is when someone insists they can drive when they shouldn’t be driving anymore. Getting lost on familiar routes is one thing but mistaking the gas pedal for the brake is something all together else when attempting a getaway.
Not being able to judge speed and distance (and maybe other things) isn’t something getting fixed with a kind word and a little reassurance from the family in the passenger seat but should be sounding alarm bells for quite some time already.
If other drivers are honking at you while you’re busy discussing with your passengers how you used to ride this route as a kid; it’s time to hang up the keys; which means you’ll need assistance getting from point A to point B again.
When Signs Reveal Themselves All Together
One sign may not indicate anything but several signs show a pattern where someone living alone can no longer cope alone; nor can just occasionally visiting fill in these gaps; although it may seem manageable until something bad happens.
