November and December are the months when most people gather with family. You may have traditions that go back to your childhood, involving where you gather, what you cook, how you treat one another, etc. And, hopefully, you look forward to these family holiday get-togethers.
Holiday gatherings in 2021 may be especially meaningful to you because of the pandemic. A two-year hiatus on family events also means that some changes may have taken place in the oldest members of your tribe that will be more noticeable to you this year. These may be subtle changes or they may be quite noticeable, such that other family members are raising eyebrows or commenting on it.
Changes in appearance and habits
Pay some attention to daily routines. Are they keeping up with hygiene (teeth brushing, bathing, grooming) or are their visual cues or smells that seem different than when you saw them last?
Have they lost weight? Weight loss can be indicative of a loss in their ability to cook or a diminished sense of smell or taste. Weight loss can also indicate other underlying health conditions.
Do they seem as attentive to household chores? Is there evidence of poor maintenance or cleaning?
There is a big difference between normal forgetfulness (where did I leave the car keys? Why did I come into this room?) and the kind of memory loss that is indicative of dementia. Notice if your elder is asking the same questions over and over, failing to follow simple instructions, or confusing well-known peoples’ names and relationships. These can be signs of encroaching memory loss that is unlikely to improve.
Changes in spirit or mood
When a usually cheerful person becomes morose or negative in their demeanor, it can be an indicator that depression has set in. This is all-too-common in today’s pandemic-shocked world. Isolation may be the culprit as well.
Social Behavior Changes
Ask about their hobbies and the organizations they have belonged to in past years. Are they still getting together with friends? Attending religious services? Pursuing their hobbies?
Notice how your elders walk. Has their pace slowed? Do they seem tentative in their gait? When muscles get weak or joint pain sets in, this can affect movement. Do they seem unsteady in any way? These are indicators of a fall risk and falls are one of the most significant hazards for older adults. In the blink of an eye, a fall can end the independence your elders have enjoyed to date. Take this one seriously!
Your parents probably pride themselves on their independence and may not even be aware of the changes themselves, but it is critical to watch for these signs of their waning ability to fully care for themselves and keep themselves out of harm’s way.
How do you Intervene?
There is no doubt that conversations about changes you see in your elder’s way of life can feel like entering a minefield. These are often very difficult discussion to have. Here are some tips for raising the issues and broaching the important topics:
Find the right time and place. You may want to tell your parent(s) that you want to have a conversation and set aside a time to convene. Make sure you have a quiet space, where you will not be interrupted. It’s okay to ask one or two other family members or friends to join you, but don’t invite so many people that the elders will feel like you are ganging up on them. Avoid any period of time when there has been abundant drinking–by you or them.
Share your concerns. Reassure them that you are worried about their wellbeing. Try to convey that you are not looking to control their lives. If they doubt your ability to make a fair assessment about their health, gently suggest that they check out your concerns with their doctors.
Solutions to Consider
If your concern is structural and cosmetic safety issues around their home, you may be able to remedy some of it yourself. Things like removing area rugs, installing nightlights, and getting rid of clutter may be within your capabilities and their willingness to let you help. Then make a plan to address the more substantial hazards by hiring a handyman or carpenter to install grab bars, outdoor railings, higher toilets, and lower cabinetry.
Hiring additional help (housekeeping, running errands, yard care, limited meal preparation) may be an acceptable interim solution to concerns about minor memory loss and balance issues. However, if the problem seems more than “minor” in gravity, consider some of the solutions below.
Assistance with some of the activities of daily living (bathing, dressing, grooming, and personal hygiene) can be arranged at your elder’s home at whatever frequency is warranted. Getting their agreement to this is critical, of course, and it’s important to understand that this will likely be seen as a much more invasive intervention that will appear to compromise their privacy as well as their need to continue to be in charge of their lives. It’s a difficult step for many people.
Ultimately, your assessment of the situation may be that they need to move to a safer environment, one that includes the assistance they need to manage their lives. For some elders, a transition to a retirement community can seem more appealing than having someone come into their home every day. Others may feel just the opposite.
If you are in a quandary about what resources are available and where to find them, your local Area Agency on Aging can be helpful. Every county in the U.S. has resources for aging, thanks to the Older Americans Act. Their Elder Care Locator can be a terrific resource. Another way to find these resources in through your (or your loved one’s) county’s website.