Family Education

The Signs of Changing Needs

Aging relatives, particularly those who live alone, increasingly face medical and mobility issues, and questions relating to their physical, social and psychological well-being arise. So how do you know if a relative's needs have changed and more care is necessary?

Healthy aging and signs to expect

The aging process will slow down even healthy adults to some degree, though how much and to what extent depends on the individual. As we age, we won’t be as quick and our energy reserves won’t be what they were when we were teenagers. Even with normal aging, a parent may not be able to get through the day without some help.

That said, the aging process should not necessarily cause problems in basic functioning. Outside of slowing down physically, people should still be able to balance their checkbook, maintain personal hygiene, and conduct routine tasks. If these activities of daily living are being successfully accomplished, you probably don’t need to worry too much.

Healthy aging and signs that need evaluation

If you see signs beyond some general slowing of physical function, it’s important to take an aging parent to a doctor – if possible, a geriatric medicine specialist – for an evaluation. Any number of illnesses could be behind worrisome symptoms. Increased fatigue and reduced energy may not seem like urgent health issues, but they should still be evaluated. For instance, fatigue and weakness can be caused by anemia, common in older adults, and can be treated. Weakness and shortness of breath can be signs of heart disease, even if you parent isn’t complaining of chest pain.

A normal condition in aging adults is having a less steady gait, a common result of the loss in muscle mass that naturally occurs with age. But that unsteadiness can lead to falls, which can be dangerous for aging adults who may easily break a bone or suffer a head injury. Signs of instability should be evaluated by a doctor, and the aging parent’s home environment should be carefully checked for hazards that could cause trips and falls. See our Home Safety Checklist.

The challenges of recognizing health problems

It can be difficult to know when aging parents are experiencing health problems. Part of the problem is that aging parents often won’t admit that something might be wrong. They are afraid of being “put somewhere”, or perhaps of being a burden to anyone.

An adult child might miss the signs of health problems if she sees a parent all the time. If you live close by and visit often, health problems may be tough to spot because some conditions such as dementia can occur slowly over time. It’s a good idea to ask regularly about current events going on in the world. Also, take notice and appropriate action if the response is uncharacteristic.

Adult children who do not see their aging parents often will be more likely to observe problems right away. Some family members may talk on the phone regularly, but then when they come to visit for the holidays they realize that all is not okay.

Confusion or memory problems can be caused by medications. Many aging adults can have trouble keeping track of the many prescriptions and an overdose can easily lead to mental and physiological problems.

Following are some clear warning signs that some type of intervention is needed:

• Mail and bills are left to pile up. The simple act of opening and filing mail can become overwhelming. Paying bills on time and managing a checking account can also become too much for a parent to handle, or can be a sign that they are not thinking clearly.
• The house is cluttered or unkempt. Lack of interest. This should be of special concern if the parent has always been neat and orderly.
• Losing weight. This can happen especially after the death of a spouse. Shopping, preparing food and cooking become too much trouble.
• Food in the refrigerator is uneaten or spoiled. Shopping, cooking, and cleaning become too much trouble A parent might eat just enough to get by, but suffer nutritionally. Losing weight can be another sign that a parent is not eating a nutritious diet.
• Signs of scorching on the bottoms of pots and pans. A result of short-term memory loss, this is a dangerous sign that parents are forgetting about pots left on the stove, causing a fire hazard, and threatening both the individual and the surrounding neighbors’ safety. Look for other signs of confusion in the kitchen such as water stains and mildew under the sink and in other places because water was left on and forgotten about, dishes that are unwashed for long periods, food left out, etc.
• Declining personal hygiene as indicated by unkempt hair, dirty or lengthy nails, poor oral hygiene, body or urine odor, unshaven, and wearing same clothes over and over or wearing night clothes during the day. Especially common when the washing machine is in the basement. Or there may be a fear of falling in the tub or shower.
• Missed doctor’s appointments. Sometimes this is simply a product of not having transportation and not knowing how to access ride options.
• Getting up and down stairs and in and out of home becoming difficult. Walking unsteady on level ground and/or complaining of dizziness. Falls are likely or have already occurred.
• Forgetting to take medication. A sign of short-term memory loss or depression, this is not just a quality of life issue, but a real risk factor.
• Inappropriate behavior, clothing or speech. You may hear about this from a neighbor, someone who has noticed that your parent is not dressing appropriately for the weather, for instance. That’s a sign that he or she might be confused.
• Not recognizing need for, arranging, or scheduling necessary household repairs and maintenance. Lawn not mowed, trash not disposed of, and mail retrieved with irregularity.
• Just acting strangely or out of character. Odd conversations, signs of paranoia, accidentally taking too much medication, phone calls at odd hours, unusual fears and nervousness, all of these things may be signs that a parent needs help.

Now what?

If you see any of these signs in your parents, discuss it with them. Share your concerns and see what they say. Try to get them in to the doctor, but if you can’t, make an appointment with the doctor or a geriatric care manager yourself and discuss your concerns. The professional can point you to various agencies that can help.