Intervention Time, When Do We Step-In?
When to Put on Our Action Hero Suit
Intervention: when is the right time to take action if you’re responsible for an aging loved one? It’s hard to tell when your elderly parent needs help, especially if you are helping long distance. Elderly adults become adept at hiding their problems. Parents don’t want to burden you or they are unable to face their own decline. It’s especially easy to miss over the phone.
If frequent trips to your parent’s home aren’t possible you can’t “see” first hand how parents are coping. You can hire a geriatric case manager (GCM) to assess your parent. GCM’s specialize in assessing the needs of the elderly. The service is not covered by Medicare nor cheap but you may save money, time and stress in the long run with their advice. There are Certified Care Managers. Certification requires the education (nursing, social work, psychology), current licensure and passing an extra exam in their specialty area. These folks will help you navigate the labyrinthine health care system of Medicare, facilities and costs. Alternatively, you could ask your loved one’s doctor for a home health assessment of your parent’s needs. You can find a case manager in your area online. In all honesty, I have not used one, though I have met some I really liked.
What To Look For
What signs do you look for if you suspect your parent is no longer able to live alone. Being forgetful is not in itself a reason to intervene. The NIH lists these signs to look for:
Signs of Self-Neglect
Self-neglect describes situations in which older people put themselves at high risk. People who neglect themselves may have a disorder that impairs their judgment or memory. They may have a chronic disease. Knowing where to draw the line between a person’s right to independence and self-neglect can be hard. Here are some signs that may mean it’s time to intervene, although they can be hard to recognize during a short visit:
• Failure to take essential medications or refusal to seek medical treatment for serious illness
• Leaving a burning stove unattended
• Poor hygiene
• Not wearing suitable clothing for the weather
• Inability to attend to housekeeping
What Are Those Things When They’re At Home?
Breaking it down…
Hoarding is accumulating stuff such as magazines and stacks of mail that litters chairs and tables to the point there’s nowhere to sit or navigate through the house. My parents grew up during the depression. They didn’t throw things away. You reused them, used the spare parts or repurposed them. In dementia, organization skills decline, making it hard to sort mail, magazines and papers. My father-in-law, in his later years hoarded boxes of Ritz crackers and Coca-Cola. He filled not just the pantry but the linen closet with them. My dad filled their 1500 square feet of basement with hoarded stuff. Some develop an emotional attachment to things. It may become unsanitary but usually, it’s a just a tripping issue and a nuisance for the children who will eventually have to deal with all the stuff. It’s also a sign of trouble coping.
Seniors forget to take medications. We all do sometimes, but if critical meds are missed, they need help. The elderly may also run into problems getting refills and organizing pills. Ask your parent’s pharmacist for help or recommendations.
Unattended stoves, water left running, and electrical devices left on are health hazards. Sometimes unplugging the stove leaving only a microwave operational helps. If your parent remains unsafe, your only option is relocating them or getting live-in help. (I started to understand how my parents feel when a family member remonstrated with me for leaving a burner on, on the stove. To me it wasn’t a problem. I just turned to take the pot off the stove, the flame was on low and I was not done cooking. Resentment welled up in me that they thought I wasn’t coping. I thought, this is how my parents feel!)
Many elderly adults are reluctant to bathe. Getting in and out of a tub or shower is scary if your balance is poor. In cold weather, the elderly want to stay warm. They don’t want to take their clothes off and if they do, how will they get them on again? Dressing themselves is tiring and hard.
The days run together for the elderly. They’re not sure if it’s winter or summer, they don’t go outside much, how do they know what to wear? My mother is always cold now and wears winter clothes year round.
When your joints ache, your body is stiff and it’s hard to bend over, housekeeping chores are difficult to impossible. Add poor vision into the mix and your parent may not even see the dirt. Spoiled food in the refrigerator is a common problem.
The elderly forget to drink during the day. Their appetite is less. They may eat alone. They may have bathroom accidents, so they avoid drinking liquids. It’s easy to become dehydrated.
Look for these things when you visit your elderly parents but don’t overreact. Keep things non-confrontational. Your might say, “Dad, your mail is really piling up. Can I help you sort some of it?” Or, “Mom, I noticed the stove is on even though dinner is over. I’m concerned about your safety. What can we do to help you stay safe.” Remember your parents aren’t children. Treat them respectfully while trying to help them. Sometimes we’re incredulous learning our parents would prefer a sub-par situation to our ideal. A team approach with their input is best.
Have a good caregiving day,