How do You Know When Your Elder needs Help?

I came across this picture, titled "Father's Hands", in my perusings, and the story linked to it touched my heart. But among other things, it made me think about the conversations I have had with others about the topic of this post:

Just how do you know when your Elder needs help? Most Elders try very hard to hide the fact that they are "slipping", being fearful of what may happen if someone decides they are no longer independent. So it's usually unlikely that your Elder will just ask you for help. There are many emotional tags that go between parents and children (or grandparents and grandchildren, or whatever your relationship is). Your Elders do not want to be dependent on you, the younger. They do not want you to tell them how to live their lives. They do not want to bother you, after all you now have a pretty full life, and probably a family, of your own. They have been independent all their lives, and want to stay that way. They are proud and may be in denial about the fact that they need help. And the biggest fear: if they let on they need help, they will end up in a nursing home.

So, you need to be keen to the subtle signs, and the not so subtle signs:

• Your Elder is suddenly less social, or exhibits very reclusive behavior.
• The house isn't kept up the way it always was before; laundry isn't done; grocery shopping hasn't been done; the yard is not being maintained.
  
• Tasks that used to be routine or easy are now difficult to accomplish.
• Your Elder is not eating as well, and/or has suddenly lost weight.
• It looks like your Elder has problems taking medications properly, missing doses or taking too many. Maybe prescriptions have not been refilled, or your Elder has missed doctor appointments.
• The bills have not been paid, and/or checks have not been deposited.
• Personal hygiene is not being done; showers not being taken, oral hygiene not done, clothing hasn't been changed; hair is not being washed.
• The pet is not being cared for properly.
• Your Elder's driving skills are slipping.
• Friends and hobbies have been dropped.
• Your Elder seems confused or depressed.
• There is difficulty with stairs, maybe falling is a problem.
• Loss of bowel or bladder control.
• Anything that seems very unusual for the person that you have known can be a sign that things are not quite right. Maybe your Elder's neighbors are reporting things to you that just don't sound like your Elder at all.

So, now what. You talk to your Elder, and you ask questions. But your Elder denies needing help, makes excuses, or explains away your concerns. Be careful here. Don't push too hard, or you might risk putting a wall up between you and your Elder. Above all, the lines of communication must remain open.

Whatever you think, your Elder will be better off in their own environment as long as possible, and with the least amount of intrusive "help" as possible. But there are ways to help that could actually improve the Elder's quality of life.

Start by making sure your Elder's medical needs have been attended to. Go with her/him to a doctor's appointment and discuss your concerns. Very likely there will be things the doctor can suggest, or may refer the Elder to a professional that can further assess the situation. There may be medication changes that need to be made, or conditions that need to be treated that will improve your Elder's strength and cognitive function.

If the Elder's medical needs are under control, make sure medications are being taken properly. This is easy to accomplish as long as you have the Elder's cooperation. Very often it only takes someone to organize the medications in a pill box, so the Elder doesn't need to sort through numerous bottles several times a day. For Elders with very poor memory, you might try putting the medications in an envelope with the date and time to be taken written on it. Leave out only one days supply at a time to prevent more confusion. Your Elder can mark the envelope when the meds are taken to remind them later when they have forgotten whether the medicines were taken or not. Take a look at my post about managing medications.

Make sure the Elder's home environment is safe. Start in the bathroom. By installing some simple grab bars in strategic places, you can greatly enhance your Elder's independence in bathing and toileting. Many times simple things can fix a big problem. Maybe your Elder doesn't bathe as often as they used to because of the fear of falling.

Try to get at the bottom of the problem, then it will be much easier to work on.

• What is the real problem. (eg: not showering; not eating right)
  
• Why is this a problem (eg: fear of falling in the bathroom; shopping is too confusing and too tiring)
  
• How can we help this the easiest way possible (eg: install grab bars in the bathroom; deliver groceries/meals to your Elder)
  

Then, if your "fix" doesn't work, try something else. Always include your Elder in the decision making process. You will be likely to get much more cooperation this way.

This is just a basic idea of where to start. If you are able to notice when your Elder needs help, and are able to provide it before things get out of hand, you will be able to keep your Elder home and independent much longer. And this makes for more Pleasant Days for your Elder and you.