What are the signs that my loved one needs help?

What are the signs that my loved one needs help?

How can you tell if you or your family member is ready for a move into an assisted living facility? This is a very personal question, and every person and their family has their own answer.

Most people who are seeking senior assisted living wait until a crisis occurs before they begin searching for an assisted living facility in earnest. This may be brought about by an unexpected change in finances, family circumstances, or health.  Rather than attempting to find placement in the midst of a crisis, it is better to be on the lookout for the following signs so you will have an adequate amount of time to find an option for senior care that is best suited for yourself or your loved one.

Declining Attention To Personal Hygiene

Body odor, unkempt hair, clothes that are dirty and a general decline in personal hygiene are all indications that an elderly person may need some assistance with some of their activities of daily living (ADL). As people get older, these types of tasks may become more difficult due to pain, arthritis, diminished motor control, or a decline in cognitive abilities.

It may become apparent that your loved one is bathing less frequently and in many cases, possibly not bathing at all. The reasons for this decline may vary. This neglect of hygiene could be attributed to forgetfulness or the person may have physical limitations that makes it difficult for them to get in and out of the bath or shower. Most assisted living facilities now provide assistance with bathing if needed. While not all facilities will provide this level of care, it is important to note that your family member will be safer when bathing at an assisted living facility because adaptive equipment such as handle bars and shower chairs are available and they will also have a "call for help" alarm in the restroom should they find themselves in any type of trouble.

Unsafe Driving

Disabled senior man being pushed through a lovely garden by hisAre you hesitant to allow your elderly relative to drive by him or herself? Do you notice scratches or dents in their car that cannot be explained?  Has there been a recent rash of traffic infractions or accidents? Declining vision, motor control, and cognitive abilities may all be contributing factors.

Unfortunately this is a very dangerous and also depressing scenario for an individual. Many issues can affect the ability to drive safely including vision impairment, hearing impairment, memory loss, and more. Talking to your loved one about the safety of them driving is a difficult conversation for both parties involved. To legally drive a car is one of the first rights we get and to have that right taken away can be both humiliating and leave a person feeling robbed of a basic fundamental right. Fortunately, many assisted living facilities now provide a means of transportation which can help your family member cope with the loss of being able to drive any more.

Consider asking your primary care physician to start this conversation with your loved one.

Unkempt Living Area

Examine the living are of your loved one. Are their stains, spoiled food, stained carpets, unsanitary kitchen and bath areas?  These may be signs that an elderly person is having difficulty maintaining their household.

At times we might not always keep our house as nice as other times, but if you notice a loved one who is no longer performing like they normally do and the housekeeping is no longer as good as it was, this could be a sign that they are no longer able to perform light housekeeping duties, or that this task is simply being forgotten. Assisted living can provide housekeeping services so that your loved one will no longer have to worry whether they remembered to clean the house or not. Along with housekeeping services, most facilities will also provide a laundry service so you can be sure all of your loved one’s needs are being met.

Inability To Manage Medications

If you detect unfilled prescriptions, expired bottles of medications, abnormally high or low pharmacy expenses, or if you count the medications in a bottle and it is not correct, this could be a sign your loved one is becoming increasingly forgetful and may be taking too much or too little of their prescribed medication. In addition, if you notice that a prescription is not being refilled in a reasonable time-frame it could be an indication that medication is not being taken as prescribed. Taking prescribed medications properly can be vital to a senior’s welfare, particularly if they have serious medical conditions.

Assisted living can provide medication management. Most facilities have trained personnel that can set up the right medications for your loved one on a monthly, weekly, or even daily basis. Also, most facilities will provide a locked medication management system to ensure the medications are kept safe and that your forgetful loved one doesn't accidentally take too many medications.

Declining Mobility

Difficulty climbing stairs, rising from a seated position, and exiting and entering vehicles are all indications of declining mobility. When elderly people begin to lose mobility it is likely a good time to begin searching for assisted living or other assistance.

Unexplained bruises

Two senior citizens talking to a nurse in a hospital gardenIt is true that at any age someone can easily bump into something during the day and develop a bruise later without having a memory of what they bumped into. However, if you have a loved one that is elderly and you start noticing more frequent unexplained bruises, or bigger unexplained bruises that may indicate your loved one could be falling at home. These bruises need to be taken seriously. There is a chance that your loved one is growing more forgetful and perhaps having issues with mobility and not able to get around the house independently any more. Assisted living facilities provide more supervision so there will be someone to check on your loved one. Also, inside the apartments there are grab bars to help prevent a fall and "call for help" alarms so that in the event of a fall, your loved one can call for help fast.

Too little food available or food is beyond expiration date

We all know it is important to have food in the house available to eat, especially for an elderly person who may not be able to drive to the store frequently or even at all. If you start noticing very little food in the house or food that is past expiration dates, this could be a sign that your loved one is not eating enough and possibly becoming forgetful. If a person has early dementia they will likely start forgetting many things, even when and how much to eat. Assisted living provides the opportunity for prepared meals to be delivered to your loved one so that you can rest assured that they won’t be missing any meals.

Declining Appetite

If you notice that an elderly person begins to skip meals and starts to neglect to cook or go grocery shopping it may be a sign that they need help, particularly if they are losing weight and not getting enough nutrients to maintain their health. A move into assisted living would ensure that they would get three nutritious meals daily, and help with eating if necessary.

Neglecting Finances

If you notice that there are numerous collections notices, unopened bills piled up, or receipts for unusually large donations, it may be a sign that an elderly person has lost control of their finances. It is important for elderly people to have good control of their finances, particularly if they are on a limited fixed income.

Reduced Ability To Communicate

Do you notice that your elderly relative finds it increasingly difficult to follow directions? Does he or she frequently have to stop mid-sentence to think of words to describe what they want?  It is easy to overlook this since we don’t like to see them lose the mental acuity they had in the past. If their ability to communicate is impaired, it may be a good idea to get them the assistance they need.

Memory Impairment

Young nurse and female senior in nursing home, the blood pressurSome people retain their cognitive abilities until the end of life. For many others their cognitive abilities decline precipitously. If memory loss is an issue be sure to select a facility that includes memory care in their services.

Forgetfulness is often the first indicator to other members of the family that a loved one may need more assistance and may possibly need the consideration of an assisted living facility. When you know somebody who usually never misses appointments or other scheduled events such as phone calls and now suddenly they are, this forgetfulness can be an early sign of dementia and perhaps a sign that your loved one is not as independent as they once were. You may notice when you confront your loved one about the missed engagement, many times they might make up an excuse or try to cover for the fact that they had forgotten. Assisted living can help set appointments and phone calls and many will even provide transportation to ensure your loved one makes it to all their important events.

Depression

Depression can affect all age groups, but it is increasingly prevalent in the elderly population. Insomnia, anxiety, mood swings, and loss of interest in activities they enjoyed in the past may be indicative of depression. Make sure you stay aware of the interests of your loved one. In doing so you know if they are exhibiting these symptoms.  No one enjoys suffering from depression, and the sooner you notice it, the more quickly you can get help for your loved one.

While the signs we listed above are indications that a senior may be ready for assisted living, they are not strict guidelines. It is important that you stay involved in a senior’s life so that you are aware of any changes that occur. Stay particularly focused on changes involving personal hygiene, health, safety, and cognitive ability. If concerns arise, consult with a geriatric care professional.

The changes experienced may be related to memory impairment or this could be a display of internal aggravation due to an overall decline in functioning. For family members, this can be extremely stressful, especially when the individual was previously calm and gentle and now displays anger and aggression. It is possible that your loved one feels aggravated about losing their capability to perform tasks independently and by providing them with assistance could enhance their mood. However, it is important to note that the change in mood and behavior could be related to dementia. If this is the case, assisted living will provide more supervision and assistance making the family member safer at all times.

Contributing Authors

Kelli Wilson, RN

Kelli is a Registered Nurse with over 19 years of experience in long term care nursing homes. Though the years she’s worked up to Assistant Director, and Director of Nursing. Kelli has been involved in admissions, discharges, and arranging home care. She’s also familiar with Medicare/Medicaid requirements and how to preform pre-authorizations.

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    James Conte, RN, BS Nursing, BS Pharmacology

    James is a Registered Nurse with a BS in Nursing, a BS in Pharmacology, and a BS in Electrical Engineering. He brings with him many years of experience working in Long Term Care facilities, and as a Registered Nurse in an Intensive Care Unit. His familiarity with nursing and emergency care provides an invaluable perspective on managed care.

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      Miranda Booher, RN, ACLS Certified, BLS Certified, Tx Certified

      Miranda’s strongest area of expertise is nursing. She has worked as a registered nurse for over 6 years with 4 years experience on a pediatrics and orthopedic surgical unit and 2 years as a travel nurse, working in critical care and healthcare informatics.

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        Carolyn Falconer-Horne, Ph.D. Candidate

        Currently working towards her Ph.D., Carolyn is a licensed and certified speech-language pathologist with over 15 years of experience working in rehab hospitals, long term care facilities, and skilled nursing facilities.

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          Last modified: November 26, 2016