As families come together over the festive season, it can become apparent that changes have occurred in an elderly relative’s health, cognitive ability or general disposition. Mum is perhaps more forgetful than last time you visited and is repeating stories. Dad has lost weight and is off his food, or there may be complaints of being lonely and not getting out to see friends as often.
These are some of the more obvious signs of a decline in wellbeing, but what are the more subtle changes that family members should look out for?
Activities of daily living:
- Untidy or unclean house – Housekeeping routines may change due to the difficulty or exhaustion of performing the tasks and there are a number of reasons why someone falls behind with housekeeping. It could be that they can no longer carry the vacuum cleaner upstairs, are unable to bend down – or perhaps their eyesight is failing. It could also be a general lack of enthusiasm for this sort of work
- Declining driving skills – Keep an eye out for evidence of parking or speeding fines as well as dents and scratches on your ageing adult’s car – these may be signs of deteriorating driving confidence and skills. Reduced vision affecting the ability to read signs or see in poor light, changes in sense of direction, inability to merge in traffic, driving way under the speed limit and very slow reaction times may indicate reduced confidence to drive.
- Unpaid bills – The simple task of opening and responding to mail or bills can become overwhelming, particularly if eyesight is deteriorating or if this was once the responsibility of a deceased spouse. Financial risk or hardship can impact the option to remain living independently at home.
- Symptoms of depression – Depression causes marked changes in behaviour and daily routine over time. Many ageing adults feel isolated or like prisoners in their own homes, particularly if a health condition or the death of loved ones prevents them from going to places they once enjoyed. Feeling overwhelmed, feelings of hopelessness or despair, increased listlessness, and not wanting to get dressed can all be indications of a problem. Other signs include a change in sleeping patterns (sleeping for longer or finding it difficult to sleep) and a lack of interest in their usual hobbies and activities.
- Losing track of medications – Missed doses and medication mistakes (overdosing and running out of pills before the next prescription can be filled) can lead to serious medical issues and risks. Some older individuals take multiple prescriptions, which can be overwhelming and confusing without medication aids and reminders.
- Declining personal hygiene – Changes in appearance are the most obvious signs that some support may be needed. Look out for unkempt hair, body odour, unshaven faces or continence issues. Wearing clothes that are dirty, unchanged for days or inappropriate for the weather may also be an indication that more support is needed. These changes may occur because doing the laundry or getting in and out of the shower has become too physically challenging or they may be forgetting to perform these tasks. Many who live alone also fear slipping and falling in a shower or a bath with no one there to help them get up.
- Decreased Mobility or Signs of a Fall – Do they have difficulty getting up from being seated or standing for long periods of time? Do they have bruises or wounds that could point to a recent fall? One in four adults ages 65 and over fall each year. But many people don’t like to tell loved ones that they have had a fall. A bruise can indicate that a fall has occurred.
Nutrition and hydration:
- Food in fridge well past sell-by date – this can be a sign of cognitive decline or the early stages of dementia. People can start to over-buy food and are unable to process use by dates – so food remains in the fridge well past a time when it’s healthy to consume.
- Losing interest in food – Older adults who find themselves alone or who have reduced mobility may struggle or feel overwhelmed by cooking and may not eat properly.
- Signs of excessive weight loss can indicate poor eating habits. An ageing adult may eat enough calories to survive but may suffer nutritionally which can have broader health impacts. Weight loss is not a normal part of ageing and can indicate changes in behaviour or underlying health conditions.
Changes in memory:
- Not recognising names in Christmas cards – this may be a sign of cognitive decline as the person no longer knows who people are.
- Burnt pots and pans – This may be a sign of short-term memory loss or even the onset of a more serious health concern such as dementia, as pots used for cooking have been forgotten on the stove. Besides the danger of falls, fire is probably one of the greatest safety concerns facing older individuals and their families.
Reluctance to leave the house:
- Older individuals who are experiencing difficulties with walking, memory retention, and sensory functions such as vision or hearing may gradually distance themselves from their social circles and acquaintances, resulting in increased isolation. This, in turn, may contribute to the development of mental health conditions like loneliness and depression as well as other physical health issues.
- Resist social situations – people can start to lose confidence and wish to remain at home rather than go out.
- Missed appointments and social engagements – While this can be a symptom of increased forgetfulness, it is often simply a result of not having transportation and not knowing how to access the transportation options available to them. Missed medical or health appointments can create serious health risks.
Any of these signs of decline should trigger a discussion about the types of support your ageing loved one needs. These conversations can be tough, but they’re intended to keep your older loved one safe and well.
If you have spotted signs that a loved one may need more support at home, please reach out to your local Home Instead team. We can provide care from as little as two hours per week up to 24hrs a day to meet your individual needs.