According to a systematic review of literature on long-distance caregiving published in the Journal of Gerontological Social Work, between five and seven million Americans provide physical, emotional, social, and financial assistance to aging loved ones from a distance. This means that a significant number of family caregivers rely on regular telephone conversations and check-ins by closer-living relatives or friends to gauge an aging loved one’s well-being.
Unfortunately, age-related decline can happen quickly, and, in many cases, seniors are determined to conceal or downplay any new or worsening problems they may be having. For many of families, holiday visits are the only opportunity they get all year to see aging loved ones in person, so it’s important to pay close attention to their physical and mental health and their living situation.
During this year’s holiday gatherings, be sure to look for the following warning signs that a loved one may need some extra help at home.
Signs of Age-Related Decline
- Weight Loss
One of the most obvious signs of ill health is weight loss. Possible causes could include cancer, dementia or depression. Seniors may also experience lower energy levels or fatigue, which can make it challenging to shop for and prepare nutritious meals and then clean up afterwards. Furthermore, an elder may consider all this effort unnecessary, especially if they live and eat alone. Certain medications and aging in general can also cause a reduction in appetite and change the way food tastes. If weight loss is evident, talk to your loved one about your concerns and schedule a doctor’s appointment to address the issue.
- Changes in Balance and Mobility
Pay close attention to the way your loved one moves and how they walk. A reluctance to walk, changes in gait or obvious pain during movement can be a sign of joint, muscle or neurological problems. If your loved one is unsteady on their feet, they may be at risk of falling. According to the Centers for Disease Control and Prevention (CDC), an estimated three million people are treated at emergency departments each year for fall-related injuries like hip fractures. If you notice changes in a senior’s mobility and coordination, make an appointment with their doctor to discuss options for keeping them safe and mobile, such as pain management, physical therapy, in-home care and mobility aids. If limited mobility is not addressed, fears of falling can cause seniors to withdraw and stop participating in daily activities both inside and outside the home. Be forewarned that minimized activity can actually cause elders to become frailer and even more susceptible to falls.
- Fluctuations in Mood and Behavior
Keep an eye out for changes in your loved one’s moods and behavior. You can’t always gauge someone’s emotional state over the telephone, even if you speak daily. Look for signs of depression and anxiety, including withdrawal from social activities, changes in sleep patterns, loss of interest in hobbies, and changes in basic home maintenance and personal hygiene. The latter can be an indicator of cognitive decline or other physical ailments like dehydration, which often happens to elders in the winter months and can be serious. If you notice sudden odd behavior in your loved one, such as confusion or agitation, be sure to seek medical attention immediately. These are common symptoms of a urinary tract infection (UTI), which is prevalent in seniors and easily resolved with antibiotics.
- Changes in the Home Environment
Attention must also be paid to a senior’s surroundings. For instance, if your loved one has always been a stickler for tidiness and paying bills promptly, but you discover excess clutter and stacks of unopened mail while visiting, it indicates a problem. Take a walkthrough of their home while you’re visiting to see if they are keeping the house to their usual standards. Be aware that sometimes the signs of trouble are a bit subtler. Scorched cookware could indicate that your loved one has forgotten food on the stove or in the oven. An overflowing hamper could mean they don’t have the strength and/or desire to do laundry. Check the expiration dates on their prescriptions and over-the-counter medications and try to determine if they’re taking their medications as prescribed. You know your loved one and their habits best, so go with your gut if something seems off.
How to Handle Signs of Decline
The issues explained above are the four most common signs of age-related decline that long-distance caregivers experience during visits with their loved ones, but there are others to look out for. You can view a comprehensive list here: Signs a Senior Needs Help at Home.
While you may want to keep things light during the holiday season, do take this opportunity to address any red flags that you observe. Collect any necessary information while you are in town to avoid added frustration and confusion in the event of a crisis down the road.
The Initial Conversation
First, have a heart-to-heart conversation with your loved one about their present circumstances and both of your concerns. Suggest making an appointment with their primary care physician for a complete health assessment. The results of this evaluation will help you work together to determine what next steps are necessary to keep them safe, happy and healthy.
Identify Supportive Resources
If possible, pay a visit to the local Area Agency on Aging or department of human services for information on resources and services available in your loved one’s community. It may be difficult to get in touch with these offices around the holidays, but it is still worth reaching out, leaving a message and researching the services they offer.
Sit down with your loved one to create a current list of people they interact with on a regular basis. This list should include other family members, friends, neighbors and clergy whom you can trust to keep an eye on your loved one and contact in the event of an emergency. Double check their home addresses, telephone numbers and email addresses, and be sure to share your own contact information with them.
Prepare a To-Do List
If you realize that your loved one is showing signs of needing help at home, now is the time to begin compiling a to-do list to be implemented over a period of future visits. This list consists of three main categories: medical, legal and financial.
You’ll want to develop a complete medical record for your loved one, including their health conditions, current prescriptions, and doctors’ names and contact information. This is extremely helpful for you to have on file, and your loved one can keep a condensed copy on hand for both routine appointments and medical emergencies.
A financial list should contain information pertaining to all a loved one’s property, debts, income, expenses, bank accounts and credit cards. Should you need to assume control of their finances over the short or long term, this list will help minimize confusion and ensure all their bills are paid on time.
The legal aspect of this to-do list is the most important. There are vital documents that must be obtained to ensure you can access your loved one’s medical information, make medical and financial decisions if they become incapacitated, and administer their estate. If they have not already done so, it is crucial for your loved one to meet with an attorney to draw up medical and financial power of attorney documents and a will. As their caregiver, you should have access to these documents and other important information, such as their social security number, Medicare information, insurance policies, the deed to their home, and their driver’s license.
These preparations may seem excessive, but it is better to be over-prepared than caught off guard when a loved one’s care needs suddenly increase. Throughout this process, remember to empower them to control their own life as much as possible. You may receive some resistance, but remind your loved one that sharing this information and pursuing supportive resources will enable them to remain independent and safe in their own home for as long as possible and give you added peace of mind as you return home from your holiday visit.