How to Recognize Signs of Trouble

As residents of the Finger Lakes region worry about aging parents, spouses, other older relatives, friends, even themselves, it helps to know something about the warning signs that might indicate the need for outside help, a change of residence, and other aspects of eldercare. This segment of the Life in the Finger Lakes four-part series on eldercare offers insights into such warning signs. Subsequent segments will look at trends and regional options in the rapidly growing arena of senior life services, and at regional resources for coping with these issues as they arise.

Even though people today are living longer, bodies and minds still change over time, and everyone ages a little differently. Some people remain alert and active into their 80s, even their 90s. Others start to lose ground mentally or physically in their 60s. Some people seem to age overnight, while others age more slowly and gracefully.

AARP has said that almost 30 percent of people ages 65 to 74 have limitations on daily living activities; by age 70, that reaches 50 percent.

Having trouble keeping up with housework, driving, hygiene, health care, remembering appointments and more are all signs of aging issues. Start now to think of ways to bring up such things as examples of common problems, perhaps as situations observed in other family members and friends – and to think about practical solutions that are as uninvasive as possible and focus on helping people stay in their familiar, beloved homes as long as it is safe and feasible to do so.

As people age, the immune system tends to weaken, which is why formerly routine, easily overcome illnesses can become dangerous and many older people go from colds and coughs or simple fractures into major decline.

Some warning signs of age-related problems can be harder to see than others, because people become quite clever at hiding the extent of their health and lifestyle problems. These are some of the things that could indicate a parent, other older friend or relative, or spouse may need some help.

• Slower reaction times
• Vision problems
• Forgetfulness
• Higher blood pressure
• Dry, papery skin; changes in skin pigmentation
• Constipation and digestion problems
• Lack of appetite
• Lower immune function
• Hearing loss
• Fragility, loss of bone mass
• Less tolerance for alcohol and for over-the-counter and prescription medications
• Diminished sense of taste or smell
• Reduced ability to tolerate extreme cold or heat

Make a point of getting to know the basic details of a parent’s routine and of recent events that could indicate the beginnings of problems. If you live out of town, establish or strengthen connections with family and neighbors; a rabbi, pastor, priest or other religious figure; and friends of your own age who might check in for you. You are not asking people to spy; you are asking them to help you keep someone safe.

Memory loss
Memory loss, from minor to severe, is probably the first and most noticeable aspect of getting older. As we age, we often seem to simply run out of space to store new information.

Short-term memory loss does not necessarily mean someone can no longer function, but it does make life much more complicated. It means forgetting about appointments and losing track of familiar routines – taking medications, cooking and eating, even bathing; things that get in the way of not just managing, but enjoying, daily life.

One of the biggest fears of people as they get older is Alzheimer’s disease, the progressive, degenerative brain disease that is the most familiar, common, and feared example of dementia – a group of symptoms relating to decline in cognitive skills – because it robs people of their identity. (Rapid, sudden changes may mean other problems; dementia tends to develop over time.) Here are the warning signs of Alzheimer’s.

• Forgetting recent and long-ago events
• Difficulty with familiar tasks
• Problems talking clearly and understanding other people, managing abstract ideas
• Getting lost en route to familiar destinations; trying to go back to past jobs or homes; confusing the identities of familiar people, especially spouses and children
• Losing and misplacing things
• Mood, behavior and personality changes
• Loss of initiative and unwillingness to engage in society, favorite activities and hobbies
• Declining alertness in late afternoon and early evening (“sundowning”)
• Body or breath odor

Falls
Few signs of aging are more clear, or scary, than falling in the home. A fall with injury often means having to move to assisted living or a nursing home. Increasing age often means vision and balance problems that lead to falls in the home and when doing routine activities such as gardening, walking the dog or navigating a store. Sometimes a fall is the first indication that someone is having problems with balance, vision or walking.

The car question
Not being safe to drive is a huge issue; giving up the car keys usually translates as the beginning of the end of independence, and most people resist it with energy and subterfuge. Make a point of riding along with an aging parent, friend, or relative to assess their driving skills and reaction times. Warning signs include driving much slower than the speed limit, using the whole road instead of one lane, missing stop signs and exits, not noticing approaching sirens, forgetting to signal and getting lost.

Frame the conversation about driving as concern for the parent’s safety and the safety of anyone riding with them – especially grandchildren. Many people will do something for their grandchildren that they might not do for their children or themselves.

Personality changes
Aging can bring changes in temperament and personality – someone low-key and quiet becomes argumentative, loud, and disruptive; someone organized and efficient suddenly loses track of basic information and routine; an outgoing extrovert turns into an introverted recluse; someone neat and tidy stops bathing and lets the house become a mess.

Regular phone calls and visits are the best way to keep track of these changes. Try not to take it personally if a parent suddenly becomes difficult or mean. These changes can be reactions to frustration over reduced hearing, vision, strength and memory, or a function of serious health issues.

Nutrition
Many older people start having problems with nutrition because it becomes painful or exhausting to stay on their feet long enough to cook or prepare a meal. A few missed meals and appetite drops as well.

Fiscal matters
Try to pay attention to a parent’s financial situation, tricky as that can be. Discussing money is never easy, but bounced checks, late bill payments, and collection calls are signs that a parent is no longer managing important daily issues and may be in jeopardy of losing a home.

From noticing to coping
Being aware of these warning signs is the first step to managing the issues they represent. The next segment of this series will look at trends and options in the Finger Lakes Region, and the final segment will provide resources for answers and support.


by Ruth Thaler-Carter

Ruth E. Thaler-Carter is an award-winning freelance writer/editor who is her mother’s primary caregiver and co-author, with Jill R. E. Yesko, of The Who, What and Where of Elder Care: A handy, step-by-step guide to help navigate the maze of caregiving (2006).