No one wants to have this discussion. As an adult child, you’ve continued to reassure yourself that your mom or dad is just fine, they’re getting along well, and their little mishaps mean nothing. Then, they fall down the stairs, set the kitchen ablaze, or call you in a panic at 2 AM not knowing what’s going on (and in their jammies), and suddenly you’re all looking for solutions that should have been on the table months ago.
While this doesn’t make it any easier, there are warning signs long before the critical emergency occurs. Some are pretty obvious. Others, however, are easily missed if you’re not paying attention or if your parent has gotten particularly good at hiding their struggles. Acknowledging the red flags and getting help doesn’t mean you’re giving up on independence; it’s protecting it.
When Personal Hygiene Falls by The Wayside
You know this one is a particularly personal struggle. If your once put-together parent has started wearing the same clothes for days on end, skips a shower or two in a row or you notice their hair hasn’t been brushed without someone reminding them, it’s not laziness and it’s not being dirty; it means that they’re struggling with getting into the shower or bathtub, reaching for soap while washing their back or even keeping track of when they last got a bath.
The same goes for dental hygiene. If your parent has bad breath or disheveled teeth, they could be having issues with fine motor skills required for brushing and flossing. Sometimes depression ruins desires for taking care of oneself, which many seniors face when they’ve lost a loved one or become more isolated.
Houses tell you things as well. If your super tidy parent now has piles of laundry on the couch, dirty plates all over the counter and a bathroom that hasn’t been properly cleaned in months (a once-a-week clean is now biannually), it’s not about lowered standards; it’s about lowered ability.
The Kitchen Turns into a Hazardous Waste Zone
Walk into the kitchen and assess the situation. Check the refrigerator. If there are outdated items confined there for weeks at a time, meals sitting about unfinished because they’re now too exhausted to finish or nothing but dried out old lettuce because they’ve found grocery shopping too taxing, malnutrition is just around the corner. Seniors suffer with malnutrition before families even realize it; its energy depletes them and weakens their immune systems and mental acuity.
It’s time to acknowledge burned pots. Scorched areas on the counters or mentions about how they “almost” caught a kitchen fire should be alarming as well. If your parent is forgetting that they placed something on the stove in the first place, it’s time to reconsider being alone in a kitchen. If they’ve left the burner on without noticing or continuing to try to whip up meals that they’ve previously made without fail but are now consistently burning beyond recognition, something needs to change.
It’s time to pay attention when your parent’s weight has dropped fifteen pounds without trying. If their clothes hang off them, something is interfering with their ability to adequately feed themselves. Sometimes it’s physical, standing long enough to prepare a meal, opening containers or an intense amount of pain causes appetite suppression, and sometimes it’s cognitive, legitimately forgetting whether or not they’ve eaten.
For families facing these challenges, collaborating with a provider like New Century Home Care Agency in Philadelphia, PA can help discuss meal prep and kitchen safety before malnourishment becomes an emergent health issue.
Medication/Meds Become Unmanageable
This is where it gets scary quite quickly. If you find pill bottles dated wrong, dosages accidentally skipped or multiple dosages of the same prescription because they forgot they already had it (and you’ve been brought into the equation), it’s time to acknowledge there is not safe medication management going on. Taking heart medication twice a day is one thing; missing antibiotics for three days is another.
Observe for medications incorrectly organized in weekly containers; taking two doses in the morning because they forgot the night before; old antibiotics from six months ago still in the cabinet, and now this month’s prescription also present, along with newer medications they’ve forgotten about because they have no idea what month it is.
Some seniors even start “rationing” expensive medications and only taking half-doses, so they last longer, which doesn’t help anybody if half-doses are ineffective.
If your parent cannot tell you what each medication is for or when they’re supposed to be taking them, despite having a convenient post-it on hand, then that’s problematic. They should know why they’re taking them, even if they need a reminder via lists taped to mirrors, etc. Confusion indicates an inability to safely manage medications on their own.
Mobility Becomes an Issue
Your parent falls once down the stairs. It happens. They fall again; this is becoming a pattern. If they fall three times (or more), it’s time to reevaluate your parent’s movement patterns around the house because something’s going on and it’s not safe for them to traverse their abode on their own.
But you don’t even need falls to acknowledge there’s an issue; if your parent continually reaches for furniture to stabilize themselves while getting from point A to B, attempts to stand up from their favorite chair by seeming like they’re slowly moving across town or avoiding staircases they used to climb well without hesitation (but now you’re questioning even one step), then leg strength and stability are increasingly precarious.
Some seniors end up with unexplained bruises as well as they bump into things more often when spatial awareness goes down the drain and response time diminishes. A small chuckle may escape your parent’s lips when you ask how they got said bruise on their forearm, but it’s no joke when it takes them three separate attempts to get from sitting on the edge of their bed to finally standing so they can march into the bathroom down the hall.
Social Isolation and Personality Changes
This may be subtle but highly significant; if your once social parent no longer calls friends, skips out on activities they once loved or seem content merely sitting at home doing nothing substantial all day long, something’s changed. Sometimes it’s depression. Other times getting ready and making an effort is too taxing/complex for them anymore. An early onset of cognitive decline makes socializing confusing or stressful.
Even worse is if personality changes occur; a formerly patient individual becomes cantankerous and frustrated; an otherwise confident person becomes paranoid and fearful; a once-sharp person becomes vague and confused, this is not just aging, but diminishing quality of life markers that require professional intervention.
Money Issues Become Complicated
When cognitive decline starts settling in, financial aspects of seniors’ lives become some of the first things that go downhill. If you find piles of unopened mail (poor organization), bills that have been paid late (lost track of time) or not paid at all (forgetfulness), checkbooks that no longer balance (confusion) or purchases that cannot be explained (scammers preying on seniors), then it’s time to intervene.
Seniors are prime targets for scammers who play off vulnerable older adults with money so if your parent gives away their credit card information over the phone, believes phishing attempts as truth or cannot figure out where money went despite limited income/effort thereafter it’s time to take charge. This is not stubbornness or foolishness but an inability to protect themselves financially.
What This All Means
None of these items mean your parent needs to move out immediately into some sort of facility or give up their home altogether; instead, it means that living alone with no assistance has become dangerous. The goal here isn’t to take away control over independent living; instead, add enhanced resources so seniors can exist longer in their own homes.
Addressing red flags means approaching with honesty, not judgment, with examples instead of vague concerns brought up. “I’m worried” doesn’t carry as much weight as “I noted burned pots twice last month accompanied by expired food in your refrigerator.”
Then explore options together. Sometimes family members need to step up and visit more often; other times homes need relocating so missteps lessen (e.g., moving kitchen cabinets closer). More often than not, professionals need to enter the picture for tasks that have become cumbersome, for instance: meal prep/kitchen safety concerns; personal attention regarding personal care/kitchen safety concerns).
The worst thing families can do is wait until after the crisis. When everyone does so, it’s panic-ridden with fewer options available and your parent feeling like decisions are being made for them. When red flags are acknowledged sooner rather than later, family members can get out ahead of the situation and instead work proactively instead of reactively in a crisis.
That’s what makes all the difference in where mom or dad ends up living for the foreseeable future, safely within their own home where they’ve aged gratefully instead of a facility where they have new friends but have lost control of everything else until things get out of hand.