Early recognition that an elder may need assistance allows for proper planning and preparations (i.e. increased number of options, improved quality of care, and less expense).  Here are a few things to look for during your next visit:

  1. Signs around the house. Pay attention to the living areas. A home that has always been well maintained but is now unkempt could mean that cleaning is becoming too difficult. Look for stacked or unopened mail which might indicate the person is having difficulty seeing or is depressed.  Laundry or dishes piling up may mean the clothes are too heavy, or they have difficulty loading the washer or dishwasher.  Examine the yard and exterior of the house for signs that regular maintenance and upkeep is not occurring. These can all be signs that normal household tasks are becoming too difficult and some level of intervention is now, or soon will be necessary.
  2. Eating regularly/properly.  Sharing a meal with your aging loved one (preferably in their home).  It’s a great way to see what they eat and how much.  Pay close attention to how they feed themselves and how much they consume.  If in their home, watch how they prepare the food and whether they have difficulty.  Do they have trouble standing for extended periods or remembering to check the food, and turning off the stove or oven.  Also, check the refrigerator and cabinets to see if food is present.  Lack of food could mean that shopping has become difficult or they are struggling financially.  This will give you insights into how they eat when you are not there.  IMPORTANT: Most elderly people take medications which require food-so proper eating habits are especially important to keeping them safe and healthy.
  3. Walking/ambulation. Take a walk with your loved one.  It’s great exercise and a wonderful opportunity to chat (see final tip below).  Carefully observe whether the person is steady on their feet, how far they can walk, and if being on their feet for an extended period of time causes any residual issues (ex: dizziness or muscle soreness).
  4. Driving.  Go for rides (note the plural) in a car driven by your aging loved one.  Visually inspect the car for dents, scratches etc. If there’s damage tactfully inquire about the cause.  When riding with them observe: can they control the vehicle and maintain a steady speed; do they get frazzled or frustrated easily, can they safely make left turns, and whether they remember to use appropriate signals.  Ask them questions.  Go for drives both during the day and after sun down.  Alter your route to see whether they can get to their destination.  Notice whether they have begun to self-regulate (ex: drive only short distances or only during daylight hours).
  5. Attitude and Disposition. See if their personality or disposition has changed.  Are they unusually quiet (or alternatively upbeat), has that changed?  Are they lethargic or showing signs of depression?  Pay special attention to how they act or react to various stimuli. For example, if they seem uninterested when talking about a topic that would normally make them animated (ex: money, sports, politics etc.).  Patterns are important because we all have moments of distraction or bad days. 
  6. Telephone/FaceTime.  Communicate regularly & face-to-face whenever possible.  When visiting isn’t possible telephone calls or FaceTime can provide insights into an aging person’s health status.  Contact them on a regular basis and pay attention to the “flow” of the conversation.  Notice whether they are engaged in the conversation; speak at an appropriate speed and volume.  Do they follow and understand the topics that are discussed?  Essentially, try to determine whether you can have a normal conversation with them.  If you are concerned, a simple way to “test” your loved one is by asking them the same series of questions in different conversations.  See whether they remember you asking the questions, and also if they provide the same responses.
  7. Ask Direct Questions.  Finally, don’t forget one of the most powerful tools in any caregiver’s toolbox: asking direct questions.  To be effective it has to be done with care, sensitivity, and in a way that allows them to maintain their dignity.  When done properly, this “conversational” approach removes the guesswork and lets the person know you care about them.  It also allows your loved one to express their sincere appreciation that you’ve taken an interest in them and their wellbeing.  Note: even when they don’t say it, they ALWAYS appreciate you looking after them. And, as an added bonus, you feel great.

For more expansive explanations and additional tips & techniques please regularly visit the http://MrEldercare101.com site.  Good luck on your caregiving journeys.