Does your aging Loved One Need More Care? How To Start The Conversation.

Many families don’t prepare or have a discussion with their elderly loved one until it’s too late or until they find themselves in a crisis. Many families hold off because they don’t want to think about their loved one getting older and needing more care. When the topic is brought up, conversations can quickly turn into stressful heated arguments because emotions run high and everyone feels blindsided or under attack. While starting the conversation can be uncomfortable, you can ease the stress level by starting slowly before a crisis happens.

Conversation Starters

With the holidays recently passed, we may have observed changes in our loved one’s condition that may seem a “red flag” during our visits with them. It is never too early to begin having important conversations with your aging loved one and start the conversation with your family, as difficult as they may seem, it is vital these discussions happen as soon as you begin to notice changes. Below are some things to keep in mind as you start this conversation:

• Self-Reflection: Before the conversation begins, sit and think about what role you want to have in caregiving for your elderly loved one. How involved do you want to me? How involved do you think the rest of your family should be? Don’t assume you know how your family members will respond or how much responsibility they will want and how much they want to be involved. This will help ease the tension when it’s time to dive into specific details and responsibilities. Each person has a different relationship with the elderly, and each person has a viewpoint and opinions and emotions that should be respected – even if you don’t agree with them. Before everyone gets together, keep the conversation light and gentle.
• Be Direct & Realistic: Your elderly loved one will eventually need assistance to have a high quality of life. The amount of assistance will vary but determining caregiving responsibilities is inevitable. There will never be a perfect time to have these conversations and putting it off till there is an emergency will only increase the level of stress and frustration the family experiences. It’s better to plan and be proactive.
• Be Patient: Existing family dynamics and the potential shift of family dynamics can create a stressful environment. Being patient and meeting your family members where they are, while being present to the needs of your elderly loved one, is a balancing act. It can be challenging, but it is not impossible. Don’t force the conversation if you don’t have to.
• Professional Feedback: Talk to your elderly’s doctor and consider talking to a family therapist or clergy– they can act as a mediator and the 3rd party viewpoint and observations stay focused on the care of your loved one.
• Ask Specific & Open-Ended Questions: Have you observed...? Have you noticed...? What do you think about...? Use the signs and symptoms listed below as suggestions for the questions you feel apply best to your elderly loved one. You don’t need to ask them all, but discussing 1-3 per category is a great starting point. Everyone has different experiences with the aging loved one, so this is a great opportunity to compare notes.

Signs To Observe

It is important to note the differences between a normal aging process and what signs and symptoms aren’t normal that would fall into the red flag category. By tracking normal aging process signs, you will be able to know how much help your loved one may need. Red flag signs may indicate an immediate medical need and of signs, your loved one may have a more severe medical condition.

Normal Aging Process:

• Skin is thinner, drier, more fragile and less elastic
• Muscles weaken and lose tone, less able to perform routine movements and activities, resulting in the need for assistance with ADLs
• Sore joints and pain with movement
• The sensitivity of nerve endings in the skin: Alteration in how they feel heat, cold, pain, touch and pressure
• Responses and reflexes slow
• Short term memory loss occurs: forgets recent events
• Sense of vision, hearing, taste, touch, and smell weaken (which can affect their sense of balance, result in them being unable to smell smoke or gas leaks and unable to hear directions or alarms

Abnormal Changes Of Aging:

• Depression
• Inability to think logically
• Loss of ability to think clearly
• Poor nutrition
• Shortness of breath
• Incontinence

Red Flags

What are the red flag signs and symptoms you should be aware of to track?

They fall into five categories: physical, home environment, emotional, cognitive and financial. Several of these signs can be observed from a distance, as well as in person. Many of signs and symptoms can be observed when the family is spending time together at the holidays. While it may not be time to have serious and in-depth conversations, this is a great opportunity to start paying attention.

Physical

• Fluctuating weight
• Balance problems
• Poor hygiene
• Sleeping too much or too little
• Unexplained burns and bruises (especially on the legs and arms)
• Movement issues (stiff movements, hunched posture)
• Have there been problems with wandering or getting lost?
• Have there been issues forgetting about the stove or other appliances/home equipment?
• Has your loved one had any falls?
• Have there been repeated trips to the emergency room (ER) or hospital?

Home Environment

• Unkempt yard
• Unusual carpet stains
• Excessive clutter (several weeks’ worth of newspapers, piles of junk mail)
• Unusual odors (urine, garbage)
• Not enough food in the house
• Failure to turn off the stove, or water after use
• Have there been any car accidents or close calls?
• Do passengers feel worried when riding in the car while your loved one drives?
• Unfilled or untaken prescriptions

Emotional

• Mood swings
• Abusive behavior (most likely verbal)
• Lack of motivation
• Uncharacteristically anti-social behavior

Cognitive

• Confusion
• Repetition
• Bad judgment (poor financial decisions, public outbursts)
• Loss of inhibition (saying or doing socially inappropriate things)
• Language problems (can’t form coherent sentences)
• Hallucinations and delusions (seeing things that aren’t really there)
• Trouble performing familiar tasks (can’t remember how to get to the doctor’s office)
• Memory loss that interrupts daily life (regularly forgets recent conversations)
• Is there concern about poor safety awareness or poor judgment

Finances

• Are there problems paying bills?
• Are you concerned about scams?
• Unpaid bills

Whether these problems appear suddenly or slowly, they are all warning signs that indicate your loved one is having trouble attending to their own needs.

Next Steps:

Being able to identify the presence of these red flags as soon as possible will enable you, your aging loved one, and the rest of your family to come up with a plan that ensures everyone’s needs get met. If you notice that something seems ‘off’ or ‘wrong’, it may be time to determine an agreed-upon time to have ‘the talk’ with your loved one and other family members to discuss possible next steps.

This process will take a lot of loving patience, acceptance and communication. It is worth it because this is how we can honor your elderly loved one and ensure that they have the highest quality of life, for the rest of their life.