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Have
you had a visit with the older folks lately? Or are you planning
a get-together soon? When you were last together did you see
warning signs that worried you, or do you think you might when
you visit next?
What
would you look for during a visit to assess an elder's needs?
November and December and summertime
are the times of year when families are together the most. We take the kids to Grandmom's
house for several days, or the old folks might travel to visit
for a week or more. Instead of one or two hour visits, we're
together a lot more during the holidays. We see warning signs
that we wouldn't ordinarily notice.
During one of these longer visits a while back, my parents were
great and enthusiastic hosts. The next day, both of them were
ill and exhausted. This was a new development, and an important
clue that their health and stamina really were declining.
It's easy for our elders to minimize or cover up problems
during quick visits or in weekly telephone calls. It's a lot
harder to hide things when the family is together for several
days. Dad can cover for Mom's failing memory in a phone call.
His unsteady balance isn't obvious when he visits from his chair
for a brief hour.
When you spend more time together, you're more likely to see the
shortness of breath or unsteady feet. The piles of mail that
have been shoved to the back of the highboy are more obvious
when you're clearing it off to serve dinner.
This year, when you're visiting, preparing feasts and exchanging
gifts, you might want to take a fairly objective look at your
older loved ones. The warning signs you force yourself to see
might well prevent a crisis - and the awful scramble that's
bound to come with a real emergency.
One thing I strongly believe in is the "pit of the
stomach" test. If something doesn't feel right - if you
have that "funny feeling," you're probably right. You
might not be able to put your finger on it right away, but if
you keep your eyes and ears open, you'll probably be able to
pinpoint what feels wrong eventually. Listen to your instincts,
use the following warning signs as a guideline, and think
proactively:
The 'Walk-Up"
Real estate people talk about "walk up appeal." As you
walk up to the house, do you see weeds where there was once a
lush lawn and flower beds? Is the front light burned out? Does
the doorbell work? Is the garage a danger to life and limb, and
your father always used to keep it immaculately? Your folks may
not be able to physically keep up the house the way they used
to.
The
Gang's In The Kitchen
The kitchen is where families gather, whether there's a meal
being prepared or not. This is a good time to check on the state
of the pantry, the refrigerator, and the cupboards. If your
mother was always a wonderful cook, and now there's an
assortment of out-of-date foods, cobwebs in the pots, and burn
marks on the counters - you may be seeing signs that she no
longer has the interest or the energy to keep up in the kitchen.
What
in the World Are All These Pills?
It's OK to snoop in the medicine cabinet - or through the
collection of bottles by the bed or in the kitchen. Check
expiration dates. If medications are out of date, is it because
they're forgetting to take them, or are they too expensive and
not being refilled? Some folks will take fewer doses per day
than prescribed, thinking that, "If I take two instead of
three they will last longer."
Has the number of prescriptions increased significantly? You can
do a check on the Internet to find out what these new
medications are usually prescribed for.
Mail's In!
The mail is often a good indicator when things are starting to
go wrong. A stockpile of unopened mail, especially if it's
scattered around, could indicate memory problems, difficulty
seeing, lack of interest (possible depression), or financial
problems. A great quantity of new magazines or sweepstakes
circulars could indicate that someone is responding to offers
that might be problematic.
Are there overdue bills in the stack? Is someone using credit
cards impulsively? Are the utilities in danger of being shut
off? Could someone simply use a little help with keeping up?
Move
It or Lose It
Is your father having trouble getting up out of the chair he's
used for years? Do you notice that your mother is using the
furniture, walls and doorways to steady herself as she walks? Is
he shuffling along, instead of striding as he used to? Has a
cane mysteriously appeared - and no one said a word about
it? Arthritis, vision problems, and general weakness could
all be contributing.
Don't overlook the possibility that medications could be the
cause. Something else that we often aren't ready to acknowledge
is alcohol. If you notice that instability is worse in the
evening (usually it's the evening), is he or she tippling a bit?
One particular family I worked with finally discovered that
their mother was regularly washing down her evening pills with a
good slug of bourbon.
Jack Sprat Doesn't Live Here Any More
Weight loss or gain of more than a few pounds could be a clue to
problems. Is it getting to be too much to fix good meals? Is she
forgetting to eat? Are a beer and chips often replacing regular
meals?
If they seem to be eating pretty much as usual and there's been
a noticeable weight change, it could be a side effect of
medication or a symptom of another health
issue.
One woman I know had been confused by the advertisements for
nutritional supplements she saw on television. These products
are promoted as good additions to the diet - so she ate her
three good, nutritious meals every day and added a can of
supplement after every meal, just to be sure. Before long, her
weight ballooned and she didn't feel more energetic at all. A
trip to the doctor and a little nutritional education put her
back on the right track.
If you're seeing some of these things - and of course there are
many others you could add to the list - don't panic. But don't
ignore them, either. Talk to your spouse and your siblings, if
you have them. Let them know what your concerns are.
It's not unusual for family members to disagree about what
things might or might not be important. If you are
concerned, and someone says you're over-reacting, take it into
consideration. But if you really think something is going on,
then it's important. Listen to your instincts.
Even if everyone agrees that there may be a problem, it's still
a good idea to plan a quiet, private talk with your elder. A
circle of concerned relatives surrounding and shooting questions
isn't likely to be helpful.
Don't plan on bringing up concerns or controversial issues at
the holiday table or when there's a crowd around. A restaurant
isn't usually a good idea, either. Try to find the time of day
when your elder is at his or her best. Some people are better in
the morning, others do better in the afternoon.
Plan to listen more than you talk. Ask questions: "Mom, it
looks like you're having a hard time getting in and out of the
car. Have you talked to anyone about that?" Then - listen.
Don't interrupt, and try to curb the impulse to give advice.
If your elder is defensive, tells you to mind your own business,
or refuses to talk - try not to let it turn into an argument.
Let it go, for now. Plan to brainstorm possible solutions before
you try again another day.
In the meantime, enjoy your loved ones and the time you get to
spend together!
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