The decision to help an aging adult move out of a current home is a complex one — both emotionally and practically. Above all, you want the person to be safe and well. How can you all feel more confident about whether circumstances suggest that your loved one should no longer be living alone?
Although every situation is different, looking at the following 11 signs will give you valuable information to help make the decision.
Keep the big red flags in mind. Certain situations make it more obvious that it’s wise to start thinking about alternate living arrangements.
Recent accidents or close calls
Did your loved one take a fall, have a medical scare, or get in a fender bender (or worse)? Who responded and how long did it take? Accidents do happen, but as people get older, the odds rise of them happening again.A slow recovery
How did the person you’re caring for weather the most recent illness (for example, a flu or bad cold)? Was he or she able and willing to seek medical care when needed, or did last winter’s cold develop into untreated bronchitis?A chronic health condition that’s worsening
Progressive problems such as COPD, dementia, and congestive heart failure can decline gradually or precipitously, but either way, their presence means your loved one will increasingly need help.Increasing difficulty managing the activities of daily living (ADLs) and instrumental activities of daily living (IADLs)
ADLs and IADLs are the skills needed to live independently — dressing, shopping, cooking, doing laundry, managing medications, and so on. Doctors, social workers, and other geriatric experts evaluate them as part of a functional assessment, which is one way to get an expert’s view of the situation. Difficulties with ADLs and IADLs can sometimes be remedied by bringing in more in-home help.
Give your loved one a big hug. Clues aren’t always visible from a distance; especially when you don’t see the person every day, you might learn more through touch.
Noticeable weight loss
Does the person feel thinner? Are clothes loose, or has he added notches to his belt? Many conditions, from depression to cancer, can cause weight loss. A person who is having trouble getting out to shop or remembering how to cook (or to eat) can lose weight; check the fridge and watch meal-prep skills.
Seeming more frail
Do you feel anything “different” about the person’s strength and stature when you hug? Can your loved one rise easily from a chair? Does she or he seem unsteady or unable to balance? Compare these observations to the last time you were together.Noticeable weight gain
Common causes include an injury slowing the person down, diabetes, and dementia (when someone doesn’t remember eating, he or she may indulge in meals and snacks all day long). Someone with money troubles may choose fewer fresh foods and more packaged goods or dried pasta and bread.Strange body odor
Unfortunately, a close hug can also reveal changes in personal hygiene habits. Causes range from memory trouble to depression to other physical ailments.Changes in appearance
Does the person’s hair and makeup look all right? Are clothes clean? Someone known for crisply ironed shirts who’s now in a stained sweatshirt may lack the dexterity for buttons or may have lost the strength for managing an ironing board and iron. A formerly clean-shaven man with an unkempt beard may be forgetting to shave (or forgetting how to shave).
Think realistically about the person’s social connections. Social circles tend to shrink with age, which can have health and safety implications.
Signs of active friendships
Does your loved one still get together for lunches or outings with friends or visits with neighbors, or participate in religious activities or other group events? Does he or she talk about others or keep a calendar of appointments? Lack of companionship is associated with depression and heart problems in older adults. If friends have died or moved away, moving to a place where other people are around could be lifesaving.Signs that your loved one has cut back on activities and interests
Is a hobby area abandoned? Has a club membership been given up? A library card gone unused? There are many reasons people cut back, but dropping out of everything and showing interest in almost nothing is a red flag for depression.Days spent without leaving the house
This sometimes happens because the person can no longer drive or is afraid to take public transportation alone and lacks a companion to come along. While many older adults fear being “locked away” in a retirement home, many such facilities offer regular outings that may keep them more mobile and active, not less.Someone who checks in on a regular basis
If not you or another family member, who does this? Is your loved one willing to consider a home-safety alarm system or medical alert system?
A plan for a worst-case scenario. If there’s a fire, earthquake, flood, or other disaster, is someone on standby to assist? Does your loved one understand the plan?
Rifle through the mail. Your loved one’s mail can offer an often-overlooked clue to how he or she is managing money, a common early warning sign of cognitive trouble.
Snowdrifts of mail in various places
Finding lots of mail scattered around raises concern about how bills, insurance, and other matters are being managed. (Piles of mail are also a potential tripping hazard.)Unopened personal mail
Everybody skips junk mail, but few of us can ignore a good old-fashioned, hand-addressed letter.Unopened bills
This can indicate that your loved one is having difficulty managing finances — one of the most common first signs of dementia.Letters from banks, creditors, or insurers
Routine business letters aren’t worrisome. But it’s alarming if they’re referring to overdue payments, overdrawn balances, recent accidents, or other concerning events.Thank-you messages from charities
Older adults are often vulnerable to scammers. Even those who have always been fiscally prudent are vulnerable if they’re having trouble with thinking skills (a common sign of Alzheimer’s disease). Some charities hit up givers over and over, and your loved one may not remember having donating the first time.Lots of crisp, unread magazines
The person may unknowingly have repeat-renewal subscriptions that he or she doesn’t need.
Take a drive — with your loved one behind the wheel, if he or she is still driving. Often, the ability to drive is practically a requirement for living independently in our culture (or the arrangement of alternate transportation options).
Nicks or dents on the car
Notice the car body as you get in and out. Damage marks can be signs of careless driving.Whether the person promptly fastens his or her seatbelt
Even people with mild dementia usually follow the rote basics of driving. It’s worrisome if he or she is forgetting this step.Tension, preoccupation or being easily distracted
The person may turn off the radio, for example, or be unwilling to engage in conversation while driving. He or she may avoid certain routes, highway driving, or driving at night and in rain — a safe kind of self-policing but also signals of changing ability.Signs of dangerous driving
People whose driving ability is impaired are more likely to tailgate, drift from their lane, go below the speed limit, react slowly to lights or other cars, and mix up gas and brake pedals. See 8 ways to assess someone’s driving.Warning lights
Check out the dashboard as you ride along. Does the car have sufficient oil, gas, antifreeze, windshield-wiper fluid?
Go through the kitchen, from fridge to cupboards to oven. Because people spend so much time in this room, you can learn a lot.
Stale or expired foods
We all buy more than we need. Look for signs that food is not only old but that this is unnoticed — mold, sour milk that’s still used, or expiration dates well past due, for example.Multiples of the same item
Ten bottles of ketchup? More cereal than can be eaten in a year? Multiples often reveal that the shopper can’t remember from one store trip to the next what’s in stock at home.A freezer full of TV dinners
Your loved one may buy them for convenience sake, but frozen dinners tend not to make healthy diet. If there’s not much fresh food in the house (because it’s too hard to for the person to procure or cook), your loved one might be ready to have help with meal prep or delivery services.Broken appliances
Check them all: microwave, coffeemaker, toaster, washer, and dryer — any device you know your loved one uses (or used to use) routinely.Signs of fire
Are stove knobs charred? Pot bottoms singed badly (or thrown out)? Do any potholders have burned edges? Also look for a discharged fire extinguisher, smoke detectors that have been disassembled, or boxes of baking soda near the stove. Accidents happen; ask for the story behind what you see. Accidental fires are a common home danger for older adults.Increased use of takeout or simpler cooking
A change in physical or mental abilities might explain a downshift to simpler recipes or food choices.
Look around the living areas. Sometimes the most obvious sign is hard to see because we become so used to it.
Lots of clutter
An inability to throw anything away may be a sign of a neurological or physical issue. Obviously it’s more worrisome in a neatnik than in a chronic slob. Papers or pet toys all over the floor represent a tripping hazard.Signs of lax housekeeping
Spills that haven’t been cleaned up are a common sign of dementia — the person lacks the follow-through to tidy. Keep an eye out for cobwebs, bathroom mold, thick dust, or other signs of slackness. Physical limitations can mean your loved one needs housekeeping help or a living situation where this is taken care of for him or her.Bathroom grime and clutter
A common scenario: Your loved one makes an effort to tidy up living areas but overlooks the bathroom. Or the guest bath is clean, but not the one the person uses all the time (the one off a bedroom, for example). Here you may see a truer picture of how your loved one is keeping up.
Be sure to check out how the other living things are faring. An ability to take care of pets and plants goes along with self-care.
Plants that are dying, dead or just gone
Most of us have seen plants go brown sometimes. Keep an eye out for chronic neglect, especially in a former plant-lover’s home.Animals that don’t seem well tended
Common problems: dogs with long nails, cat litter boxes that haven’t been changed lately, or dead fish in the fish tank. Poor grooming, overfeeding, and underfeeding are other red flags.
Walk around the yard. Yard maintenance — or lack of it — can yield clues that your loved one isn’t faring as well at home alone anymore.
Signs of neglect
Look for discolored siding or ceilings that might indicate a leak, gutters choked with leaves, broken windows or fences, dirty windows.Newspapers in the bushes
Are papers being delivered but ignored? Sometimes people pick up those they can see on a driveway but not those that go off into the yard.Mail piled up in the mailbox
Go out and check — it’s an indication that your loved one doesn’t even retrieve it regularly.
Get the input of others who know your loved one in order to collect a fuller picture of reality.Gently probing about what others think isn’t nosy; you’re being loving, concerned, and proactive.
Input from those in your loved one’s circle
Talk to old friends and close relatives to get their sense of how the person is faring. Listen for stories that hint that the person doesn’t get out much (“She doesn’t come over anymore.” “She quit book club.”). Pay attention to comments that indicate ongoing concerns (“Has he had that heart test yet?” “We were worried the day the ambulance came.”).Medical insight
With appropriate permission, your loved one’s primary doctor may share your concerns about his or her patient’s safety at home — or may be able to alleviate those concerns or suggest where to get a home assessment.A second opinion
A social worker or professional geriatric care manager visits older adults’ homes and does informal evaluations. While your loved one may initially resist the notion of a “total stranger” checking on them, try pitching it as a professional (and neutral) second opinion, or ask the doctor to “prescribe” it. Some people wind up sharing doubts or vulnerabilities with a sympathetic, experienced stranger that they’re loathe to admit to their own children or family.
Finally, realize that some of the information you collect is intangible — it has to do with feelings and emotions, and the stress levels of everyone involved.
How you’re doing
While this decision to remain in one’s home is not primarily about you — the son, daughter, grandchild, caregiver — your own exhaustion can be a good gauge of a decline in older adults’ ability to care for themselves. Keeping someone at home can require lots of hands-on support or care coordination, and this is time-consuming. If your loved one’s need for care is just plain wearing you out, or if a spouse or children are feeling the collective strain of your caregiving activities, these are major signs that it’s time to start looking at other options.Your loved one’s emotional state
Safety is crucial, of course, but so is emotional well-being. If someone living alone is riddled with anxieties or increasingly lonely, then that may tip the scales toward a move not solely based on health and safety reasons.
If your loved one has a full life, a close neighborhood and community connections, and seems to be thriving, it’s worth exploring as many in-home care options as possible before raising stress levels by pressing a move from a beloved home.If, on the other hand, your loved one is showing signs that living alone is a strain, it may be time for a talk. Broach the subject of where to live in a neutral way and you may find that your loved one harbors the same fears for current and future safety and security that you do. Find out what your loved one fears most about moving and about staying before launching into your own worries and what you think ought to be done.
Written by consumersadvocate.org
If you have an older parent, husband or friend that is not able to take care of themselves on their own, it’s not only disheartening, but can be hard on everyone. It’s hard enough that you need to be the one addressing all their needs, emotionally and physically, but then there is also the added task of convincing your loved one that they need to let you be in charge.
If you are in that position or even have hired a caregiver to help care for your loved one, a medical alert system can be a big help and relief for everyone. Medical alert devices can help a caregiver or whomever is looking after the senior in question to call for help if necessary.
Medical alert devices are not only imperative, but can even save a person’s life. If the senior in question is wearing a device and still has the ability to think on his or her own, he can get in touch with you, a caregiver or even emergency services if they have fallen or have been hurt.
If your loved one or even a caregiver presses a medical alert button, they will be connected automatically to a monitoring service where the trained specialist that answers the phone can assess the situation and call the appropriate hospital or emergency services.
Some companies will also have the medical information of the senior in question in their records to help gauge the situation.
There are many different medical alert devices that will have the ability to protect your father or mother who is not only at home but if he wanders. Some of these devices have motion sensors that can help if your loved one falls or is any area of the home that poses more of a threat to themselves such as the top of a staircase.
When medical alert devices first became available, they were usually in the shape of a pin-style button that connects to a base station and hooked to a home phone landline. This was helpful but only for those who rarely left home.
Today, since technology has improved greatly, there are many different combinations of base stations and pendants that can be tracked much further. And, of course, this can be a very important feature for those that wander.
There are even mobile-phone based services that use a cell phone instead of a landline to connect. This feature can be great for those with dementia because they have a GPS position function to allow caregivers to know the exact location of the senior.
There are also different devices that contact the responsible caregiver if the senior falls or hurts themselves and can’t get to a phone on his own for help. As most of us know, falling is very common among the elderly.
Now that you have decided to purchase a medical alert system, there are some other things to consider before purchasing one.
It’s important to learn how the different systems work, the different components they include and how to maintain them.
With older systems, home bases will not work if the alert button isn’t close by.
If the senior has limited mobility, then you need to make sure to purchase a unit that has an alert button close to the base unit in every room that he or she might enter.
Of course, as with anything you purchase, it’s important to read the contract thoroughly to understand how the service works, how long the agreement is, trial periods and cancellation.
Many providers will offer discounts for longer-term contracts or if you pay more up front for the entire year.
Once you learn the best system for your needs, it’s important to get a few quotes to compare pricing.
Try to find the company that has the best system and service for the best price.
Once you’ve narrowed down the device you want and the price, the next thing to consider is how customers like the service.
Some things to consider:
If you can find positive answers to all of the above, you can feel assured that you should have a good experience with the company and specific medical alert device.
Medical alert devices for your loved one are one of the most important devices that you will buy. With a little research, you will find the best medical alert device that will give you the reassurance that your elderly loved one or caregiver always has a way to get in touch with you or medical help if necessary.
consumersadvocate.org has created an in-depth review of some of the top Medical alert devices to help you make your choice.