Medical Edge Newspaper Column

When Should Aging Parents Have More Care?

November 5, 2007
Dear Mayo Clinic:
How do I know when it's time to suggest that my parents shouldn't be living on their own anymore?

Answer:
Sometimes, the decision is brought on by illness, an accident or other circumstances related to aging. But when you're not sure, warning signs can help you gauge when loved ones need assistance in their home or alternative living arrangements. These signs may also indicate that a call or visit to a primary care doctor is in order.

Losing weight without trying can indicate a significant health problem, such as cancer, dementia, depression, dental issues or heart failure. It may also be related to difficulties with food preparation or eating.

Poor home maintenance may be another sign. Noticeable changes in home upkeep are clues that health problems or age-related changes are making it difficult to keep up with household chores.

You may notice a change in personal hygiene, such as the failure to keep up with teeth brushing, bathing and basic grooming. Also, though everyone has good and bad days, deterioration in outlook could be a sign of depression or another health concern. Losing interest in hobbies or daily activities is not a natural sign of aging.

We are all familiar with forgetfulness, but there's a big difference between normal absentmindedness and the type of memory loss associated with conditions such as Alzheimer's disease or other forms of dementia. Early warning signs of dementia can include repeatedly asking the same questions, having difficulty finding words, using inappropriate words, forgetting appointments and being unable to complete familiar tasks.

Finally, muscle weakness, joint problems and other age-related changes can affect movement and the ability to perform basic tasks. Unsteadiness increases the risk of falling. And falls can cause major injuries and even death in older adults.

It can be difficult for everyone involved to determine that independent living is no longer safe or practical. Talk with your loved ones about their home situation. Ask about any concerns they have. Some issues may be amenable to help in the home or help with tasks. Sometimes, a family member's expression of concern helps the elder to realize it's time to see a care provider or consider other living arrangements.

— Paul Takahashi, M.D., Internal Medicine, Mayo Clinic, Rochester, Minn.