Your parents are getting older, and while they insist they’re fine, you’re not so sure. If your parents had always kept a tidy home, you’d probably be concerned about the ants crawling across the kitchen counter, the puddles of water on the basement floor, and the strong aroma wafting from the litter box. You’d know that something was off and, despite any protests to the contrary, your folks might need some help.
Are Those Red Flags Normal or Signs of Decline?
It wasn’t so clear with my parents. Whenever something leaked, broke, or just stopped working, they created workarounds. For most of my childhood, water dripped through the living room ceiling whenever someone took a shower. My parents addressed this problem by keeping a bowl on the floor to catch the drips. Because the oven thermostat never worked properly, we ate a lot of charred food, until my mom figured out that propping open the oven door with potholders fixed the problem. Expired food filled their cupboards, and once they joined Costco, the fridge was like a small industrial compost facility. And yet, my parents were high-functioning professionals who loved to entertain, go to theater and opera, organize bike trips, and travel the world.
But that was then. Now they were declining, and I was ignoring the changes. Not my sisters though, who lived out of state and visited less frequently. They were alarmed by the downward slide.
Their experience mirrors that of many adult children who don’t see their parents regularly, said Tanya Castillo, RN, Director, Lifespark Community Home Care. “After family vacations and holidays, especially Thanksgiving and Christmas, we have a spike in referral calls from adult children who’ve come home and noticed the changes in their parents.”
Because I saw my parents so frequently, the changes were less obvious to me, but according to Tanya, there are red flags, triggers, and signs that can alert family members to potential issues.
Based on her 25 years of experience working closely with older adults, Tanya has identified key triggers and warning signs for adult children. “Evidence of injury, such as bruising or skin tears, can be a sign that mom or dad has been falling, or that something else is not right at home,” she said. “Hygiene is another red flag. If they’re not brushing their teeth, their nails are really long, their clothing is soiled, or there’s an odor of incontinence, they may be struggling to keep up.”
The general condition of the house (though not, perhaps, my parents’ house) also offers clues.
“Spoiled food in the fridge or no food at all are two big ones,” Tanya said. “Pay attention to how their clothes fit—if they’re looser than usual, your parent may not be eating and has lost weight which can lead to frailty, falls, and hospitalizations.”
Other telltale signs include piles of dirty laundry, stacks of paper or unopened mail, appliances left on, dirty dishes in the sink, or a loaded dishwasher with mold growing on the plates. “A quick scan of their home can tell you a lot,” she said.
Missing appointments—eye exams, dental checkups, routine labs—can be signs of cognitive decline. However, if the parent has always been the clinic’s point of contact, the adult child might not be aware that there’s an issue.
Only after my mom missed several periodontal appointments and then showed up twice when she wasn’t scheduled did her clinic finally contact me. I’d made the mistake letting my mom’s claim that she was perfectly capable of getting herself to the Medical Arts Building cloud my judgement. That was five years ago, and she still tells me she doesn’t need me to take her to appointments. We’ve agreed to disagree.
A related issue is medication errors, accidental or intentional. “One client regularly halved or even quartered her high blood pressure medication, claiming she knew better,” Tanya said, adding that this practice could have increased her risk of falls and injury.
When my dad went on dialysis, I should have paid attention to his infinitely more complicated medication regimen, but my parents were adamant about handling this on their own. It wasn’t until we moved them into senior living that I realized neither of them had been taking their meds consistently or correctly. Eventually, we asked the nursing staff to take over their med management. My mom continues to find this slightly insulting, but at least she tolerates it.
From awareness to action
Looking back, I wish I’d been more proactive in seeking support for my folks, especially because the process isn’t that complicated—and also because there are plenty of options, including private-pay nursing and caregiving or in-home care, , skilled home health, Everyday Support, moving to a senior living community, and later, when needed, hospice.
“The first step is the intake call,” “Tanya said. “Next, one of our Registered Nurses or Clinical Liaisons comes out to the home for an in-person consultation with the client and their family to see the environment, learn about their needs, and make recommendations. That includes looking at what’s covered by insurance, what’s out of pocket, and whether the client has the financial means to stay in their home. The last step is the admission process, which is based on the service line they choose.”
For example, if a client can no longer manage on their own, but they want to stay in their home and can afford it, they can have a full-time, live-in caregiver or to save on costs, rely on a combination of Lifespark caregivers and family members.
Some clients do well with a Case Manager to coordinate services, like grocery delivery and housekeeping, make appointments, arrange transportation, pick up medications, and more. For others, Lifespark COMPLETETM is an option that’s available at no additional cost under participating senior health plans, and is a fulfilling and cost-effective option.
“We offer our best recommendations, but it’s up to the client and their family to decide what happens next,” Tanya said.
To find out how Lifespark can help your loved ones live more independently, visit Community Home Care or call us at 952-345-8770.