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Holiday Visits Can Raise Concerns

When families live far away from one another, the holidays may be their only chance to personally observe their older relatives. Age-related declines can happen quickly. Family members who haven’t seen their loved one since last year might be shocked at what they see – a once healthy father looking frail or a mom whose home was well kept now in disarray.

For those family members who have relied on regular telephone calls, the upcoming holidays might be revealing. When family members visit for the holidays it gives them an opportunity to observe a situation through new eyes. The following changes might indicate the need to act to ensure your aging relatives’ safety and good health.

Weight Loss – One of the most obvious signs of ill health, either physical or due to cognition struggles, is weight loss. The cause could be related to a lack of energy to cook, or it could be more serious. Certain medications and aging in general can change the way food tastes. If weight loss is evident, talk with your loved one about your concern and schedule a doctor appointment to discuss the issue.

Balance – It is important to pay attention to how an older adult moves and walks. An older adult who is reluctant to walk or has pain while they move may have muscle or joint problems. If your loved one appears unsteady on their feet there could be a risk of falling. This is a serious problem and could result in a severe injury.

Emotional well-being – Be cautious of obvious and subtle changes in your loved ones’ emotional well-being. You can’t always gauge someone’s spirits over the telephone, even if you speak daily. Take note of signs of depression, withdrawal from activities with others, sleeping patterns, loss of interest in hobbies, lack of basic home maintenance or personal hygiene. All of these are concerns of depression, dementia or other physical ailments including dehydration. If you notice different behaviors with your loved one, be sure to seek medical attention.

Home environment – Pay attention to your loved ones’ surroundings. For example, your parent might have been a stickler for neatness or for paying bills on time. If you discover clutter or mail piled up, a problem might exist. Keep an eye out for other concerns. Scorched cookware could be an example of a stove that was left on. An overflowing hamper could mean your loved one doesn’t have the energy or desire to do laundry. Check prescription bottles for expired dates and make sure medications are being taken as directed.

If you visit your loved one over the holidays and have concerns, Geriatric Care Management can be of assistance in assessing and developing a care plan for your loved one to help ensure their safety and help with decisions about their future. The more systems you have in place, the better peace of mind you’ll experience as you return home from your holiday and future visits.

Kathleen Weston
Preceptor Home Health Hospice

STARTING THE CONVERSATION

Have you seen the bumper sticker that reads: “Be nice to your children, they’ll pick your nursing home?” Although this saying might seem funny to our young grandchildren or other family members, it’s not so funny to older adults or caregivers. However, when you notice your parents or loved ones need more help than you ever imagined, you need to know how to start the conversation.

There is a long list of red flags that can tip you off when the time has come to have the conversation. A few of them are as follows: A gradual or sudden change in mood or behavior, a decline in health or increased trips to the doctor or emergency room, not enough food or rotting food in the house, a change in personal appearance or increased confusion.

This is the time to call a family meeting. It is important to have everyone involved with your parents at this meeting. Have an agenda and appoint someone to take notes. Ask questions and find out what others might be concerned about. Their responses might surprise you.

After the meeting, pick a spokesperson to lead the conversation with your parents. Explain it is your responsibility as an adult child to see that they are safe and healthy. Be respectful and explain you’re being realistic while being loving and practical, trying to avoid a crisis.

Talk about your feelings. Look for body language and facial expressions – are you hearing your parents? Are you reading them correctly? Encourage them to share their own feelings. Many older adults feel a loss of independence and are worried about their declining health and the emotional changes they are experiencing. Maybe they don’t want to be a burden to their children or caregiver. Be a good listener and be patient. Do your best to hear what they are saying – and not saying. Expect there might be some negativity in the conversation.

Take small steps. Don’t overwhelm them with too much action at once. Tackle one or two small issues such as helping around the house, gathering their important documents or offering assistance with paying their bills. Allow them to participate in the solution to whatever is going on that causes concern.

Once they accept help, do your homework. Knowing available resources is important. In the past I have stressed the importance of knowing your parent’s doctors and other vital information (Social Security number, life insurance, Medicare, bank accounts, financial investments, power of attorney documents). Start a notebook or file with this information.

You can also get expert advice from a professional geriatric care manager who can help you navigate through the system. Collaborating with a geriatric care manager can save you time and provide you with information, recommendations and serve as an advocate for you and your parents. Geriatric care management is privately paid, but also cost efficient when you think of the decreased stress and anxiety, and time away from work or your own family, while at the same time providing a valuable service to the family.

Kathy Weston
Director of Hospice Operations