Visiting with elderly loved ones over the holidays is a good time to look for warning signs about whether they’re still fine living on their own.
“A lot can change with an 80-year-old parent in six months, even a couple of months if you haven’t seen them,” said Andrew Carle, a faculty member at the Program in Senior Living Administration at Georgetown University.
Families evaluating someone’s condition should check three key factors in specific order, Carle recommended: Whether they’re safe, whether they can meet their physical needs, and whether their emotional/social needs are being met.
“Number one, first and foremost, are they safe?” Carle said, referencing cognitive and physical safety.
Cognitive and physical safety is about questions such as: Are they going to leave the stove on? Do they smoke and are at risk of setting a fire? If dementia is developing, might they go wandering and get lost? Are they going to eat spoiled food? Are they at risk of being scammed? Can they manage medications?
“The number one reason older adults are hospitalized is due to medication errors,” Carle said. “People over 65 average anywhere from seven to 12 or more medications.”
As for physical safety, Carle said the number-one cause of hospitalizations in older adults is falling down. Falls affect one out of every three people over 65, and one out of every two people over 80, he said.
Can they take care of themselves?
“What we call ‘activities of daily living’ [are] things like bathing and dressing and grooming and ambulating and things like that, but also what we call ‘instrumental activities,’ things like cooking and cleaning, and home maintenance and shopping,” Carle said.
Do they smell nice? Are their nails trimmed? Are they shaving? Are their clothes clean? Are they paying their bills?
Social isolation and loneliness among older people is epidemic, according to the World Health Organization.
“We now have data that shows that loneliness is very unhealthy for you. It can result in a 59% increase in functional decline, a 50% increase in developing dementia, a 45% increase in the risk of death. And, some studies have shown that loneliness can be as dangerous as smoking or obesity or physical inactivity,” Carle said.
He summarized the warning signs: “What I tell families is, go in that order: First of all, are they safe? Secondly, can they physically meet their needs? And then third, even if in theory, they can do those things — have you checked on their emotional wellness and see how they’re doing?”
If your elderly loved one needs an adjustment, Carle said options include finding a way they can stay at home by themselves using assistive devices, home modifications or technology.
“There’s ways to stay at home by themselves if you hire some outside help — home health aides, for example — or if they go out during the day to maybe a senior day center, some of them offer transportation,” he said.
“But if those things can’t be met, and they’re still not safe, or they’re still not physically able to stay home, or emotionally able to stay home, then you’re looking at a new home,” Carle said. “You’re looking at senior living and all the options: everything from independent living, to assisted living, to memory care, or a life-plan community that offers all of those.”