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How can we tell if our aging parents need help?

by Carol Bradley Bursack, Editor-in-Chief

Adult children get busy with their own lives, and many live quite a distance from their aging parents. If you are a 'long-distance child,' the holiday season may present your only chance to detect changes in your parents' health, their environment and their overall attitude toward life. What should you watch for that could help you decide if you need to suggest to your parents that they get some help?

For years, when I knew my brother and his wife were going to visit our parents, I'd prepare my sibling for how "bad" Mom and Dad were going to look. Our parents both lived with degenerative diseases, and each had a different type of dementia. It seemed to me, their primary caregiver, that they were fading away. My sister saw them nearly once each week, as well, and she agreed with me. We didn't want our brother to be shocked by their failing health, so we prepared him. Or so we thought.

It turned out that our parents were so pumped up about their son coming to visit, that he'd arrive and see our elders looking really quite good. I then felt foolish for having over prepared my brother in excess for something he just couldn't see.

As soon as my brother would leave, like a deflated balloon, our parents would sink back to the level where they were before the visit. One year -- and this nearly broke my heart -- my mother was so excited about the visit she could talk of nothing else. Then, after my brother left, Mom asked which weekend he was coming. She'd totally forgotten the visit had happened.

Still, the aging parent can only keep up this wellness act for a short time. So, if an adult child coming from a distance can stay a few days, he or she does have a chance to get a fresh look at how the parents are doing. Their input can help the caregiver who sees the parents daily, since a primary caregiver may not notice subtle changes.

Also, we who live close to our elders, or who are primary caregivers, tend to do what needs to be done, so it could be that the elders are losing certain abilities and we haven't noticed. That's when someone who only sees the elders occasionally can be really helpful.

Do Mom and Dad cover for each other?

Long married couples can often finish each other's sentences. They can help each other read, eat and do other things so common to daily life that no one stops to notice that they are such a team they are 'filling in the gaps' for each other. Often, even they don't know this is happening. When you visit, try to "separate" the team a bit. See if Dad's hearing is getting worse, but Mom is hearing for him. See if Mom's balance is bad in the morning, but Dad is getting her breakfast and making sure she is steady before anyone else sees her. In other words, see if it takes a team for them just to hang on.

Teamwork is wonderful, and it's beautiful to see long-married couples working seamlessly beside each other. However, if there are health issues that need tending to, this teamwork can be detrimental. Getting each of your parents alone helps you identify strong and weak points.

Take a look around the house

Look at the rugs. My neighbor used to have wood floors and scatter rugs all over. I had to fight with him to get those rugs removed, finally agreeing to slide them under the bed, so he could get at them if he wanted to (he never did.) Scatter rugs are a favorite with many elders, but they can be dangerous. Try to get rid of them, or at least get them to let you put rubber backed rugs down.

Showers and tubs should be checked. Do they need grab bars? A good shower chair? A hand-held shower? Tub mats in and out of the tub need to be firmly attached and non-skid.

The dishes they use daily should be on low shelves. Most elders don't do fancy cooking. Encourage them to let you help arrange dishes and pans in the most convenient fashion.

Replace door knobs. Door knobs can be replaced with levers, which are easier for aging hands to use.

Consider long-handled grabbers. Long-handled grabbers can help keep your parents from stooping over to pick things up off the floor, if they have problems staying steady.

Take a look at your parents

Check their balance. Speaking of 'staying steady,' how is their general balance? Falls are one of the worst problems for elders as they can lead to broken bones, especially hips, and complications from a broken hip can lead to death. If you see one of your elders is wobbly, try to talk him or her into seeing a doctor. Balance problems can be an early sign of dementia, or simply that joints are bad. They may have numbness they aren't mentioning or an inner ear infection.

Don't forget to check their alcohol habits, and have the doctor look into medications that can cause dizziness. There are many reasons elders get wobbly, so it can take some doing to figure out the cause. However, it's necessary to get to the bottom of balance issues or they won't be safe.

Are they eating well? Elders often don't have big appetites, but if you notice significant weight loss, you may want to take a look in their pantry and refrigerator. If they aren't eating well, you can suggest Meals-on-Wheels, a community program that brings a nutritious dinner to elders for a very reasonable price. If eating doesn't seem to be the issue, then a complete physical should be done to see why the weight loss is happening.

Do they seem depressed? Depression could be the hardest thing to notice if you are coming for a rare visit. As I mentioned above, your parents may be extra excited to see you, so their depression, which perhaps a sibling has mentioned, may temporarily lift. However, do watch for signs of depression, such as sleeping too much, loss of interest in former hobbies they once loved (without other reasons such as failing eye sight), no appetite, or no interest in anything at all. Also, most seniors love getting mail, so if you see piles of mail lying around unopened, depression may be an issue. You may want to ask a good friend or neighbor about your parents' general moods when you aren't there. Someone who sees them frequently may get a better handle on depression.

One thing to remember when you do visit is that you shouldn't swoop in and try to change everything. Just get a feel for what is going on, how your parents are doing, in general, and what needs to be done. Then offer to help them get things done.

Talk about in-house care

Often, elders won't disclose that they are having trouble, because they think they may have to go to a nursing home. They should know about in-home care agencies and how they can get just a few hours a week of help. Many elders can stay in their own homes much longer than they thought, because they get some in-home care for bathing and other hygiene, some medication supervision and even some light housekeeping. The caregivers who come in from agencies are generally trained to watch for just the things we've discussed in this article, and more.

You and you parents may feel better if you line up some in-home care for them. Personal medical alarms are another good way to stay at home longer. If you approach your parents in a way that lets them know you want to help them stay in their home, they are more likely to cooperate. If you are lucky enough to still have two parents, don't break up the team before you have to.