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Symptoms of decline in elders' health: should family members intervene?

by Isabel Fawcett, SPHR

For some elders and their caregivers, accepting subtle or increasing health challenges with advancing age may not come easy. For others, the handwriting is on the wall for such health challenges. Elders and their caregivers approach and handle declining health with advancing age as best they can. No two circumstances are alike.

Life Activities and Joint Health

I was in my 30s when Mom first mentioned that her ability to grasp ordinary household items was not up to par. Oddly, though, I recalled no more than a couple of times where her soft drink in a glass had fallen out of her hand. Not a big deal, I thought. Things happen to all of us. I asked Mom why she was so concerned with her grasp when it really had not been a recurring issue to my knowledge. Her reasonable reply was that I did not understand. She was right.

I did not understand that particular issue in context of an individual's declining ability to perform basic life activities until more than a decade later when I literally felt that my grip on a can was not as snug as it used to be. The can slipped right through my grasp. I was puzzled. Much later, when some item slipped out of my hand again as if I'd never had a grip on it, I had a flashback to Mom's concern decades earlier. My living alone at the time made it easier to understand.

While reduced hand and joint strength in grasping is not one of Mom's escalating health symptoms, she has always been realistic about her physical limitations with advancing age.

Driving and Mental Confusion

Mom voluntarily decided to stop driving long distances alone after an incident in which she found herself driving into oncoming traffic in the opposite lane. When she realized that her small car was facing a big rig head on, she safely stopped her car. The driver of the truck also stopped in time without further incident. The truck driver got out of his rig and asked Mom whether she was okay. Not only was she not okay, she wasn't sure how she had gotten into the opposite lane.

She was horrified and knew something was terribly wrong, though she had no idea what had happened. Her blood glucose had plummeted. With the severe drop in her blood glucose, Mom became disoriented and confused after dropping a relative off at an Amtrak station in a city she otherwise knew like the palm of her hand. That was the last thing she recalled, other than feeling slightly shaky for a brief spell. It happens to some diabetics. It can happen on the road.

Thankfully no one was hurt. After that long-ago incident, Mom chose short, familiar drives solo. For all longer drives, she had someone else along for the drive. Usually Dad accompanied her on longer drives. I lived thousands of miles away when the incident happened. I am glad she told me about her decision to cut back on long-distance drives. There was no shame in her disclosure, only heightened family awareness.

A Simple Care Intervention

I had no concerns about Mom's driving or post-incident handling until the day she retired many years later and was living alone. By then, my Dad was long dead.

Perfect timing for my first simple care intervention. I invited Mom to relocate in her retirement to be geographically closer to where I lived. I told her that if she didn't want to relocate, I gladly would have relocated to live closer to her. If she ever needed care, I would be within driving distance, I reasoned.

I kept our options simple. Mom could opt out. If she did, I would bear the burden of relocating at a time when my life was uncomplicated. Nothing more required from me as a carer at the time.

That may have been the best care decision I ever made. My decision was proactive. I invited Mom to vacation in my town and then decide whether she liked the area or not. She loved the area and the change of venue. Mom has always been as adventuresome as I've been in my own life. She made her own friends easily. So her golden life transition and active retirement lifestyle began. She remained socially active and independent well into her late 70s.

I had no long-distance care worries in my life. Life was good. Mom was in charge of her own medical and healthcare routines. All I did was find the best doctors I could for her, locally.

My first care intervention self-rating merited 5 stars based on a happy retirement beginning for Mom, with minimal effort required on my part.

Driving, Night Vision and Depth Perception Dangers

Years ago, at dusk, I was a passenger in a car driven by an elder. All was fine until daylight became scarce. As darkness descended, the driver started driving on the opposite side of the yellow line divider on the 2-lane road. Though the car was not over the yellow line by much, I waited a few seconds before I calmly sounded a gentle passenger alarm.

"There's a car headed toward us," I said. I'd seen the oncoming car lights in the distance. You need to pull back into the lane in which you're supposed to be driving."

The driver assured me there was no cause for alarm and continued straddling the yellow line. The elder failed to recognize that his car was straddling the yellow line. As both cars continued driving toward each other on what would have been a certain collision path, I screamed, "You need to turn your steering wheel -NOW- if you don't want to kill us all!" I simultaneously grabbed the steering wheel, swerved it right, then slightly left to position the car in the proper lane. We averted a head-on collision.

Still in a state of shock, I shook uncontrollably. Eventually, I cried silent tears in the dark. The remainder of our drive back was quiet and awkward for both of us, as well as the other passengers in the car. I was bummed that I had been the sole passenger in the car who sounded the alarm. Then again, my life was on the line.

It is best to not wait until you need to grab hold of a steering wheel, or sit in a car looking like a deer in headlights, before it all goes down. If you're anything like I am, neither do you ever want to scream at another person, much less a confused driver or an elder.

When my life suddenly flashed before my eyes, I experienced a moment of pure adrenalin.

Family Interventions: Timing is Everything

It is neither uncommon nor unreasonable, when some family members dread talking with an elder regarding the elder's need for assistive care. Who wants responsibility for shaking another person's confidence to the core, much less an elder's? Not I! Yet, there comes a time in some elders' lives, where direct intervention is necessary. It may be an elder's fading vision, memory loss, failure to follow established self-care routines, road safety concerns or any number of little cues that you notice. Whatever it may be, time is of the essence.

If that day comes, tackle the issue head-on, more so if an elder poses a direct threat to his or her own life or safety or someone else's. Your life and your elder's, or someone else's, may depend on your timely intervention. If you can't bring yourself to intervene, find a medical, geriatric or social work professional to guide you.

Sounding an elder alarm is no fun. Trust me on that. Make it easier on yourself by not waiting for something to go wrong. If you procrastinate, something can, and surely will, go wrong. I regret bearing bad news. Timing is everything when it comes to family intervention in eldercare.