Aging parents: do these changes mean something? Part 1
by Kathryn Kilpatrick
In part one of this series, some of the concerns about memory loss, hearing problems, moodiness and decreased interest in activities were addressed. Below are some other concerns that are frequently mentioned. Is it time for a parent to move to a smaller home, or to a place where there is more assistance? Should mom be driving? Why is my dad coughing when drinking water? What can I do if mom is losing weight and skipping meals?
- Do you have concerns about driving, a current living situation, or a person's ability to remember, but you don't know how to begin those difficult conversations? There are ways to begin those conversations. Doing it earlier rather than later can make a significant difference. No one likes change or having to give up something that is important in their life. When these issues are addressed long before they are a concern, people have the opportunity to share their wishes. If these concerns are just minor, more options can be explored and the person gets the chance to possibly make a choice that appeals to them. When the need to address the problem is more urgent, it is often such a sensitive issue that the conversation is put off or avoided. Possibly, the person no longer is able to process the options or the consequences related to their safety. In these cases, it is more likely that a crisis will occur without a real understanding of the person's wishes, and choices may have to be made without time to thoroughly explore appropriate options.
- Is there a previous diagnosis of memory loss, dementia or Alzheimer's disease? Perhaps the person had a stroke, a traumatic brain injury or another neurological problem. Are you noticing new difficulties with memory, cognition, or the ability to communicate effectively? Sometimes, if the diagnosis has been many years ago, situations or caregivers may change. It may be in the best interests of all involved to have a re-evaluation. Changes may need to be made in the home for safety. Physical and occupational therapy may be able provide an updated exercise program or home modification suggestions. A social worker may be able to connect the caregiver with appropriate resources, or arrangements may need to be made for additional respite for the caregiver. Hearing, vision, speech, or memory may have changed and new strategies may be helpful. Contact your physician to discuss your concerns.
- Are there some problems with appetite, swallowing, chewing or nutrition? With aging may come some changes in appetite and the impact on nutrition may be significant. Getting to the store or cooking may become a problem due to physical problems. With memory difficulties, organizing a shopping list and doing all the steps needed to make something to eat can become challenging. With some of the neurological diseases, difficulty in handling certain types of food textures or liquids may happen. If someone has a diagnosis of Alzheimer's disease, there may be swallowing problems. Sometimes swallowing problems start with just a constant clearing of the throat, a little coughing and choking, or an avoidance of foods like chewy meats, greens or crumbly textures. If someone has lost a lot of weight, their dentures may no longer fit. Contact your physician to learn if a referral needs to made to a specialist in the appropriate area. As a speech-language pathologist, I am seeing an increased number of patients with swallowing problems (dysphasia), sometimes after aspiration pneumonia. Treatment can include an exercise program for the muscles involved in swallowing, as well as swallowing strategies and menu modifications appropriate to the difficulties found after an in-depth assessment.
Caregiver Stress and Memory Loss
Are you a caregiver, either locally or long distance, and noticing that your memory is not as good with the stress in your life? Caregiver stress often has a significant impact on your memory and it is important to learn what you can do to take better care of yourself, improve your ability to recall information and function more effectively in your day to day situation. Family members who are caregivers do not usually take care of themselves like they should. Stress has a way of creeping in and can often have a significant impact on your health, quality of life and ability to continue in that caregiver role without burnout. Be proactive.
Perhaps the suggestions under the caregiver stress link will prompt you to get more information and increase your observations. That may lead you to move ahead with an assessment to assist in long term planning if necessary. For those of us that are coming up on retirement age, awareness in these areas might serve us well if we notice some changes in our own capabilities in the upcoming decades.
In my presentations on this and related topics, there are always a few people that will share they wish they had heard this talk when their loved ones were going through these changes. I encourage them to pass along what they learned and consider being proactive now, having conversations with their family and adult children about their wishes and preferences, perhaps creating a lifestyle care plan in addition to their advanced directives.
My upcoming blogs on this topic will provide insights into the many situations I have frequently encountered, personally and professionally, along with the recommendations that were suggested. These families have taught me a great deal by trusting me with information and insights. By letting me into their lives and their hearts, they showed they wanted ideas so they could be there as best they could for the people they care about. We are all in this journey together so please share any information you have found to be helpful so that others may benefit from another perspective.
"They may forget what you said, but they will never forget how you made them feel." Carl W. Buechner