12/12/2019

4 Signs An Elderly Loved One Needs A Little Help

The holiday season is often the part of the year during which we are able to spend the most quality time with relatives and friends.

This represents an opportunity to check up on how elderly parents or other relatives are coping with living in their homes independently. 

It is not pleasant to think about, but as we age it can become challenging to live in the manner to which we are accustomed. It can be even more challenging to accept that we or our loved ones are struggling to cope. Most people want to remain living independently in their own homes as they age and can see admitting to difficulties as embarrassing or as an acceptance that they cannot continue living at home. This can be counterproductive, as if early signs of difficulty are recognised, acknowledged and mitigated it is possible to continue living independently for far longer. Below are some typical signs that someone needs a little bit more support. So whilst enjoying the company of loved ones over Christmas, please keep an eye out for any of these signs, both for their sake and for your own peace of mind.


1. Noticeable degradation in standard of housekeeping

Cleaning, tidying and other household chores are time-consuming and tiring for the most young and spry amongst us. For older adults they can become a daunting and even painful task. Bending over, reaching and stretching can become all but impossible. A slow decline in the cleanliness of a home can be difficult to notice at first, but is perhaps the most common sign that someone needs a little help. It is not uncommon for parts of the house that were previously kept to a high standard to start to look neglected, especially if they are areas that are not frequented by visitors. 

Struggling to keep on top of day to day tasks can visually manifest itself in other ways, with dirty, dishevelled or frequently re-worn clothing, unopened or built up post, un-replaced broken appliances, or even expired food not being disposed of, being common warning signs. Sometimes these problems are invisible to the elderly person themselves, and can even be deliberately ignored or denied out of sense of embarrassment or shame. These feelings can contribute to a loss of motivation and even to depression. If you do see any of these signs it may require considerable tact to approach, but it is important to do so, as often only a small amount of help can have a huge difference in maintaining the quality of life desired and in improving general mood.

2. Disengagement from family and other activities

This can take many forms, and may be a gradual change in behaviour rather than a sudden shift. Key signs are, a reduction in enthusiastic participation in festive activities, displaying less active interest in the lives of family members and a difficulty with remaining engaged in conversations (particularly those with multiple participants). These signs are not necessarily indicative of cognitive decline, but could instead be the result of tiredness or stress as a result of increased difficulty in maintaining a standard of living. It is also possible that there is an underlying fear that more active engagement could reveal a difficulty that they would rather hide, such as remaining seated rather than joining others in another room so as to conceal tiredness, pain or unsteadiness. Alternatively, they could also be caused by a partial loss of hearing.

Another sign is a reduction in, or complete withdrawal from, activities that previously formed a regular part of life. This could be no longer attending church, a club or other regular meeting. It could also be an avoidance of necessary activities such as shopping, or a general failure to fulfil arranged appointments. The social activities we perform are often a crucial part of a person’s self-identity, and finding them difficult or impossible to continue with can be very distressing, as well as representing a significant blow to perceived independence.

Other behavioural changes can also be indicative, such as uncharacteristic mood swings, irritability or moments of confusion.


3. A marked increase in risk aversion.

Falls and small accidents are for many people and unfortunate symptom of aging. Even a minor fall can have a significant negative impact upon the confidence and dignity of any older adult. They can often result in behavioural change driven by the fear of subsequent falls, or even being seen to fall. This may mean that some potentially risky tasks are not performed, such as light bulbs being replaced. Alternatively it could lead to relocation of household items or furniture, often including the clustering of regularly used items around the most commonly inhabited part of the house.

Whilst this risk aversion might seem to simply be sensible caution taking, it can often represent the start of a decline towards frailty. The fear of falls is often cited as a major cause of falls, as the resultant reluctance to perform medium or relatively low risk tasks, represents a significant reduction in activity and a tendency towards a sedentary lifestyle which impacts the health and particularly musculoskeletal strength. 

This is not to say that no attempt should be made to mitigate risk. A balanced approach, perhaps including assessing the risks prevented by different locations and activities in the house together, is a good way of working with an elderly relative to support them without impinging upon their independence.


4. Concealing or excusing bruises, burns and other small injuries.

As discussed above, a fall or other accident can be a chastening experience for an older adult who has been accustomed to looking after them self for their whole adult life. It can also be very embarrassing to admit, especially due to a worry that it will be interpreted as a sign of frailty or inability to live independently. As a result it is not uncommon for such accidents to go unreported, and to be actively hidden. It is often easy to make a believable excuse for a bruise, especially when there is no know history of such accidents. Nobody wants to imagine those we care about suffering the indignity of falls, and most of us will be psychologically predisposed to accept a logical excuse that explains an injury.

Burns and scalding are common injuries for elderly people, often caused by difficulty cooking or in manipulating hot items such as kettles. Whilst people of any age can suffer from burns in such circumstances, multiple burns or a pattern of injuries can be indicative of a deeper problems. Other corroborative signs include burnt or blackened pans or a sudden simplification of diet.

If you believe that bruises or other injuries may be the result of falls, it may be difficult to confront the subject directly, particularly if this means challenging the given explanation. It may be necessary to approach the subject of falls from an abstract direction, discussing the risk of future falls without directly insinuating past incidence.


What other help is available?

There are many organisations offering advice, guidance and support for those who want to maintain their own or a loved one’s independence. The Royal Society for the Prevention of Accidents (RoSPA) has some excellent resources, as do other charities. Your GP may also be able to point you at some local organisations able to offer support. Helpline have many articles on this website pertaining to maintaining independence, and also provide the pendant alarm service, which is an effective way to ensure that an older adult has 24/7 support without compromising on that independence. 

Read more about the pendant alarm and other services we offer: https://www.helpline.co.uk/

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