Everyone remembers their first! Do you remember the first time your family-order was reversed? The first time you felt like the parent and your parent seemed to be child-like? It could have been when Mom was flustered over getting that mouse-thing to make the cursor move. Maybe it was when Dad asked for help doing something financial. It can be striking, or unsettling, or maybe, only in retrospect, can you pin-point “that” moment.
Aging parents are a joy and a blessing that many of us share. If we are lucky, we grow into a new routine with our parents. Talking and sharing as equals, watching kids and grandkids grow up, finding a comfort together as adults. These are all special experiences that can be shared between adult-kids and parents.
However, as parents age, there may come a time when they need more help. Sometimes it’s hard to tell, and other times it is obvious. What can you do to prepare for and recognize that time? One thing is to be aware of some common signs.
As you watch for “signs,” also remember “frequency illusion” – or the idea that something just discovered or reinforced suddenly appears everywhere! The kid who screams at a parent, “You have dementia! I’m taking your keys away!” over losing a set of keys is not as helpful as the kid who observes the whole person and circumstances before stepping in.
Balancing a person’s individual agency with stepping-in to help can be uncertain territory, especially with aging parents. Culturally, we often value youth more than age. Consequently, older people are sometimes pushed aside or overlooked because of their age. Have you heard an older person share that they feel invisible?
Older adults have been making independent decisions for their whole lives. To recognize a need and to allow others to help may not be immediately welcomed. Sometimes an aging person’s choices may not be what we would do, but they are also not harmful choices. For instance, driving the beater-car through the yard to visit the neighbor is kind of kooky. Right? But then again, the older person recognized that her shaky driving skills would likely not hurt anyone (other than the flower beds), and the impromptu over-land route facilitated a much-needed social outlet with a neighbor.
We all have some brand of crazy. But when is that crazy actually cautionary? When should you consider if Mom, Dad, or an older friend needs extra help or special attention?
The Caveats – and they matter. Lawyers are famous for saying, “it depends.” And here again, it really does depend on several factors. Whether you are near or far from your parents, whether you see your parents daily or yearly, whether your parents have known or undiagnosed conditions, and other factors can impact your understanding and decisions to intervene.
We are not doctors or healthcare advisors, and we recognize that every person and family are different. The list below is from our experience with aging people and their caregivers. Like many things in life, this list is not exhaustive, but we hope it is helpful.
Po-tay-toe or Po-tah-toe? It is not just pronunciation. If your parent answers a question or makes a statement that is out of context, check to see if they clearly hear you. Aging adults want to participate fully and may be embarrassed to say they cannot hear. Hearing loss is common and is a bigger deal than we sometimes think. Loss of hearing can be frustrating, isolating, and can also relate to balance issues and loss of cognitive ability. Have a professional check your parent’s hearing. If possible, get a baseline test so you can track the amount of deviation over time.
Drivin’ N Cookin’. No, it’s not a new, knock-off band your folks have joined. Be on the look-out for new or unexplained dings and scratches on the car. We have seen older people who mistook the gas for the brake, and who measured a parking space by tapping the car in front. Is your parent having trouble with spatial awareness, vision, or reflex control while driving? Also, see if the cooking pans are burned or never cleaned, or if the kitchen is not used as in the past. Forgetting what’s on the stove or losing interest in cleaning (of all kinds) may indicate a cognitive, physical, or emotional concern. A change in nutritional intake is also as sign that a person may be overwhelmed with shopping and cooking. These are signs to investigate further and consider whether a professional evaluation is needed. This might be the time to discuss whether your parent is ready to hang-up the keys or get some extra help in the kitchen.
Moody Blues and Reds – Dramatic or long-term mood changes may indicate an issue. Sometimes these are obvious, like an unexplained outburst. Other times the changes can be gradual, like a growing unease that turns into constant agitation. Increased agitation could be a sign of a urinary tract infection, or it may be a sign of a more serious condition, like dementia. Older people sometimes have trouble articulating that they don’t feel well. When you have aches and pains in life, “one more in the basket doesn’t register,” said an older friend. Medical and psychological tests can help determine causes of mood changes. And confirm that your parent has signed HIPPA forms so you can learn more about the results and proposed recommendations from their doctors.
Show Me the Correct Amount of Money – Many aging people know to be aware of scams. Even so, our parents’ generation’s sense of social norms and manners make saying “no” or hanging up on a hard-sale telemarketer incredibly challenging. Recent advice to “just don’t answer the phone” was met with skepticism from an older family member – “It must be important if they call me!” Falling for financial scams, bills that are late or don’t get paid, services that are cut off, or overpayment for services are all signs that a person may need some assistance. Expressing frustration or a reluctance to discuss any financial things are also signs. How can you help? There are land-line phones with Caller ID that can block telemarketing calls. Some adult-children take over the family checkbook and start paying parent’s bills. You can also help aging parents by setting up on-line payments that you monitor while they continue to manage paper-bills and payment. In some cases, you might discuss a financial power of attorney, and in extreme cases, a conservatorship might be needed. Your attorney can help with these decisions and documents.
Did Ya Hear (again) the One About? Like a great movie, a good story is worth hearing again. However, retelling the same stories or details multiple times, within a short timeframe may indicate a cognitive decline. Confusion over or forgetting skills that had been frequently used, like working with an iPhone or Kindle, or losing all interest in a loved past-time may be signs that a person needs help. Be careful to see whether there is a true loss of interest or instead, an inability because of cognitive or physical limitations. Addressing your observations directly with a parent is a great start. If this becomes a difficult discussion, a physician, therapist, or social worker might be useful to engage.
Not So Peace Out! When one parent, typically the caregiver, leaves the other in a situation they cannot handle safely, the care-giving parent may be at the end of their rope. The stress of caring for an aging spouse is compounded when a care-giving parent is also facing their own issues. The frustration may be expressed in several ways, such as angry words, physical confrontations, financial abuse, or abandonment. Try talking with your parents separately. Consider asking what events precipitated the incident. Depending on the severity, you may need to consult with a professional.
Bruises, Cuts, Scrapes – Oh my! Have you seen unexplained bruises, cuts, or scrapes? Watch to see if your parent has trouble standing up from a chair. Loss of strength and balance can contribute to instability and lead to bumping into things or even falling. Falls are especially dangerous for older adults whose bones are more brittle and for whom activity is essential to staying healthy. Bleeding may be hard to stop depending on certain medications. Also, watch for other muscle weaknesses or neurological changes, such as shaking that leads to spilling food or drink. Health care professionals can help you determine and diagnosis the root cause of these physical concerns.
Remember, you know your parents. Gather the facts. Trust your instincts. Ask for help. As the saying goes, none of us gets out of here alive. If we are lucky, we’ll grow old and may face some of the same issues our parents face. Until then, we can be present and active in our parents’ lives. And when they need a little help, we might just be the one to recognize it and give it. You can do this!