Life Journeys, LLC Care Coordination
|Posted on 30 December, 2013 at 13:25|
If you don’t have an aging parent, you probably know someone who does. Perhaps one of your closest friends is struggling to try and care for their loved one as they go through changes in their health, and trying to meet the needs of the others in their family at the same time.
How do you know when these changes are occurring in your loved one? What do you look for when your parent is telling you that everything is fine, but you see evidence to the contrary? Or maybe you have a gut instinct that is telling you that your parent is bluffing by using humor in odd ways to cover for the beginnings of forgetfulness, or no longer being able to care for their own needs as well as they used to. Maybe you are seeing changes, but you are avoiding confronting the concerns because you don’t know what to do or where to start. After all, this is your parents, we are talking about. They have always been there to help with our needs. They can’t possibly be getting older and frail!
Are they safe to be left alone?
Let’s start with some commonly observed potential areas of risk:
o Are clothing items frequently stained by food?
o Is the person losing weight without an obvious explanation?
o Are they drinking enough water, especially in the Summer? (Urine may be dark and concentrated or they may have a dry mouth. They may complain of dizziness when they stand or a frequent nagging headache)
o Are food items being kept long past expiration dates?
o Do pots and pans appear to have repeated scald marks?
o Has the stove been found left on?
o Is the client making healthy food choices, or is there mostly cereal, breads, soup, and easy to eat without preparation foods?
o Can your loved one, plan and prepare a balanced meal?
Getting in or out of chair or bed:
o Does the person rock back and forth several times before actually getting up?
o Are nearby furniture items or objects used for support?
o Does sitting seem to involve falling backward into a chair?
o Are clothing items soiled or wet?
o Is there a noticeable odor of urine or improper hygiene?
o Is the person’s hair and skin dirty or oily?
o Is there notable body odor?
Dressing and Grooming:
o Does the person have a rumpled or disheveled appearance?
o Is there inattentiveness to hair, make-up, clean clothing, jewelry, or other things that were once important habits?
o Does it take them an extremely long time to manage getting dressed on their own?
o Do they avoid going out and being with others because it is too hard to get their bra fastened or they can’t put on shoes and socks any more?
o Does the person seem unsteady or have poor balance?
o Have there been reported falls, or the observation of bruising and abrasions?
o Do prescriptions last longer than they should?
o Are prescription refills being needed prior to the refill date on the bottle?
o Are you finding loose pills in unusual places?
o Can the person read the labels and understand what conditions the medications are actually used to manage?
o Are prescriptions being ordered from more than one pharmacy?
o Or several different doctors?
Using the telephone:
o Does the person seem to understand phone conversations?
o Is the phone not answered when the person is known to be home?
o Can the person demonstrate the ability to call 911 if given a hypothetical safety risk situation?
o Are you finding that your loved one often has the thermostat set way too high or low, especially in the Summer or Winter months?
o Are you noticing changes in their abilities to use the microwave & stove?
o Is a ‘simple style’ tv controls too difficult (Let’s face it, there ARE way too many buttons most tv controls for most people’s needs)
o Are they able to get out of the home safely if there is an emergency?
Managing money, mail, and paying bills:
o Do bills go unpaid, leading to overdue notices or shut off of utilities?
o Has the person been repeatedly notified of overdrafts on accounts?
o Are you noticing a lot of window mail from charities?
o Can the person demonstrate counting the correct amount of change while making a purchase at the store?
o Or do they hand their cash and credit cards to others to count for them?
o Does the person complain about too many telemarketers calling and bothering them?
o Are you noticing bruises and abrasions that your loved one minimizes?
o Are you getting phone calls in the middle of the night to help them get up off of the floor?
o Is your loved one having more difficulty finding their way around inside or outside of their home?
o Are clothes clean?
o Is the person wearing the same outfit for more than 2 days in a row?
o Are they unaware when they have spilled food on their clothing?
o Are you seeing socks and underwear hanging in the bathroom, but there doesn’t seem to be much in the laundry basket?
o Is your loved one trying to hand wash disposable incontinence briefs to save money?
o Are pathways clear and clutter free?
o Are there loose throw rugs or cords that create a fall hazard?
o Can the person find things readily when they are needed?
o Do they have so much stuff that they can no longer manage it all?
o Does the word “hoarding” keep coming to your mind when you think of having to manage all of the stuff that is over accumulating?
o Do you feel panicked about not knowing how or where to start helping them?
o Are they still driving even when you are concerned about their safety?
o Or has the person repeatedly become lost while traveling in ways or on routes that are usually familiar?
o Are you afraid to ride with them yourself for safety reasons?
o Is the kitchen or pantry stocked with a reasonable amount and variety of food items?
o Are the food choices healthy or convenient foods that don’t need preparation?
o Is the person complaining of not being able to sleep at night and watching tv at unusual hours?
o Are you noticing an unusual number of packages being delivered in the mail? (Mostly from QVC and HSN)
o Are they left unopened once they arrive?
o Are they useful or unusual items?
Suspicious or Paranoid behavior:
o Does the person accuse others of stealing things? Things that typically hold no interest for others, or things that are typically found later, maybe in odd places.
o Are they easily offended by remarks of others, comments that would not have bothered them in the past?
o Is the person often defensive or argumentative in their responses?
o Are they trying to convince you & themselves that everything is “just fine” and that they are not having any difficulties with anything?
o Are their responses to you realistic?
o Are they beginning to hoard money or food?
o Are they resistant to help, because they have always managed on their own, and will continue to do so until they absolutely can’t anymore?
So now what?
• Who do you call to help you understand what your choices are once you find yourself spending more time in the emergency room or doctor’s office than seems reasonable?
• Or when you are experiencing repeat hospitalizations?
• When you are getting panicked phone calls in the middle of the night and at work?
• What do you do when taking yet another day off work is putting your job security at risk?
• Who is available to help if your parents live in a different city than you do?
You may be at a crossroads and the choices seem overwhelming and daunting. Partnering with an RN Geriatric Care Manager for a comprehensive assessment of your loved one’s abilities and needs may be the key to helping you know where to start. We can also help to navigate the healthcare delivery system with less stress and a better understanding of your choices. Please call for a free in home consultation for you or your loved one.
Brenda Rose, RN
Life Journey, LLC. Geriatric Care Coordination
Changing the end of the story…