After a parent dedicated their life to taking care of you, it can feel natural to want to return the favor in their older years. However, knowing when and exactly how much help a senior loved one isn’t always easy to discern. After all, either overstepping or regretting it being too hands off can lead to friction.
“When you just want to help your parent, it’s very easy to run away with it and start taking over their lives,” says Laura Horton, a registered health professional and caregiver to two parents. “They may also feel bullied, even though that’s the last thing you intended.”
If you find yourself currently contemplating whether to step in or continue celebrating your loved one’s independence, you are not alone. We consulted experts who shared signs to be on the lookout for as well as the best ways to intervene once you’ve determined that a loved one might need additional support.
Signs a senior needs help with their health
When evaluating a senior’s situation, it’s essential to take a holistic approach and look at overall health, according to Dr. Steve Lee, president of Conviva Physician Group, a network of primary care clinicians specializing in senior care in Florida and Texas. However, there are specific signs to take into consideration that a loved one might be struggling.
Changes in weight. Unexpected weight loss can be a sign of something “simple,” like lack of nutrition from forgetting to eat, just not eating enough or an inadequate diet. “This is commonly seen in early dementia or untreated depression,” says Dr. Norm Goody, an emergency room doctor, pain and palliative care specialist and former hospice medical director. “Or it could be the sign of a serious underlying medical condition that is being neglected, like cancer.”
Changes in sleep patterns. Are they struggling from sleep disturbances or have delayed waking times each morning? A significant change in sleep patterns may indicate declining health.
Emotional changes. A shift in moods with both familiar and new people may point to pain or struggles with chronic conditions that they don’t want to share but which might need medical attention, notes Dr. David Hatfield, Chief Medical Officer at Hatfield Medical Group, a network of doctors who specialize in providing primary care for people on Medicare in Arizona.
New bruises. Parents may or may not share their mobility challenges, and bruises can indicate that they’re having trouble. “Doctors can support them and even provide advice on increasing strength to prevent falls,” adds Hatfield.
Trouble managing medications. “From refilling or remembering to take them or even expressing frustration at the number of medications from different specialists, this could be a sign your parent needs a primary care doctor to manage their prescriptions,” says Hatfield.
Inability to follow medical directions. Are they intentionally or unintentionally ignoring doctors’ recommendations? Skirting a doctor’s advice could lead to a readmission, which might also be a red flag, according to Judith Sands, R.N. and author of “Home Hospice Navigation: The Caregiver’s Guide.”
Increased confusion. Some cognitive signs can manifest themselves in increased confusion with everyday tasks, such as putting groceries away or making their bed, says Hatfield.
If their response to these lapses is emotional upset, Hatfield says this could also be a sign that this is more than regular forgetfulness that can happen to anyone while doing everyday things.
A home that isn’t being maintained properly. You might also notice that the house isn’t as well looked after, explains Horton. “These chores can become overwhelming, and all these are signs that your parent is not managing their lives very well,” she notes. “It may be an indication of physical illness which has not yet manifested.”
Missing doctors’ appointments. Failure to schedule or to attend follow-up appointments due to confusion or lack of caring can be problematic. Not scheduling or following through with preventive appointments can also be a red flag.
Lack of grooming. A decline in their personal hygiene can be a sign of depression, change in their health inability to care for oneself, or need to change a previously trusted doctor explains Liz Barlowe, President/Certified Care Manager of Barlowe and Associates, which offers aging life care management and patient advocacy in Florida.
Noticeable difference in dexterity. “The parent may seem more clumsy and drop things a lot and may even have an altered gait,” said Danielle DiBlasi, a full-time caregiver. “These signs can be hard to recognize at first because they can be easily written off as stemming from tiredness or stress — especially if close family doesn’t want to accept something may be wrong.”
Changes in overall appearance. Examples of changes to note include appearing pale (which could indicate circulation issues or anemia) and making unusual facial expressions or bodily movements (which could point to a stroke), explained Lisa Owens, a registered nurse and VP of Clinical Operations at Cosán Group, a healthcare organization offering concierge home care for older adults.
Signs your older loved one is doing well on their own
Consider these tips for evaluating that it’s OK to step back:
Set up small tasks. This way you can see if your parent is capable of tackling everyday to-dos like getting to the post office, grocery shopping for the week or walking their dog. If they “pass” these little tests and prove safe while doing them, you can step back, says Sands.
Look at how they are filling their days. Being capable of consistently maintaining a social life requires a certain level of physical and mental function, so if they’re keeping up with friends — even virtually these days — you can rest easier.
Peek inside their refrigerator. “Doing their own shopping and keeping the fridge full of fresh food indicates that they are taking care of their needs,” says Hatfield.
See if they are consistent with doctors. When parents are staying on top of picking up prescriptions and engaging with their doctors, this is a positive sign that they’re on top of their health care, according to Hatfield.
Consider how well they are able to navigate their homes. “Even if they have mobility challenges, if your parents are using their walker regularly, they can maintain their independence,” says Hatfield.
Check out their transportation. “If they have access to transportation and can get to their medical appointments and do essential shopping, that is a good sign that they are doing well being independent,” he adds.
See how they respond to your concerns. “If your parent has a valid plan to address your concerns, you may want to step back or at least pause to allow them to improve the situation or circumstances,” Barlowe says. “Allow them time to consider what is needed and then to initiate the plan.”
Consider their confidence and self-esteem. See if they are able to confidently voice an understanding of their current health status as well as what to do in case an emergency or medical issue arises.
Helpful ways to step in
Once you realize that an aging loved one needs additional support, you’ll want to figure out how you can best support them during this transition. Here’s what experts recommend.
Spend more time with them. Begin by connecting more in person or over FaceTime, according to Dr. Namita Sahai, an internal medicine and palliative care physician who serves as Associate Medical Director at On Lok PACE, a healthcare program in California that includes senior services. Consistent calls will give them something to look forward to and serve as a reminder that they are not in this alone.
Step out of your usual “child” role. This can be a mind-shift for some people as you transition from the listener to the protector and one giving the advice, shares Horton. As you get into the headspace of your parent’s caregiver versus their child, consider whether they need to see a doctor. “They may not go on their own as older people often don’t want to be ‘a nuisance,’” she adds.
Start by asking questions instead of making statements. Alicea Ardito, a licensed clinical social worker, suggests this approach because it avoids putting the older adult on the defensive. Being gentle with a curious question instead of making an accusatory statement allows them the opportunity to share their perspective and feel heard.
Be a good listener. Although it’s safe to assume parents are likely going to deny and disagree with observations we make during the initial conversation, Sahai suggests being patient and just listening. “The process of accepting any suggestions of change will take time,” Sahai adds.
Be honest. Let your loved one know that you have noticed the changes and offer concrete examples. “They may not be aware, and it is important to have those candid discussions,” says Lee.
Be united. DiBlasi recommends first getting on the same page as your parent’s spouse (if they are in the picture and healthy) or any siblings. “You will need to be a united team,” she says. “Ask them to help ease your anxiety by making a routine appointment just to rule things out.” She says that, from her experience, the parent will always be more likely to take care of themselves medically if you say that their care will make things easier for you or their spouse.
Ask their preferences. Check in with your parent about the kind of health and daily care they prefer now as well as in the future, suggests Barlowe. Emphasize your love for them and willingness to help achieve their goals.
Know who their doctors are. Parents can often feel supported in their health when you take the time to get to know the people taking care of them, says Hatfield.
Familiarize yourself with the resources at their disposal. Your parent might have certain benefits available to them, such as Medicare-covered home health care for assistance with hygiene and meal prep, explains Hatfield.
Learn to spot fall hazards around the home. Hatfield says to be on the lookout for uneven surfaces, carpets or rugs that can pose trip hazards or furniture that isn’t arranged well to prevent a larger problem.
Start a spreadsheet. A helpful tool that Ardito recommends to families is to create a spreadsheet to track the following: name and contact information for each doctor, why this doctor is involved, relevant diagnoses, medications prescribed as well as dosages and the next follow-up date. This will keep everyone on the same page and prevent confusion.
Ask them to create a food diary. If weight loss is a problem, don’t just ask them about what they eat because you will rarely get a direct or specific answer, says Goody. “You will often hear, ‘I’m just not very hungry,’ which could be true but could also be a sign of forgetfulness, depression or even of a financial problem they are embarrassed or ashamed to admit to,” he notes.
Consider Remote Patient Monitoring. This is an additional tool, paid for by Medicare, that provides devices for recording important vital signs specific to an individual’s health concerns, such as a blood pressure cuff for a person with high blood pressure or other devices such as a weight scale, pulse-oximeter, and thermometer, says Owens. “The readings are transmitted electronically to the doctor’s care team to monitor, intervene or change treatments, and identify problems promptly,” she explains.
What to do if you find that your parent needs extra help
Whether you provide the additional help yourself or seek professional assistance depends on the level of support your parent needs — plus your bandwidth. Although you may be able to help with some tasks like paying bills, cooking or shopping for groceries, long-term care or hygiene issues could indicate that it’s time to call a pro. Here are some additional tips:
Don’t take on more than you can handle. Just because you’ve identified that your loved one needs extra support doesn’t mean that it has to be provided by you exclusively. “You can only help them if your own life is balanced, so do what you can,” says Horton who encourages family caregivers to bring in professional help whenever they feel the time is right.
Research outside resources. Hatfield suggests familiarizing yourself with the senior-serving resources in your parents’ communities. “They will know how to best and consistently offer support to your parents when you are not able,” he says.
The best place to start to find senior-serving resources in your parents’ communities is with their health care providers. “Any provider who specializes in senior care should have a list of community-specific resources available — including support services for you and other caregivers,” says Hatfield. “This is another reason developing a relationship with your parents’ provider is so important — especially if you live in a different community.”
Check with AARP or your state’s or city’s department focused on older adults. “They will have a list of programs available and even potentially local senior centers,” he says.
Have a frank conversation with their doctors. “It is quite common for elderly folks trying to remain independent not to tell their doctor ‘the whole truth’ because they are worried they might have their driver’s license taken away or be told they need to be placed in a nursing home,” says Goody. But by connecting directly with their doctor, you can provide context or background information, like that your parent has three flights of stairs at home or doesn’t drive and can’t easily get to the grocery store. This will allow their provider to have a better understanding of them as a “whole person.”
In addition, the health care provider might be able to share health information that your parent has neglected to tell you — sometimes intentionally and sometimes because they just didn’t understand or don’t remember, says Goody. “All too often, their doctor has a diagnosis and even has given them a detailed plan to address an issue but then they go home and don’t follow through on it,” he notes.
Consider an assessment from an aging life care manager. Barlowe recommends reaching out to an Aging Life Care Professional, a health and human services specialist who acts as a guide and advocate for families who are caring for older relatives or disabled adults.
The Aging Life Care Professional is educated and experienced in any of several fields related to Aging Life Care management, including, but not limited to counseling, gerontology, mental health, nursing, occupational therapy, physical therapy, psychology or social work with a specialized focus on issues related to aging and elder care, she notes. They also have extensive knowledge about the costs, quality and availability of resources in their communities.
Leaning on an aging life care professional can ensure your loved one is reaching their maximum functional potential, says Barlowe. That way, they’ll be able to safely maintain their independence as much as possible.