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The 6 Signs of Decline

June 14, 2011

How to decide what's natural old age and what may be a cause for concern.

Is it inevitable that aging must bring disease, debilitation and dementia? Jack Lalanne, the exercise guru, continued his two-hour daily workouts into his nineties. Clint Eastwood, at the age of eighty, continues to produce, direct, and star in major motion pictures.

Sure, our parents are aging. But while chronic illness and increased frailty take their toll on many, some are maintaining their independence, vitality, and mental acuity well into their eighties. Yet we still worry when these seemingly healthy parents forget their phone number or lose their car keys. So how can we differentiate the normative aspects of aging from disease?

My father was in his early seventies when he began showing signs of dementia. Though keenly intelligent, he had always been absent-minded -- misplacing things, mixing up the names of his children, and growing agitated when events did not go as planned.

So it was no cause for alarm when he began to seem increasingly forgetful and disorganized: the emotionally wrenching search-and-rescue missions for his lost glasses were just business as usual. It was not until my father became disoriented on a short bike ride to the local grocer and was forced to call my mother to pick him up that we recognized something significant had changed. It was then that we made the decision to have my father undergo a medical evaluation for dementia.

For those of us caring for aging parents, we must balance concern for our parent's welfare with respect for their autonomy and independence. In addition, we may live a distance from our loved ones and view changes through a magnifying lens.

How do you know if what you're seeing is a true decline, versus a natural state of old age? These 6 warning signs will help you determine whether your parent is facing a medical problem or simply following the usual path of aging:

  1. Physical Changes
    Are there gait changes, extreme weight fluctuations, or a decline in personal hygiene?

  2. Household Changes
    Is there no food, old food or expired food in the fridge? Are there scratches or dents on the car?

  3. Mood Changes
    Does your parent show signs of anxiety or depression? Depression is NOT a normal part of aging -- and it can be treated!

  4. Forgetfulness -- out of the ordinary
    Like my Dad, losing glasses was expected. A repeated pattern of forgetting pertinent events, however, may be cause for concern.

  5. Misuse of Prescribed Medications
    Are there expired prescriptions? Can your parent remember what medication he or she is taking and when to take it?

  6. Mishandling Finances
    Are there unpaid bills, problems keeping track of expenses, signs of carelessness with money?

Once you recognize, like my family and I did, that the changes you are observing may be signs of dementia, a chronic illness, or increased frailty and dependence; it is time to communicate your concerns in a compassionate and clear manner. You can then take proactive steps to plan for the type of care that will give your parents the independence and well-being they deserve, while maintaining their safety and your peace of mind.

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