Adults change in different ways, for different reasons and at different times. There is no such thing as a standard or right way to change as we get older. We continue to be uniquely individual as we get older. Changes we see in our parents’ abilities are often signals of other underlying conditions. Some changes in abilities are strictly related to changes in their bodies, such as bones and muscles, heart, lungs or brain. Other abilities change because of socio-economic factors, such as decreased funds, lack of transportation, and less contact with friends and family. Other miscellaneous factors can also trigger changes, such as medication reactions.
Many seniors try to hide these changes from us. They don’t want to be a burden to family, and they want to maintain their independence. They are concerned they will be removed from their home if these changes are detected. Therefore it is important to recognize subtle changes such as:
- Vision loss: You may notice your parents holding items closer to their face, ordering at a restaurant without looking at the menu, dishes are not totally cleaned when washed, mail stacking up, holding the paper upside down, watching TV from the corner of their eyes, writing things in a larger font. If you notice this, ask if they have seen an eye doctor recently. Suggest a visit and help them make an appointment. Help arrange transportation to the appointment and even pay for the appointment if needed. Some vision changes are not correctable, but can be compensated for so a person can still stay at home, such as making sure there are lights in all the important places -- hallways, outside walkways, stairs, every room of the house, closets and pantries. Increase wattage in light bulbs, make color contrasts on the stairwell and counter tops, and label the stove controls, telephone and remote control with large letters and numbers.
- Clothes beginning to fit loosely: Your parents may try to hide this or say they are trying to lose weight, but it is still important to check this out further. Look in the refrigerator, the shelves and the trash can. Is there food that can be fixed easily by the person? Is it fresh? Is there evidence of them having fixed food--scraps, containers in the trash? Getting to the root cause of the problem may take some difficult conversations, especially if you and your parent have not discussed care matters before. There are resources in the community to assist. They may qualify for mobile meals or SNAP. There are also area grocery delivery and meal preparation services. Home care assistants can come in to prepare the meal, and provide other services important to a senior remaining in their home.
- Difficulty getting in and out of chairs or the car, or pausing for a bit after standing: These are signs that your parents’ muscles and bones are changing--causing pain, stiffness, and decreased range of motion. This can cause a person to be more sedentary which leads to decreased strength, balance, endurance, ability to care for themselves, social isolation, and depression. Ask what they are doing for the pain. Their doctor may recommend medication or a topical cream to help. There are home exercise programs that can be safely done from a chair and standing while holding on to a chair or counter for support, that will keep muscles and joints strong so the person can remain in the home safely.
Ellen Smith serves as center manager for PACE of the Triad, a Program of All Inclusive Care for the Elderly. She has been a registered nurse for more than 30 years with experience in various health care settings including hospice, a skilled nursing facility, hospital and as a congregational/parish nurse. Smith is a graduate of Lenoir Rhyne College (now University) and has completed graduate-level coursework at UNC-Greensboro in Education. In 2015, she received the NC PACE Association Individual of Merit Award for Indirect Care.