For most of us, independence and privacy are an important condition for a comfortable life. We each have our habits and methods of doing things, and life has a rhythm that just “fits” our personalities. But as people age and physical changes occur, we may find ourselves or loved ones dealing with those changes ineffectively. Sooner or later the question starts ringing in our heads, “When should I look for help?”.

But then we think, “Oh, I don’t need help. I don’t want to be a burden to anyone.”.  Or, “I can’t tell Mom what to do; she’d never listen to me.”.  Or, “Dad would never accept help; he’s too proud.”. Or, “It’s not time yet. Let’s wait.”.  So, we wait and do what we can ourselves, all the while still wondering, “When should I look for help?”

The good news is we don’t have to guess. There are some common indicators that tell us when it’s time to get some help. We don’t have to wait for a crisis situation to throw everyone into a panic. If fact, the goal should be to avoid the crisis, for everyone’s benefit.

Here are some indicators to consider:

1. Physical Condition: Have you or your loved one been diagnosed with a medical condition that affects their daily living? Examples: dressing, grooming, shaving, toileting, eating.
2. Personal Care: Are baths/showers being taken regularly? Is there any body odor? Are teeth and hair brushed and washed regularly? Are incontinence products worn if necessary and changed regularly and correctly?
3. Driving: Has driving become difficult, uncertain or scary? Have reflexes and decision making slowed? Have new dings, dents or scratches appeared on vehicles?
4. Nutrition: Is your or your loved one’s weight stable? Are they eating regularly and nutritiously? Is the refrigerator properly stocked with a variety of foods? Do any of the foods have expired dates? Is there spoiled food in the refrigerator or on the counters?
5. Household Tasks: Are household chores being done regularly? Examples: dusting, laundry, vacuuming.  Are bed linens changed regularly? Have household chores become frustrating, physically demanding or time consuming?
6. Socialization: Does your loved one have moods of loneliness, despair, depression, frustration, irritability or anxiety? Is there fear or anxiety about leaving the house?
7. Mental Health: Are there memory lapses?  Is there difficulty finding the right words? Is there inconsistency between words and action? Is insecurity or moodiness evident?
8. Medication: Are medications being taken regularly and on time? Are medications being refilled on schedule? Does your loved one understand what the medications are being taken for?
9. Finances, Mail, Paperwork: Are they having difficulty managing their checkbook, finances, bills or personal affairs? Are there past-due notices arriving? Is mail piling up? Is there a reasonable amount of cash on hand? Are important documents or similar items like purses, wallets and keys being misplaced frequently or for long periods of time? Are they appearing in unusual places?
10. Safety, Security and Sanitation: Are appliances being left on such as the stove or coffee pot? Does your loved one fall asleep with cigarettes burning? Is the house temperature getting too hot or too cold? Is the house frequently unlocked? Have they fallen in the past 6 months? Have there been multiple falls? Is there clutter on the floor? Is trash piling up in or around the house? Are toilets functioning properly? Are pets being taken care of?

Family members often see the changes in the way their loved one moves, acts, thinks and responds to situations around them but dismiss them until one of two things happen: (1) family begins to spend so much time helping their loved one that they have little time for their own responsibilities, or (2) the senior experiences a physical or medical crisis. Both of these result in undue stress for the family and their loved one. If you have a concern with even one set of indicators, it’s time to acknowledge it, learn more about what is causing it, and explore what options are available to overcome it. Speak openly, calmly, and honestly about the issue(s) and the type of assistance needed to support your loved one. Frequently, simple changes can make big improvements.

We encourage you to be proactive and avoid a crisis situation that throws everyone into an emotional reaction. Calm, rational transitions are easier on everyone than stressful, rushed ones.

Finally, keep your efforts as informal as possible. Rather than going through the house like an inspector with a checklist, make your observations through normal, casual interaction. Make a mental note when you see things that are of concern. Keep conversation non-threatening and cooperative. Make every effort to respect the senior’s wishes while assisting and supporting them.