Most people say they want to age at home, and this makes sense. Home is familiar and comfortable. For people who remain injury and illness-free, this can work out well for them. But for many older adults, the problems associated with aging tend to catch up to them.
When safety becomes an issue, an older person may not be able to live alone. Living alone doesn’t necessarily mean that they must switch to 24-hour care, but they may require some assistance. Help can come in the form of hired caregivers several hours a day, or a move to an assisted living facility.
As a friend or family member of an aging adult, recognizing the signs of decline can be challenging. Approaching the subject takes compassion and tact. It is important to maintain the integrity that comes with being as independent as possible. Look for these signs that may alert you that your loved one could benefit from additional care.
1. They Can’t Cook Safely
The inability to cook safely is a sign that something is wrong. If your loved one is leaving the stove on or isn’t able to sequence the steps necessary to make a meal, it is time for help. The first concern is safety and the second is nutrition.
Older adults need good nutrition. Weight loss can also be a sign that your loved one is not getting enough calories because they can’t cook any longer. One way to assess this is to visit and ask to have a meal together. You can observe how your family member is functioning in the kitchen.
Take a look in the cabinets and fridge to see if there is adequate food. You may want to consider asking about how food is being purchased and what some of the barriers are.
2. They Have Memory Problems
Memory problems can lead to a host of other issues that we will discuss below. Families often attribute memory problems to “old age.” It is important to remember that any kind of cognitive impairment is not a normal part of aging.
Start by getting a complete evaluation by a physician, one who preferably specializes in this area. There may be a reversible cause that can be addressed. If your loved one is diagnosed with dementia, this progressive disease will require long-term care planning and support in their home or a move to assisted living.
3. They Start Wandering
Wandering is a serious safety concern, as many aging adults have been known to leave on foot at night in the winter without proper clothing. Sadly, reports of death are not uncommon. The Alzheimer’s Association estimates that six out of ten people with dementia will wander.
Wandering doesn’t just apply to leaving the house. Often some people get lost driving to very familiar places or can’t find their way home. If your loved one has been diagnosed with dementia and tends to wander, you will need safety protocols in place, along with daily supervision to prevent this from happening.
4. They Begin Falling and Having Mobility Issues
According to the Centers for Disease Control and Prevention, one in four older adults falls each year, resulting in catastrophic injury and sometimes death. If you find out your family member has had a fall, they most likely have had several falls.
Causes of falls include weakness, vitamin deficiencies, poor vision, medications, and household clutter. Many older homes can be split level, and some may have laundry facilities in the basement. Stairs exacerbate fall risk. Problem-solving the issue can help, but if falls persist, more intervention might be necessary.
Single level living, assisted living, or significant caregiving in the home might be required. You may not be able to eliminate falls, but leaving someone in the home alone without changes and supervision could lead to a crisis.
5. Their Home Isn't in Great Condition
If you haven’t visited your loved one in a while, doing so will reveal quite a bit. You might be surprised to see that the condition of the home has deteriorated. Some things to look for are the following:
- Clutter that impedes safe mobility.
- Neglected home maintenance like electrical repairs, roof problems, plumbing issues, or landscaping issues
- Poor lighting which might increase fall risk
- Lack of accessibility modifications such as grab bars or shower chairs.
- Inability to clean house
- Exterior house issues are not being taken care of like painting, gutters, etc.
These red flags can be indicative of larger problems. In some cases, these household tasks might have become too much to manage due to poor health or cognitive problems.
6. They Mismanage Finances and Fall for Scams
It may come to your attention that your loved one is not paying bills, giving money away, or has become victim to fraud and scams. Having a financial power of attorney will help, and even turning over bill paying to a reliable source can stem the tide of mismanagement.
Scams, however, can be much harder to stop. If your family member is home alone, scammers can call, show up at the door, or otherwise find ways to part vulnerable adults from their money.
Common scams can include home repairs, lottery and sweepstakes, charity, identity theft, and Medicare fraud. As a family member, if you discover one incidence of financial fraud, there may be others.
7. They Start Having Problems With Driving
Driving is a symbol of independence and freedom. Older adults who have problems driving may be very reluctant to admit it. Some signs that driving is an issue are accidents, unexplained dents and dings, and confusion about stop signs or other traffic signals. Impaired driving is unsafe driving and can lead to serious accidents.
Giving up driving means increased isolation, difficulty accessing appointments, dependence on others, and an admission of decreased functioning. It is crucial to help your family member find reliable and safe alternative transportation for senior adults so that your loved one doesn’t become isolated.
8. They Mismanage or Forget to Take Medication
Missing or misusing medications can have significant physical and mental health consequences. Some of the contributors to medication problems are:
- Confusion over what to take and when to take it
- Refusal to take prescribed medications
- Poor eyesight leading to medication mistakes
- Difficulty picking up medicines at the pharmacy
There are all kinds of fancy automated medication systems and bubble pack delivery, but these methods don’t solve all problems. It might be necessary to ask a caregiver to assist during the day or consider assisted living where medications are dispensed.
9. They Can't Keep Up With Personal Hygiene
Deterioration of personal hygiene is a symptom of a larger problem. If an older adult hasn’t been bathing or has unclean clothes on, it might mean they have memory problems or don’t have the physical function to accomplish the task. Even for people who can bathe independently, that doesn’t mean they will. If they are a fall risk, having someone to stand by or assist can be helpful.
Personal hygiene problems can also be a symptom of depression. Depression in older adults is not normal and might be the result of declining mental or physical functioning. Loneliness is another cause of depression.
10. They Feel Isolated and Lonely
Loneliness and isolation can have significant detrimental mental and physical health outcomes. Isolation occurs in older adults for a variety of reasons. The main reason older adults become isolated is because they no longer drive.
The other reason for isolation is memory problems that make it very challenging to socialize with other people. Leaving someone alone for long periods is not healthy. People need companionship and social interaction.
11. They Miss Medical Appointments
Missing important medical appointments could be a sign of something more serious. Perhaps your loved one is afraid to drive; maybe they forget their appointments or are confused by what the doctor has to say.
As a family member, if you live at a distance, it may not be possible to attend appointments with your loved one. If that is the case, a private caregiver can step in and assume that responsibility. As more health providers are using telehealth services, having someone in the home to help coordinate telehealth can ensure that the appointment takes place.
12. They Can't Keep Up With Activities of Daily Living
When an older person has ongoing medical or other daily living needs, they can’t be alone. Things like blood pressure and blood sugar checks might be too challenging for an older person. An accident or illness leads to difficulty with dressing, bathing, ambulating, or transferring.
In these cases, either someone like a certified nursing assistant, companion, or nurse should be in the home. The other option is assisted living, or if the situation is serious enough, a nursing home.
How to Know When an Older Person Can’t Live Alone
It is normal to want to avoid the difficult decisions that come from recognizing that an older person can’t live alone any longer.
Intervening earlier rather than later when you see the signs of decline will give you the best chance to ensure your loved one’s safety. It may be hard, but the relief of knowing a loved one is safe and sound may be a boon to your relationship with them.\
- “Wandering.” The Alzheimer’s Association, www.alz.org/help-support/caregiving/stages-behaviors/wandering#:~:text=Six%20in%2010%20people%20with,services%20to%20help%20prevent%20it.
- “Important Facts About Falls.” Centers for Disease Control and Prevention, www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html
- “Elder Financial Exploitation.” National Adult Protective Services Association, www.napsa-now.org/get-informed/exploitation-resources/