During the holidays, be observant to the challenges your loved one might be facing

The holidays are here. For those of us whose older loved one lives independently, this will be a chance to interact with and spend more time with them. It’s an opportunity to get a peek into their world; a chance to see for ourselves how they are coping with the onset of aging.



Everyone experiences changes to their physical and mental abilities as they age. These changes can come on gradually or happen quickly. When we notice a change in our loved one’s condition and ask about it, they often downplay and minimize any new symptoms.



Look for a decline in their ability to function independently — what are you seeing, smelling and hearing? Have things changed since last year? If your loved one’s daily needs are not being met, and safety issues are a concern, it may be time to act. It can be unsettling to see the challenges our loved ones are now facing. But not addressing the changes you see is setting your loved one up for trouble.



Common challenges in aging



1. Impaired balance and mobility

Falls are generally caused by impaired balance and/or mobility and are the leading cause of fatal and nonfatal injuries for older Americans. The majority (60%) of falls happen in the home. Falls are a threat to an older adult’s independence and quality of life. To make sure your loved one does not become a statistic, encourage them to talk with their doctor. Help assess their living space for any hazards.  



The most common causes of poor balance/mobility include:

• Lower body weakness.
• Vitamin D deficiency.
• Use of certain medicines, such as tranquilizers, sedatives or antidepressants. Even some over-the-counter medicines can affect balance and steadiness.
• Vision problems.
• Foot pain or poor footwear.
• Home hazards or dangers such as broken or uneven steps, unsafe indoor or outdoor stairs (especially without railings), poor/inadequate lighting and throw rugs, or clutter that can be tripped over.

*Centers for Disease Control: Older Adult Fall Prevention, Sept. 6, 2022



The CDC has a program called STEADI (Stopping Elderly Accidents, Deaths and Injuries) to help you and your loved one learn more about preventing falls in the home.



You can also reach out to Baillie McCane BSN, RN, UK Injury Prevention/Outreach Coordinator - baillie.mathis@uky.edu.



2. Depression



Depression is not a normal part of aging, although it is common among older adults.



It can be difficult to spot, as older adults often display symptoms of depression differently than younger people. In older adults, sadness is not the main symptom; it is more a feeling of numbness or a lack of interest.



What are the other symptoms of depression?

• Deceased energy levels
• Irritability or restlessness
• Withdrawal from or making excuses not to participate or attend family gatherings or social events
• Loss of interest in once-enjoyable activities
• Difficulty concentrating, remembering or making decisions
• Difficulty sleeping, or sleeping more than usual
• Eating more or less than usual
• Persistent sad, anxious or empty mood
• Feelings of hopelessness, guilt, worthlessness or helplessness

It can sometimes be difficult to tell whether your loved one has the onset of dementia or is struggling with depression. While depression and dementia share certain traits and symptoms, there are some important differences:

• Decline in mental functioning tends to be more rapid with depression.
• Those with depression are usually not disoriented.
• People with depression have difficulty concentrating, whereas those affected by Alzheimer’s have problems with short-term memory.
• Writing, speaking and motor skills are not impaired in depression.
• Those with depression tend to notice their inability with memory problems, but those with dementia usually do not notice memory changes.

*Harvard Health Publishing: Is it Depression or Dementia, April 5, 2022



Talk with your loved one and ask them how they are feeling. Sometimes the simple act of just listening and allowing someone to talk can help. In addition, encourage them to speak with their doctor or a therapist.



3. Home safety



According to AARP, three quarters of Americans age 50 and older want to continue living in their own homes for as long as possible. A few basic home preventive measures can go a long way toward improving their safety and comfort.

• Fire hazards: Are the smoke detectors and carbon monoxide detectors tested regularly? Batteries need to be changed once a year and the alarm itself needs to be replaced every 10 years, according to the U.S. Fire Administration.
• Check the house water temperature. The CDC recommends water heaters should be at or below 120 degrees to prevent a scald or burn.
• A person in their 60s requires three times more light than a person in their 20s. Good lighting adds safety to all areas of the house. A well-lit hallway or stairway is easier to navigate, rooms with balanced lighting make hazards easier to see, and bathrooms and kitchens are safer.
• Bathtubs, showers and bathroom floors should have nonslip or textured surfaces that keep floors from getting slippery when wet. Add grab bars to the walls of the tub and shower and next to the toilet to provide a secure handhold. A shower seat can help with getting in or out of the tub or maintaining balance while in the shower. Replacing the toilet or toilet seat with a taller model can help your loved one rise easier.  
• Aside from good lighting, staircases should be clear of clutter with well-tacked-down carpeting and a sturdy railing. Wooden stairs should have attached non-slip strips.
• Make sure door and window locks are secure and functional.

Talk with your loved one and address any safety concerns you may have. Contact a local contactor/locksmith to fix the problem areas.     



4. Personal safety



Activities of daily living (ADLs) are common tasks we do every day to take care of ourselves and our home. Taking a shower, dressing for the weather, preparing a meal and doing our laundry are examples of the ADLs required to maintain an independent life. They also provide a way to measure how well we are able to live alone.

• Is your typically clean and laundered loved one looking disheveled and untidy? A noticeable decline in your loved one’s personal hygiene is a sure warning sign that they are struggling physically and/or mentally to meet their own needs.
• Check the refrigerator and cabinets to see how they are eating. Are they able to clean up after themselves? Is the food prepared and stored properly? Check the expiration dates, seals on food containers and food quality. Are there items on the pantry shelves? If a winter storm hit, would they be prepared?
• Is there a system or routine for your loved one to take and refill their medications? Do they use a pill organizer, a pill dispenser, a medication timer, or are the medications unorganized and scattered about?  How do they get their medicines refilled?
• Driving is a complex endeavor. It requires focus, coordination and concentration. Is your loved one up to the task? When was the last time you rode with them? Here are seven signs that it might be time to give up the keys:
  •  Unexplained dents and scratches to the car
  •  Frequent close calls
  •  Increased traffic tickets or warnings
  • Ignoring or missing stop signs and traffic lights
  • Weaving between or straddling lanes
  • Difficulty keeping appropriate or constant speed
  • Unable to navigate frequently used routes and getting lost

Talk with your loved one about the things you are noticing. A decline in functional ability does not necessarily mean a move to a senior living community or skilled care facility, but it might indicate the need for extra support and help from family, friends or paid caregivers to ensure they are safe in their home.



Use this time together to gauge your loved one’s health and functional abilities. There is no need to bring up your concerns over the dinner table, but note what changes you see, and set aside a time to talk about it with your loved one as soon as possible after the visit.



Have a healthy and happy holiday,

Terri