Home for the Holidays- Making the most of visits with aging loved ones

Holidays are occasions that many of us spend with family, whether we live down the block or across the country.  For those with aging loved ones, these visits are an important time to take stock amidst the hustle and bustle, and to make plans.  Notable changes in an aging person’s appearance, behavior, or environment can be warning signs that his or her health, mentation, and function are changing.  If you notice changes, dig in while you’re there together to further assess the situation and determine if intervention is needed.

Start by making observations

Person centered-

*Has your loved one’s hygiene changed? 

*Is he or she wearing clothing that is dirty, falling apart or inappropriate for the weather? 

*Has there been a significant weight change? 

*Has his or her gait changed?  Are they “couch surfing” or using furniture items for support while walking through the home? 

*Any bruises or cuts that you can see?

* Are they using mobility or other adaptive equipment properly?

 

Behavior-

*Has mom or dad stopped going out for social engagements?  Discontinued activities that were important to them? 

*Do they have any new friends or organizations who they have a lot of contact with?  Is anyone or any organization asking for repeated or large donations or loans? 

*Do they seem forgetful or more repetitious in conversation?  

*Does he or she seem more withdrawn or sad?

 

Environment-

*Looking at their home environment, are there areas of disrepair?  Obstructed walk ways?  Burned out lightbulbs? 

*Any changes in cleanliness of the home, especially in the kitchen and bathroom?  Are there items piling up on counters, table tops, or spare rooms?  Unopened mail? 

*Check the fridge to see if there are expired or spoiled food items. 

*Does their car have scratches or other areas of damage?

 

Start a conversation

If any of these questions lead to concerning answers, it is vital to start a conversation with your loved one about your observations.  Try to remain open and curious, not making assumptions or judgments since issues great and small can lead to similar presentations. 

As an example, Dad may be wearing light summer clothing even though it seems too cold.  This may be because his cognition is declining and he is not oriented to what month or season it is.  Alternately, you may learn that most of his warmer sweaters have buttons and his advancing arthritis makes it difficult for him to manage these closures.  Perhaps his winter clothing is stored in the attic or a high shelf that is difficult to access because of strength or balance issues.  Or he may relay that he’s been very busy with his men’s group and just hasn’t gotten around to switching out his wardrobe.

It is important to understand whether your loved one is aware of the issues you’ve noticed, and if he or she sees them as a problem or not.   What has she thought about or attempted in order to address the situation?  Have there been barriers to resolving the problem?  It can be difficult for someone with a lifetime of independence to admit that he or she needs assistance.  Many of these red flag issues are highly personal in nature so depending on the circumstances and the personality of the older person, these topics may need to be approached gently and with compassion. 

Preferences and Health Care Wishes

Also consider talking about what is important to your loved one.  What gives them a good quality of life?  And a vitally important question: What are their health care wishes?  People fall all over the spectrum when it comes to thinking about, talking about, and making legal documents specifying their health care wishes.  Wherever your loved one falls on this spectrum, it is important to check-in regularly or in some cases, for the first time about their thoughts and preferences about medical care, where they want to live, and what they want their lives to look like.  If dad has already prepared legal documents designating health care decision making agents and even some advance directives about treatment options, does he still feel the same?  Do the appropriate people and organizations have copies of these documents?  If this conversation has never been broached, test the waters.  See if this is a topic your loved one avoids or welcomes. 

The observations made and conversations that take place during holiday visits are most often starting points rather than final conclusions.  Most of these topics are on-going and evolving as your loved one continues to age.  There are resources available in all states to help navigate elder support services and having as clear a picture as possible about what your loved one is struggling with will help target these resources.  A good starting point is the county based Area Agency on Aging offices or investigate whether there is an Aging Life Care Professional in the area who can offer assistance.  Most importantly, enjoy your time together celebrating and giving thanks!

By Heather Imhoff MSW, LMSW

Back to Basics: What is Aging Life Care and What Can a Care Manager do for You?

Across the country, our population is aging.  The number of people who are 65 years old or older is increasing rapidly.  While many people are living more actively and healthier into their older years, the majority are coping with chronic health issues which can affect a person's ability to complete daily living activities.  This may be the catalyst for seeking assistance from natural supports, such as family, or professional services.  However, many older adults are justifiably perplexed by the maze of medical and other service providers, how to maximize their insurance benefits, where to live, and how to preserve dignity and quality of life.  

In troubling times when individuals, couples, or families are unclear about what they are dealing with, unsure about their options, or feeling overwhelmed by their situation, involving an Aging Life Care Professional or Care Manager is a great way to get additional support and expert advice.  Aging Life Care, also known as geriatric care management, is a holistic, client-centered approach to caring for older adults or others facing ongoing health challenges.  The expertise of Aging Life Care Professionals can be summarized into 8 knowledge areas: Health and Disability, Financial, Housing, Family, Social Resources, Advocacy, Legal, and Crisis Intervention. 

When services are engaged, the Care Manager begins the process with a comprehensive initial assessment, typically completed in the home, to understand the needs and preferences of each client.  What is working well and what isn’t?  What problems need to be resolved?  With this knowledge, the Care Manager will discuss possible solutions and information about options.  He or she will provide the support needed for the individual or family to make the right decisions for their situation. 

Depending on the needs of the client, this could be a one-time meeting or could lead to a long-term professional relationship.  Care Managers can provide on-going care management, monitor outcomes, needs assessment, recommendations, guidance, and advocacy, as requested.  Additionally, Care Managers can serve as the eyes and ears to assist out of town family members coordinate care for their loved ones and can serve as peace of mind for individuals with few natural supports who want someone to call in times of need. 

Many Care Managers are a part of the Aging Life Care Association.  To find an Aging Life Care Professional in your area, visit their website www.aginglifecare.org.

 

Heather Imhoff, MSW, LMSW, CMC is a certified Care Manager and has been a licensed social worker working older adults and people with physical disabilities for 11 years.  She has a special interest in behavioral health and enhancing quality of life.  She co-owns and operates Crossroads Aging Care Professionals, LLC in Santa Fe, New Mexico.