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Red Flags for Older Adult Safety and Independence – Keystone Elder Law – Mechanicsburg, PA

Do you have elderly loved ones who are still living independently in their own home? After spending time with them over the holidays, are you questioning their ability to do so safely?  While some clues of changes in a senior’s level of functioning may be readily apparent, others may be more subtle.  Following are some clues to look for which might indicate that your loved one may require additional help at home, or would benefit from a move to a care facility.

Physical signs, such as changes in grooming habits, are often the ones that are the most obvious to families. One may notice that the individual is not combing their hair, is wearing wrinkled or stained clothing, or has developed body odor.  Changes in strength, balance, or endurance may be evidenced by difficulty getting out of a chair, holding on to walls or furniture when walking around a room, or fatigue with physical tasks such as laundry and shopping.  An event such as a fall or accident may be an indicator of decreased physical functioning, or may trigger the beginning of a decline in overall functioning.   Weight gain or loss may be a sign of altered eating patterns or poor food choices. When individuals have a slow recovery after an illness or a chronic condition that is progressing, they are at risk for changes in their ability to remain independent and should be observed for some of these red flags.

Socially, some seniors are at risk of becoming more isolated, which can affect their ability to remain independent.  Sometimes, social isolation is related to the physical factors mentioned above. An investigation why daily routines have changed; why the person may be reluctant to leave the house for days at a time; why they are not participating in favorite hobbies or interests; or why there is limited contact with previous friends, neighbors, and acquaintances brings the physical change to light.  Mental and emotional factors may also influence these changes in behavior.  If the senior has recently lost a spouse or friend or has given up driving, the grief process may significantly affect functioning.  Seniors who are beginning to develop dementia may change their behavior to try to hide their symptoms, or may no longer understand how to perform activities they used to enjoy.

There are multiple clues to difficulty managing finances.  When visiting, look for unopened mail, piles of mail scattered around the house, or mail located in odd places.  More in-depth observation may reveal unusual letters from financial institutions or insurance agencies, mail from large numbers of charities, bounced checks or checks routinely written out of order, unpaid bills, or an inability to balance the checkbook.  Although many seniors may initially be reluctant to share the details of their finances, the presence of even one of these signs warrants investigation in order to prevent potentially devastating results.

The kitchen is a prime area to check for household red flags to independence.  Is there an adequate supply of food in the cupboard/refrigerator and is it fresh?  Are food choices appropriate? Is there an overabundance of a certain item, demonstrating the individual can’t remember what is already in the cupboard when out shopping?  Are there signs that the person is still cooking, such as dirty or recently washed dishes?  Are there any danger signs from cooking, including burns on potholders, pots and pans that have scorched bottoms or are missing (they may have been thrown away due to damage), and soot or grime on the walls from smoke?  Household red flags may be noticeable in other areas of the home as well.  Even if someone is able to keep a living room relatively clean, the bedroom or bathroom (especially a master bath) may be a different story.  Routine spills that aren’t cleaned up may be a sign of dementia.  Increasing amounts of clutter should be a cause for concern, as well as neglecting routine home maintenance tasks or the care of plants or animals.

One final aspect of independence that should be considered is the ability to drive.  Our culture places a strong emphasis on driving as a prerequisite to independence, and as a result, many seniors probably continue to drive longer than they should.  Some indications that driving may need to be monitored include:  new damage to the car such as scratches or dents, routinely forgetting to use a seat belt, and unsafe practices such as tailgating or consistently driving below the speed limit.  Slow reaction time or changes in driving habits (such as not listening to the radio while driving and avoiding night or highway driving) are additional signs that warrant observation and that transportation support may be beneficial.

These red flags are not an exhaustive list, and a key factor to be aware of is the presence of a change in behavior or habits.  Some seniors may recognize their limitations and try to hide any evidence of change, while others have a lack of awareness of the health and safety risks they are facing, affecting both themselves and others.  Whether an elderly person you know is a family member, a neighbor, or a church acquaintance, your knowledge of their routines, likes/dislikes, and patterns of behavior can help connect the dots when your gut tells you “something isn’t right.”

Portions of this column were adapted from an article by Paula Spencer Scott titled 11 Signs It Might Be Time for Personal Care,

Karen Kaslow, RN