Guest blog By Kathryn Arbour
Families often gather and reconnect during the holidays. For long-distance caregivers the time to be with aging parents or relatives can also be used as time to assess how things are really going. The National PACE (Program of All-inclusive Care for the Elderly) Association, an organization committed to helping elders age at home and to reducing nursing home placement for the frail elderly, conducted a free national teleconference on December 16, 2009 to offer tips and insights on how to use time with elders this holiday season noting physical, emotional and behavioral conditions that may indicate a change in health status.
Cheryl Phillips, M.D., Chief Medical Officer of On Lok Lifeways and President of the Geriatrics Society, outlined five areas to observe when visiting elders this season. While phone calls and other long-distance means help caregivers who do not live near their loved ones stay in touch, there is nothing quite like sitting in the same room to understand the status of those loved ones.
Make note of the overall appearance of the individual and home. Changes are more noticeable after a period of separation. Dr. Phillips suggests looking for weight loss, appropriate dress and grooming, and clues for how the home is being kept.
Observe signs of changes in physical health. Assessing the physical status of elders can be challenging because there are often clusters of conditions, such as high blood pressure or diabetes, that may not have any outwardly visible physical effects. Noticing any new visual or hearing problems, walking or balance issues, or incontinence issues, including problems with toileting will offer clues on what may be some bigger health issues. Older seniors especially often speak about their conditions as complaints. Listening for themes about chronic pain can offer indications of what conditions may have changed since the last visit.
Assess mental state. Dr. Phillips reminds caregivers to look for signs of disorientation or forgetfulness, or an increase in these symptoms if elders demonstrated some of them previously. Are they getting out or have they become more isolated? Are there chronic problems with sleeping? Too much or too little? Depression among elders is commonplace and is often not diagnosed. Other signs of depression are a decreased appetite.
Paying attention to nutrition. Visiting with aging relatives around the holidays gives the opportunity to share meals. How are they eating? What is in the refrigerator? Can they get to a grocery store regularly? Who is preparing the meals? If they eat out a lot, where are they eating? Dr. Phillips shared a story about one of her patients who finally confessed that he goes to Taco Bell three times a day because it is close and cheap.
Ask about social activity. Studies are clear that health is enhanced with social interaction. Try to get a feel for who comes into your parents’ or relatives’ lives with regularity. Do they get out? Have people in? Do they participate in activities, hobbies, events? Perhaps they belong to a church or community center. Can you assess when they went last? What about driving? This activity is a double-edged sword for elders. They should not drive if there are safety issues. Once they no longer drive, how do they stay connected to outside activities?
Using holidays not only as a time to reconnect with family, but also as an opportunity to see for yourself what is going on with your aging relatives can bring peace of mind and action, if needed.
Consult these resources for more ideas:
Patients and Families , a virtual tool for staying connected with family members, neighbors and health care providers while caring for a loved one.
Toghers, a virtual caregiving resource with practical tools and tips for caregiving.
Doctor Marion , a site dedicated to elder care and caregiving.
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Kathryn Arbour, founder andPresident of Capabilities and Capabilities.com with products and services for elders, people with disabilities, their families and caregivers, writes about caregiving, aging, mobility and independence in several online venues. See more at Examiner.com as the Disability Examiner , Mobility Products Examiner , and Senior Care Examiner
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