Celebrating 60 Years of Service

Assessing the Older Adult Members of your Family

By: Kerry R. Peck, Esq.

Contributing Author: Sofia Vatougios, Law Clerk

Looking back on the last holiday season it’s easy to understand that the rushing around for gifts and planning holiday parties causes us to overlook signs that perhaps an older adult family member is in declining health. It is important that we be vigilant in making certain our aging family is safe happy and healthy.

            According to the AARP, an assessment is “a comprehensive review of a person’s mental, physical, environmental and financial condition.”[1] Assessing an older loved one is important in determining his or her ability to continue living safely and independently while identifying risks and ways to minimize them. A thorough assessment should combine a plan to meet the needs of your loved one while addressing potential issues. The results of such assessments may be necessary in changing your family member’s living situation, level of assistance they may need, and over health. Having a strong plan may very well reduce the amount of accidents and illnesses, expand independence and lend toward a longer life and improved quality of living for your loved one. Above all, make sure to keep your loved one in the loop about their options once an assessment has been made and try to involve them in the process as much as possible.

            One of the ways we can keep an eye on our older family members is looking out for and preventing potential falls. More than one in three people age 64 years or older fall each year, and the risk of falling only rises with age. Making sure your loved ones are receiving regular checkups for eyesight, hearing, and reflexes is the first step you can take in preventing falls. Diabetes, heart disease, and problems with thyroid, nerves, feet, or blood vessels can also induce dizziness or sleepiness, increasing the risk of falling. Additionally, certain medications can bring about sensations of confusion or dizziness. Keeping tabs on your loved ones’ conditions and medications is a key step in preventing them from injury. Beware of wet or icy surfaces, as they can be a slipping hazard. Make sure to spread sand or salt on icy areas by your front or back door and wear appropriate footwear when walking outside. As always, if your loved one is need of an assistive device, make sure that they are using it whenever possible. Appropriate use of canes and walkers can prevent falls. It is crucial to make sure these devices are the right size and operate smoothly.

            Frequent cognitive screening is also important in keeping tabs on your loved ones’ mental health. Many individuals who are developing or have dementia do not receive a diagnosis. In fact, more than half of patients with dementia had not received a clinical cognitive evaluation by a physician, according to a 2014 study.[2] While your family member’s primary physician may perform routine cognitive tests during checkups, it is beneficial to have extensive assessments performed to look for signs we may otherwise not notice. First and foremost, it is crucial to keep an eye out for potential red flags. Symptoms such as changes in memory or thinking are indicators that your family member should be screened for cognitive impairment; this is especially true if they are also over the age of 80. Other risk factors that indicate the need for dementia screening include low education, history of type 2 diabetes, stroke, depression, and trouble managing financials or medications. Additionally, early screening has many benefits. Even if the screening is negative, you will enjoy peace of mind knowing things are well for the moment. In the event that the screening is positive and further evaluation is warranted, you can take steps together with the physician to identify the cause and potentially treat the underlying condition more quickly and effectively.

 

While it may seem like assessing cognitive impairment involves your family member and their physician, as a family member you also play an important role. The most successful approach to assessing cognitive ability is a combination of cognitive testing and information from someone, such as a spouse or caregiver, who has frequent contact with your family member. If you are the primary caretaker for your loved one, speaking privately with the physician allows for a more candid discussion. You may also choose to be present during their cognitive assessment interview and contribute additional information once they have spoken. If you are curious and want to get involved in the process of evaluating your loved one, especially during the hustle of the holiday season, resources such as the Dementia Screening Indicator[1] and Geriatric Depression Scale[2] may prove to be very helpful to you.

In addition to cognitive issues that may arise, there are other signs to look out for as well. While it may seem obvious, making sure your loved one is eating regularly is not only important to their health, but can also be indicative of something more serious. Although appetite is known to change with age, there are a number of factors that can also cause loss of appetite in older individuals. The loss of appetite may be due to a lack of energy to cook, lack of interest in food due to depression or loneliness, lack of appetite due to health conditions, or a side effect of medication. Certain health changes can also affect appetite, such as lower metabolic rate, lessened physical activity, dental problems, gastrointestinal changes, or even changes to sense of smell and taste. More serious health issues that may occur in conjunction with decreased appetite are Alzheimer’s or Parkinson’s disease.  If you are concerned about your loved one’s lack of appetite, notice unexplained changes to their dietary health, weight, or general malaise, and want to rule out any underlying health problems, consult a physician.

            Refusing or forgetting to take medicine can also be a red flag when assessing your loved ones. People neglect to take their medicine properly for a number of reasons. Most commonly older individuals just simply forget to do so. When considering the fact that the average senior takes about seven different medications (OTC and prescribed), it is not surprising that they may lose track and forget to take them. If this is the case, keep a log of your loved one’s medicinal intake and make sure they are taken at the appropriate time and frequency. If you are unable to do so, do not hesitate to ask another family member, friend, or caregiver to do so. Tools such as pill organizers, medication management devices, event reminder services (like cell phone alarms), medication checklists, and consolidating medications into fewer pills may also be useful in combatting your loved one’s forgetfulness. A more serious problem arises when your loved one refuses to take their medication. If this is the case for your loved one, you may want to consider hiring a full-time caregiver or placing them in an assisted living facility.

            Your loved one’s health should always remain a priority. Plan in advance to give you and your family peace of mind throughout the year by looking out for symptoms and red flags of declining health. Set a goal for your family members health and happiness.    

[1] Barnes, et al. Dementia Screening Indicator. http://ars.els-cdn.com/content/image/1-s2.0-S1552526013029403-gr2.jpg.

[2] Stanford University. Geriatric Depression Scale. http://web.stanford.edu/~yesavage/GDS.html.

[1] https://www.aarp.org/caregiving/basics/info-2017/assessment.html

[2] Kotagal V, Langa KM, Plassman BL, et al. Factors associated with cognitive evaluations in the United States. Neurology. 2014 Nov 26. pii: 10.1212/WNL.0000000000001096. [Epub ahead of print] www.ncbi.nlm.nih.gov/pubmed/25428689

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