10 Warning Signs for Caregivers That Your Loved One May Need More Support
By Amy Goyer, who is a paid spokesperson for HEALTHY ESSENTIALS®
As a caregiver with a busy life outside of those duties, it can be difficult to monitor changes in your loved one’s abilities and needs. Knowing what to look for to spot changing needs will help you care for them; if you observe changes in any of the areas listed below, your loved one may be experiencing a temporary challenge, or they may need a more permanent transition to more ongoing care and support.
Look for these potential telltale signs that their needs are changing:
- Safety: Driving issues (increased traffic violations or accidents, dents and dings in the car, misjudging distances or turns, driving too fast or too slow), increased falls or fall hazards in and around the home (loose throw rugs, stairs without railings or poor lighting), inability to carry groceries into the house, inability to keep outdoor walkways clear of snow and ice or fallen leaves, poor judgment about whom to allow into his or her home, giving untrustworthy people keys to the car or home, inability or forgetting to lock doors or windows or inability to call for help.
- Finances: Unopened mail, unpaid bills or bills paid twice, bounced checks or signs your loved one is being scammed, an unkempt filing system or inability to find important documents, trouble following budget, unusual spending and saving or different investing patterns.
- Physical and Mental Health: Difficulty breathing, difficulty swallowing or chewing, bad breath (halitosis can be a sign of a deeper health concern), poor dental care, hearing impairment, decreased sense of smell, vision changes, increase in unmanaged pain, skin irritations, foot problems, poor circulation, numbness, change in sleep patterns, changes in toileting, gastrointestinal problems, anxiety, complicated grief, depression, sadness, anxiety, anger or manic behaviors.
- Medication: Repeatedly missing doses, not taking medications as prescribed, difficulty ordering or picking up prescriptions, borrowing or lending medications, self-prescribing multiple over-the-counter medications, drug interactions or side effects.
- Cognition: Changes in communication skills and patterns (such as difficulty expressing their thoughts, forgetting words, or slurring their speech), memory changes, increased confusion, inability to handle complex financial or business affairs, appearing lethargic or sleepy, vulnerability or changes in judgment.
- Nutrition: Drastic changes in eating habits, unusual weight loss or weight gain, uncontrolled blood sugar levels, inability to plan or prepare meals and clean dishes, moldy leftovers or expired food in the refrigerator or cupboard, inability to go grocery shopping or order food.
- Self-Care: Strong body odor, difficulty bathing, dirty and unkempt hair, old or stained dirty clothes or changes in attention to personal details (such as haircuts, nail care, shaving, wearing make-up).
- Mobility: Difficulty moving (walking, standing, sitting, rolling over in bed, bending over, stretching, turning, going up or down stairs), changes in strength, onset of or increased/unmanaged pain, dizziness, difficulty getting up and down or in and out of bed, chairs, toilet, shower/bath or car, need for mobility aids (walker, cane, wheelchair, chairlift) or not using them appropriately.
- Housekeeping: Falling behind on home repairs and cleaning, peeling paint, overgrown garden, consistently unmowed grass, light bulbs that need replacing, overflowing gutters, need for snow removal or trouble operating appliances.
- Socialization: Increased expression of loneliness, quitting clubs or group activities and hobbies, change in participation in faith-based and community activities, staying away from family gatherings, changes in patterns of contacting family and friends (more or less often), changes in visiting patterns (appearing desperate for visitors or refusing visitors) or drastic changes in his or her peer group and friends (deaths, friends or family moving away).
If you notice any of these red flags, the first step it to discuss them with your loved one. Share your observations, but don’t jump to conclusions, and try to be objective. It may take some detective work – there can be numerous reasons your loved one is experiencing difficulties and often many things are interrelated. And they may not always be forthcoming. Your goal is to help your loved one uncover and address the root causes, so he or she can maintain independence and quality of life as much as possible.
Safety issues are most urgent, and may need to be addressed immediately, but usually these things signal gradual changes and require increases in support that can happen over time.
Dealing with one problem can take care of several other issues too. For example, a medication change may address pain management and at the same time help mobility impairments and therefore increase safety, improve socialization (because he or she can get out more), and alleviate cognition problems (which can be from medication side effects). Some problems may not have obvious causes, such as gastrointestinal problems that are caused by eating old or moldy food, which is the result of decreased vision and sense of smell.
For help addressing concerns, contact your area agency on aging, consult with your loved one’s doctors, or ask a social worker, physical or occupational therapist or aging life care specialist for assistance.
Amy Goyer is a caregiving expert with over 35 years of experience advocating for and caring for older adults. She has also been a family caregiver her entire adult life and is currently caregiving for her 93-year-old father who has Alzheimer's and lives with her. She is a paid spokesperson for HEALTHY ESSENTIALS®.