How to figure out if older family members need help

If you see your older parents, relatives, and friends frequently, you may not notice changes in their behavior and wellbeing that could mean they’re developing issues with their cognitive or physical health and may need extra support to remain safe and healthy. This checklist can help you take stock so you can develop a plan to provide the help your older family members need.

1. Can they handle essential everyday activities? Next time you visit your older family members, watch how they move around. Do they seem unsteady on their feet or have trouble getting up from a chair or sitting down? If they have a cane or walker, are they using it as recommended? Check the safety and condition of the home. Is there nutritious food in the refrigerator? Are the trashcans emptied and the house clean? Is the lawn mowed or the snow shoveled? Are there broken appliances? Are there new dents or scrapes on the car that could indicate unsafe driving?
2. Are there changes in their appearance? Consider their appearance and grooming. Are their clothes clean and do they seem to be keeping up with personal hygiene? Have they lost a noticeable amount of weight? Do they have unexplained bruises or scrapes that could have been caused by a fall?
3. Are they taking their medications as directed? If older family members have been prescribed medications for a chronic condition or other health problem, it’s important that they take the correct dose as directed. Check to make sure they’re getting needed refills or that they haven’t run out of medication too soon, which could mean they’re taking more than they should. You can offer to pick up their prescriptions or help them set up mail order delivery of their medications and set up a daily pill organizer to help simplify medication management. If they take several medications, consider setting up a medication review with their doctor. This is a chance to check for potential interactions, talk about side effects, and deprescribe unneeded medications.
4. Do they show signs of depression or anxiety? Especially during the ongoing pandemic, many older people have become more isolated and less social, which has increased the number of people living with mental health issues. Depression in older people is often misdiagnosed as dementia, because depression shares some symptoms with the early stages of dementia, such as forgetfulness, sleep problems, and trouble concentrating. If something feels off in terms of their mood or energy level, schedule an appointment with their primary care physician or a geriatrician for an assessment.
5. Has their quality of life declined? Beyond the standard measures of physical and mental wellbeing, think about your family members’ quality of life. Are they taking part in activities they enjoy like playing cards with friends, gardening, or reading? Are they living with chronic pain or discomfort that’s limiting their ability to enjoy life? Are medical or mental health issues making it difficult for them to do the things they enjoy?

Once you have a sense of what’s going on in your older family members’ life, talk with them respectfully and non-judgmentally about any issues you’ve spotted. Discuss why you’re concerned and offer a few possible solutions or types of support. For example, you could offer to help with grocery shopping or yard work or arrange for a cleaning service. If they’re having trouble with the activities of daily living, talk with them about getting a home health aide to lend a hand. Offer to come with them to doctor’s appointments or work with a health advisor who can attend appointments, take notes, and help arrange follow-up care and specialist appointments.

You’ll most likely need to make this an ongoing conversation. Some family members may reject help at first, but as their needs or attitudes change, be willing to accept it later.