Tuesday, October 23, 2007

How Do I Know if Mom Really Needs Help?

In some cases, the sudden start of a severe illness will make it clear that help is needed. In other cases, your loved one may ask for help. When you don't live with the person you are concerned about, you have to think carefully about possible signs that support or help is needed. You might want to use any time that you are together to take stock.

Some questions to answer during your visit include:

• Are the stairs manageable or is a ramp needed?

• Are there any tripping hazards at exterior entrances or inside the house (throw rugs, for instance)?

• If a walker or wheelchair is needed, can the house be modified?

• Is there food in the fridge? Are there staple foods inthe cupboards?

• Are bills being paid? Is mail piling up?

• Is the house clean?

• If your loved one is still driving, can you assess their road skills?

• How is their health? Are they taking several medications? If so, are they able to manage their medications?

• What about mood: Does he or she seem depressed or anxious?

If you do not see your loved one often, changes in his or her health may seem dramatic. In contrast, someone who is with him or her everyday might not notice such changes, or realize that more help, medical treatment, or supervision is needed. Sometimes a geriatric care manager or other professional is the first to notice changes. For families dealing with Alzheimer’s disease and other dementias, it can be easier to “cover” for the patient — doing things for him or her, filling in information in conversations, and so on — than to acknowledge what is happening.

A few good conversation starters are:

If you thought there might be a change in Aunt Joan’s condition, whose opinion would you seek?

"I didn’t notice Dad repeating himself so much the last time I was here. Do you remember when it started?" Some changes may not be what you think. Occasional forgetfulness does not necessarily indicate Alzheimer’s disease. Before you raise the issue of what needs to be done, talk to your parent and other involved family members about your concerns.

Try not to sound critical when you raise the subject. Instead, mention your particular worry, for example, “Mom, it looks like you don’t have much food in the house — are you having trouble getting to the store?” and explain why you are concerned. Listen to what she says about the situation, and whether he or she feels there are problems.

Discuss what you think needs to be done: “Do we need to get a second opinion about the diagnosis? Can you follow the medication schedule? Would you like some help with housework?” Try to follow up your suggestions with practical help, and give specific
examples of what you can do. For example, you might arrange to have a personal or home health aide come in once a week. You might schedule doctors’ appointments
or arrange for transportation.

In some cases you may have to be forceful, especially if you feel that the situation is unhealthy or unsafe. Do not leave a frail adult at risk. If you have to act against the wishes of your loved one, be direct and explain what you are going to do. Discuss your plan and say why you are taking action.