How to know when an aging parent needs help at home

Like so many seniors who’ve lived independently for decades, Kathleen Ward was determined to remain in her home.

An active senior who lived just outside Pittsburgh, she still got her hair done and did her own laundry and grocery shopping after her husband died in 2013. “Her big thing was, ‘I’m fine, I’m strong,’ ” recalls daughter Margaret Robbibaro.

Yet over the next few months, Robbibaro started to notice things weren’t quite right with her 84-year-old mother.

She was sleeping more than usual and, at times, she just seemed to drift through her days. Bills were also occasionally being returned because Ward — a homemaker and mother of six who had always been meticulous about balancing her checkbook — had already paid them.

The biggest red flag came in 2014, when Ward fell and broke her wrist while talking on the phone, sending her to the hospital and to rehab.

“She hadn’t been eating,” Robbibaro said. It seemed obvious to her daughter that her mother’s living situation had to change.

Knowing when an aging loved one needs additional support can be difficult for family members. Signs of lapses in judgment or attention are so variable and potentially embarrassing, and seniors — like most people — cherish their independence so much that they are often reluctant to admit they need help.

‘Used to being in charge’

Not only is it hard to relinquish the role of “parent,” but it’s scary when people get older and realize things happen to them physically and emotionally that are out of their control, says Richard Morycz, associate professor of psychiatry, medicine and social work at the University of Pittsburgh. “It can make them become even more stubborn or rigid because they’re used to being in charge.”

It can be even more complicated if you’re caring for an aging parent or relative from a distance, and can’t observe behavioral or functional changes like poor hygiene or difficulty walking, which can be signs of physical and mental decline.

In Robbibaro’s case, there was no doubt. Given her mother’s frail state, she says, she felt certain she would keep falling. Robbibaro also said she knew her mother would not thrive in a nursing home. So after talking with her siblings, she and her husband, Bruce, took Ward into their nearby home and, with the siblings’ assistance, took care of her until her death last year at age 93.

“Once she was with us, there were eyes on her and people around, and she really improved,” Robbibaro says.

Common indicators

Experts say there are some common signs that indicate when it could be time to step in.

“I always bring it back to the basics of daily living, such as bathing, eating and walking, “ says Lyn Weinberg, a geriatrician and director of the division of geriatrics for the AHN Primary Care Institute. “When people are having decline in any one of those areas, you know they are at risk.”

Changes in the home environment are often a first clue your senior may need assistance, says Morycz. Is someone who has always been able to cook, do laundry and pay their bills suddenly making late payments and not changing their clothes? Is a house that used to be pristine now messy, with spoiled food on the counter?

Neglecting household tasks is a familiar sign of decline, so it’s important to observe even small changes. And don’t just take your parents’ word that everything is fine, Morycz says. Pay attention to how they seem day-to-day.

If you spot unusual irritability, note it.

“If the thought is, ‘that doesn’t sound like Mom or Dad,’ that could be a warning sign to seek help,” he says.

One of the first things that made Patricia Blessitt of Braddock, Pennsylvania, realize her mother, Jacqueline, now 95, was having problems at home was when she began hoarding toilet paper. She also started accusing a family member of taking money and refused to go on a family cruise because she had an irrational fear of being arrested.

“It was terrible,” Blessitt recalls. “I cried day and night.” Eventually diagnosed with dementia, her mother ended up moving in with her in 2008 so she could be safely cared for.

Sadness vs. depression

While sadness is natural with the loss of friends and spouses that most elderly people experience, depression is something else, and signs of it can include changes in sleep patterns and a loss of interest in activities or hobbies. And you want to keep an eye out for forgetfulness.

But just because you’re old and forget something doesn’t mean you’re on the path to dementia, says Sara Murphy, vice president of programs and services at the Alzheimer’s Association Greater Pittsburgh Chapter. But if memory loss is impacting someone’s life on a consistent basis — say, forgetting where their bank is or missing doctors’ appointments — that’s concerning.

Keep in mind, though, that issues like dehydration, medication interactions, UTIs and nutrition deficiencies can cause memory lapses, confusion or poor judgment, mirroring dementia. “So it’s really important to get a cognitive screening” of your loved one to distinguish between what’s normal and what’s not.