Yesterday, as I was leaving my father after our weekly visit, an elderly woman stopped me in the hall outside his assisted living apartment. “Can I go with you?” she asked.

“Sure,” I said thinking she wanted to take the elevator downstairs with me.

“Where are you going?” she asked.

“I’m going to a basketball game,” I said. “I don’t think you want to go with me.”

“But I can’t find my room,” she said.

“Oh, I can find your room.” She was wearing her key, with the room number written on it, around her wrist. I led her to her apartment, took her key, and unlocked the door.

“Is this home?” I asked.

“Is anyone home?” she replied.

I said no, watched her walk in, asked if she was okay, and closed the door. On the way out, I told an aid what had happened and asked her to check on the woman. As I drove to my daughter’s basketball game, I wondered about her. Was her confusion a recent development? Did she need to be in a memory care unit and could she afford it? Did she have any family or outside advocates?

I knew nothing about this woman outside of our interaction and so speculating wasn’t really helpful. Still, our brief encounter got me thinking of what-ifs. What if she had a family and they just didn’t recognize the signs that she needed help? Or what if her family thought it would be cruel to take away her independence? And those what-if’s led to this post.

It’s easy to overlook and minimize signs that your aging parents need more assistance; the status quo often feels like the path of least resistance. And it’s difficult to acknowledge we are all aging and that people in our lives may need more assistance than they want or than we are prepared to give. But if you notice one or more of the following signs, it’s time to assess your parents’ needs and determine if they need some lifestyle adjustments, additional support, or perhaps, a change in their living situation.

1. Finances: Are your parents losing their handle on their bills? Is their mail piling up unopened? Do they seem susceptible to offers in junk mail? A simple fix is to offer to help with bill paying and, if they are willing, to redirect their mail to your address. But is there a deeper issue with their cognitive ability? It may be time for a cognitive assessment.
2. Falls: According to the Center for Disease Control, at least 250,000 older people are hospitalized for hip fractures every year. And many people who fall, even if they’re not injured, become afraid of falling causing them to cut down on their everyday activities. If your parents experience a fall it may be time for a cane or walker. If your parents are going to remain at home, evaluate their residence for trip hazards like area rugs and retrofit the bathroom with anti-slip materials and grip bars in the shower. Get a medical evaluation to check for any trauma resulting from the fall and to see if any underlying medical issues caused it. Tip: I had my children decorate a cane for my mother. How could she refuse to use a gift from her grandchildren? 
3. Food: Have your parents stopped cooking? Is the fridge full of expired food? The kitchen can be an excellent indicator that mom and dad may need more support. Meals on Wheels may be an option or maybe your parents would benefit from a home health aide to prepare a few meals a week. Maybe they’d love the idea of assisted living where they can get three meals prepared for them each day. You won’t know unless you ask.
4. Is your parent forgetting family member’s names or getting lost while traveling familiar routes? Have they left a burner on after cooking? While we often want to dismiss forgetfulness as just “old age,” it’s wise to have your forgetful parent assessed for cognitive issues. Tip: My father started to have difficulty using his computer. I didn’t know it at the time, but it was one of the first signs of mild cognitive impairment. 
5. Have you noticed your parent’s home or personal appearance has become messier? This may just be a sign that your parent is more easily tired by household chores and could benefit from a housekeeper or a home health aide. But this could also be a sign of something more serious such as depression or dementia. Mention these signs to your parent’s doctor. Tip: If you don’t have a relationship with your parent’s doctor and HIPPA prevents the doctor from sharing information with you, ask the doctor if they will at least listen to your input even if they can’t respond to you.

Of course recognizing a family member needs help is one thing; accepting that idea is another. Sometimes we don’t act on these warning signs because we don’t want to take away our family member’s independence. But what if we think about helping our parents in a different way? What if we think about the comfort and security we might be providing them? What if by providing more structure, safety and routines, we are actually allowing people to maintain their independence longer? What if? What if more structure allows an elderly person to maintain their independence longer? Click To Tweet

For advice on how to talk to your parents about assisted living, click here.