by Amy Natt, MS, CMC, CSA

Q: I recently came down to visit my dad and noticed that things around the house were a bit disheveled, and he did not seem to have much food in his refrigerator. He insists that he is perfectly happy living alone and taking care of things, but the stacks of mail have me concerned. What should we do?

A: Observations can be worth 1000 words. There is nothing more enlightening than spending a few days with a family member, to really find out how things are going. If you ask someone how they are, most people will say they are doing just fine. When it comes to an aging parent, they might just be telling you what you want to hear. He probably feels like he is doing fine and even if he wasn’t, he would not want to burden you. 

So, when you visit, make the most of it. Go in with your eyes wide open and look for any red flags that may indicate things are not as good as they seem on the surface. Here are a few indicators that increased support may be needed:

Mail and bills are left to pile up.The simple act of opening and sorting mail becomes overwhelming. Managing a checking account can also become difficult to maintain. Look at a few statements: are bills being paid on time? Can he determine the difference between junk mail and real mail? 

The house is cluttered or unkempt. This is especially troubling if a parent has always been neat and orderly. 

Food in the refrigerator is uneaten or spoiled. Shopping, cooking, and cleaning can become too much trouble. A parent might eat just enough to get by, but suffer nutritionally. Losing weight can be another sign that a parent is not eating a nutritious diet. Try cooking and packaging meals, with instructions on how to heat them up. When you go back, see if they have been consumed.

Signs of scorching on the bottoms of pots and pans. A result of short-term memory loss, this is a dangerous sign that parents are forgetting about pots left on the stove, causing a fire hazard, and threatening both the individual’s and the surrounding neighbors’ safety.

The same clothing is worn over and over again and other personal hygiene issues. Doing laundry has become physically challenging, particularly if the washing machine is not easily accessible. There may be a fear of falling in the tub or shower. Is shampoo and soap getting used? Or is it always the same bottle when you check?

Missed doctor’s appointments. Sometimes this is simply a product of not having transportation and not knowing how to access ride options. It may also be an issue with short-term memory or keeping information organized.

Repeated phone calls at odd hours. When a parent telephones friends or family at odd hours, it may be a sign of memory loss, or a cry for help— a sign of depression or isolation. Arranging for a daily check-in phone call, or
a regular volunteer visitor, could make all the difference.

Forgetting to take medication. A sign of short-term memory loss or depression, this isn’t just a quality of life issue, but a real risk factor. Check the bottles, dates, and quantities; if allowed, talk to the pharmacist to see if refills are happening routinely. 

Inappropriate behavior, clothing or speech. You may hear about this from a neighbor, someone who has noticed that your dad is not dressing appropriately for the weather, for instance. That’s a sign that he might have something going on. 

Symptoms of depression. A frequent problem for many older people, who feel isolated and alone, depression causes marked changes in behavior and routine. Feelings of hopelessness or despair, lack of interest in once pleasurable activities, crying, listlessness, and not wanting to get dressed can all be indications of a problem. 

Changes in sleep habits. Is your dad sleeping more or less than he has in the past? Is he up at odd hours or report being tired all the time? 

Changes in social activities. Do you see evidence
of your dad participating in activities outside the house? Just saying he went to golf doesn’t mean it actually happened. Try to dig a little deeper without upsetting him. 

You want to respect your dad’s privacy, while looking out for his best interest. Ask questions and listen. Ask if it is okay if you look around the house: 

  • Look in refrigerator, freezer and drawers. 
  • Look on top of furniture and countertops. Are dust and dirt signs that household tasks are becoming more difficult?
  • Look down at floors and stairways. Have
  • shaky hands spilled drinks and food, becoming an issue?
  • Look through the mail. Has he forgotten to pay bills and answer correspondence?
  • Look at your dad’s appearance. Is clothing dirty and unkempt?
  • Look around the home. Are general repairs and maintenance needed?
  • Look at the yard. Is it maintained as it has been in the past?

If you find that several of these items are becoming issues, make sure to discuss them with your dad and encourage him to talk to his doctor. Some things may be an easy fix, like bringing in someone to clean or do yard work. Others may be an indication that something is going on and should be assessed. Keep notes and try to have an open dialogue with him about your concerns and possible solutions. Remind him that staying on top of things and adding support as needed will help him remain safe at home and maximize independence.