With medical breakthroughs and improvements in the standard of living, people in Canada are living longer and healthier lives. Today's 'average' senior (person over 65) lives at home, is generally healthy, reasonably comfortable financially, and has an active lifestyle, according to Statistics Canada. Despite this rosy picture, some changes occur inevitably as an elderly person passes the age of the 'average' senior, into 'old age'. The degree and nature of these changes will vary considerably from person to person, but no one is entirely immune. Many of the elderly experience limited abilities in one or more of the following areas:
mobility, i.e. getting around the house or neighbourhood
memory or mental awareness
ability to manage their finances
maintaining their personal hygiene
As friends or adult children notice these changes in their elderly loved one, the role of caregiver inevitably shifts onto them. Many people feel perplexed and uneasy about the responsibilities involved in this change of role or relationship.
Knowing when to get help
It's not always easy to recognize when an older loved one needs help. We all want to support their desire to continue to live independently, even when we have concerns about their safety and well-being. But how do we know when it is time to intervene?
Fortunately, there are good assessment tools and professional consultants available to the elderly and their family members to help decide when assistance is necessary. An assessment is a comprehensive review of a person's mental, physical, environmental and financial condition to establish his or her ability to remain safely independent. It identifies risks and helps determine options to reduce these risks.
While it is possible for families to complete assessments on their own, using standard forms, there are also experienced professionals who can help. Involving a neutral and well-informed third party is often a very useful step in the process. For many families, the first step is to involve a doctor or health professional, preferably one who is known and trusted by the elder person. With medical recommendations in place, your local public health care team or agency for seniors can then guide you to organizations and professionals who will be able to assist you. In many cases, the most difficult part of the process is deciding that the time has come to seek help, and enlisting everyone's cooperation. The elderly person him/herself may not be aware of, or ready to acknowledge, a need for assistance. Although different assessment forms and professionals will offer slight variations, here are some basic areas you will want to consider:
Has your elderly loved one been diagnosed with any chronic diseases such as diabetes, high blood pressure, arthritis or emphysema, bowel or bladder problems, heart disease, stroke or cancer? Does he or she have vision or hearing problems, or difficulty walking? Be sure to gather a list of health professionals involved in their care and details of any recent hospitalizations.
Has the elderly person been diagnosed with any psychiatric disorders such as depression, anxiety, psychosis, Alzheimer's or any other form of dementia? Are they presently showing signs of confusion, disorientation or depression?
What medications are currently prescribed for them, and what is the dosage? Are they taking their medication reliably and as directed?
Daily Living Skills
Are they able to dress, bathe, use a toilet, climb stairs, and use the phone? Can they shop, prepare meals, do housework and yard work? Can they drive safely?
Home and Community Safety
How safe is their neighbourhood? Does their home have smoke alarms that they can hear? Can they avoid telephone and door-to-door fraud?
Does your elderly loved one have regular visitors or contact with friends? Do they go to a Seniors' Center, or leave the house for other social reasons? Do friends or family members live close by? Who can they call in an emergency?
Appearance and Hygiene
How is their overall appearance? Do they dress appropriately in clean clothes?
Can they live on their current income? Have they arranged for necessary legal documents such as trusts, living wills, and/or durable powers of attorney? Do they pay bills on time and make informed financial decisions?
Do they engage in their favourite hobbies, read books, watch their favourite TV shows, exercise, stay connected with their friends? Are they still engaged in the activities they have always enjoyed?
Developing a care plan
Developing a care plan starts with involving your elderly relative or friend in the discussion as much as possible. First, consult a health care professional (such as a doctor, nurse or an occupational therapist) to complete an assessment of areas where your elder may be at risk, and to advise you about the options available. The most common forms of support needed are:
personal contact and emotional support through visits, phone or email
help with errands, appointments and household maintenance
help arranging for and coordinating services provided by professionals
Next, ask yourself whether you are physically, mentally and financially able to give the care yourself, or if you are more comfortable arranging for care to be delivered by someone else. A comprehensive plan is based on the needs and abilities of everyone involved.
Remember that your elderly loved one may be anxious about what lies in the future, so be gentle and supportive as you move through this planning process. Don't be surprised if there is resistance to these discussions. You may need the help of some other trusted person(s) to keep the process on track.