Top 8 Warning Signs to Notice in Elder Relatives

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(Photo: Sharon McCutcheon on
’Tis the season to gather with a limited number of friends and family, warmed by the glow of hearts and hearths during this lingering pandemic.

It is also the perfect opportunity to check in with elder family members, many of whom have been socially isolated and stuck at home since March.

There are eight red flags that you should be aware of during your holiday visit with elders, according to Samara Elias, MSW, LSW, a social worker for the Adult Day Center at Parker, which provides aging services including nursing care and assisted living in Piscataway, Highland Park, New Brunswick, Somerset and Monroe.

These red flags will help to identify signs of decline in physical health and functioning, mental health and/or cognitive functioning.

1. Inability to maintain physical appearances.

You may not think twice about a stain on grandma’s favorite holiday sweater, but it could indicate that there’s a larger issue.

“Often, it’s an indicator that they’re no longer able to maintain their physical appearances,” Elias said. “They may be struggling to do the laundry or maintain good personal hygiene. The evidence could be easy to spot such as food smudges on their clothing or unbrushed hair.”

2. Weight loss or weight gain.

Elders can have a well-stocked refrigerator and pantry, but they might not remember to regularly eat their meals. Or, at the other end of the spectrum, they may not recall eating a short while ago and then have another lunch.

 “I think it's probably more common that someone would notice weight loss,” Elias said. “But certainly, if somebody is having some cognitive changes and they don't remember that they've eaten a meal, they could make themselves another one. As people start to have challenges, they gravitate toward the things that they know they can do. They might think, ‘I don't remember that I ate. But I know that I did eat a meal.’”

3. Changes in mood or behavior.

 “Look for an unpleasant change in their mood,” Elias said.  “If the darkened mood appears consistent, assume something is wrong.”

This is a tricky one to spot because these changes can be triggered by something as common as a headache, minor joint pain or bloating. But it could also indicate declining mental health.

4. Unpaid bills.

If last September’s credit card bill is sitting under a stack of mail or if the check for the electric bill was mailed to the cable company, they could be warning signs that someone is struggling with executive functioning.

“It’s an early indication that they’re having a harder time managing everything,” Elias explained. “Maybe they can no longer do such tasks as writing a check or balancing a checkbook. They will need help.”

5. Messy house.

Take a look around their home. If it’s uncharacteristically disorganized with clothes strewn on the bedroom floor or dirty dishes left on the table or outdated food in the refrigerator, those are signs of concern.

“I think the kitchen and the bathroom are good places to check,” Elias said. “That’s where you could see a lot of mess and clutter that typically was not there. It could signal that they are having a hard time keeping up with the chores and might need help.”

6. Damage to the car.

The body of your loved one’s  vehicle can tell a story. If there are scrapes, scratches and dents that you haven’t noticed before, it may be time to make the difficult decision to take the keys.

Age-related changes can affect memory and decision-making processes, the ability to see and hear, reaction times and other skills and abilities needed to safely operate a car.
If they are struggling to drive safely, it may be time to see what other skills they are struggling to maintain.

7. Inability to manage their medications.

Americans ages 65- 69 take an average of 15 different prescriptions per year, and those ages 80-84 take an average of 18, according to a recent study by the American Association of Consultant Pharmacists.

It could be a tall task for anyone to keep track of that many pills. It is important to double check that your family member is taking prescribed medications correctly.

“If it’s somebody who always had a pillbox to keep everything organized, and now there's bottles around and then they're not using the pillbox, that’s a warning sign,” Elias said. “Or, check to see if they’re using expired medications.”

Not taking medication, or taking it incorrectly, can expedite the deterioration of the body and mind, which is why regular checks in the medicine cabinet are warranted.

8. Inability to follow conversations.

“Are they having a harder time following the dinner conversation?” Elias said. “Is this somebody who always used to be super involved and engaged in conversation and maybe they're taking a little bit more of a backseat? Are they asking repetitive questions and can't seem to follow the string of the conversation or hold on to information from the beginning to the end?”

Sure, short-term memory loss is a common part of aging. But the inability to follow a conversation from beginning to end could indicate a number of issues ranging from dementia to hearing issues to stroke-related aphasia to Parkinson’s disease.

“If you spot any of these warning signs, you should consider consulting with a physician and reviewing all available options for help,” Elias said.

One resource is Parker Health Group, who can consult with you and your loved one to determine if a helping hand is required. Parker can assist in helping you determine if your loved one is ready for an assisted living or nursing care community. They also offer rehabilitation services such as speech, occupational and physical therapies virtually or in the comfort of your home.
If you have questions or want to learn more about services for the elder community, contact Parker Health Group at 732-902-4200.