With the second holiday season of the pandemic, many people will have the opportunity to rejoin family and friends for celebrations. The pandemic has kept many people apart longer than expected, and it may have been months since a visit with loved ones. In addition to enjoying food, folks and fun, there may be some not-so-pleasant surprises.
Geriatricians often see patients whose families voice concerns about their health or well-being. This can be especially heightened if family members haven’t seen each other in a while. The holidays can be an opportunity to not just enjoy the fruitcake but observe how aging parents, grandparents or great-grandparents are doing at home. Objectively observing their functioning and memory can uncover warning signs that more evaluation is needed.
This can lead to uncomfortable situations and often feels like role reversal. Maintaining older adults’ autonomy and dignity needs to be the core of all of these conversations. If someone is concerned about a loved one’s health, an open mind and genuine interest are vital in having a conversation. The concerned person should make observations – not assumptions.
The simple face of age doesn’t dictate anyone’s ability to care for themselves. Many people do quite well taking care of themselves and remaining independent well into their 90s or more, while other people may need more assistance with self-care earlier in life.
Have loved ones been able to keep up with basic care of the home or yard? If not, these can be signs that someone may need more help at home. Sometimes that could mean simply hiring someone to clean the pool or shovel the snow. Other times, it may be a sign of limited physical function: Maybe they can’t move around as well or bend over to pick things up.
But if basic cleaning isn’t happening, that could also be a sign of limitations in cognitive function – perhaps they forget to remove the trash from the kitchen for weeks or don’t remember to go to the store for basic needs. Other times, it’s just a sign that they were too busy to mow the yard before your visit. Again, a visitor shouldn’t make assumptions, just observations – and always see them in the larger context.
How does the older person move around the house? If they have been told to use a cane or walker before, are they? Is their balance bad? Are they getting by with “furniture surfing,” holding on to furniture or walls while walking?
What about driving? It’s about skills, not age. Arthritis in the neck might make it hard to look at crossing traffic. Vision problems can cause blurring, especially at night. Limitations in cognition can also cause trouble, such as getting lost while driving somewhere familiar – including the grocery store or a friend’s house.
The pandemic has put extra stress and anxiety on many people. Over the past two years, some people have not just been social distancing but also experiencing social isolation. Feeling cut off from the community can lead to serious health problems. The National Institute on Aging has great resources to understand the difference between being lonely and being socially isolated, and how to identify and act on these concerns.
See something, say something – with care
The holidays can bring chaotic schedules. Many people can be overwhelmed by their commitments, or forget important plans, and it’s not necessarily a sign of dementia. Anybody can forget to bring home cranberry sauce or which exact yogurt the grandchildren like.
When it may be a sign of something more significant is if memory loss affects daily life – especially activities such as eating, dressing and hygiene.
Nonjudgmental questions are best to start a conversation. Instead of something such as “Why didn’t you tell us that you’re not safe at home?,” an observation is better: “I saw that you just stumbled in the hallway. Is that something you have noticed before?” Allow space for reflection and insight. Don’t tell other people how they “should” be feeling, but listen for their own thoughts and observations.
Getting together at the holidays is intended to be a reunion of family and community to enjoy the season. Nobody wants to focus on problems, but it’s wise to be observant. If warning signs indicate that things may not be going well, it’s time to say something – thoughtfully.
This article is republished from The Conversation under a Creative Commons license.