10 signs that an older adult may need help

With advances in medicine and a broader focus on health and wellness, older adults are living longer than ever before. 

However, many live alone or lack access to routine medical care and social connection, which can lead to isolation and related health effects. Others may not recognize that changes related to their age are affecting their quality of life, or are simply resistant to asking for help.

“The three biggest reasons for decline in our older population are failing health, depression and dementia,” says Norma Reggev, a licensed clinical social worker with Sharp Senior Health Centers. “Depression can set in when older adults feel isolated and lonely, and early dementia may be subtle and tricky to spot if you don’t see your loved ones regularly — it might look like general memory loss or absentmindedness.”

10 signs an older adult needs help
According to Reggev, older adults who want to remain in their home may not admit they need help for fear of being forced into an alternate living situation. It might be up to you to watch for signs indicating your family member isn’t as independent as they once were and take action. 

She recommends watching for these 10 signs that a family member or friend may need help:

1. Missed medications. Take a look at your family member’s pillbox to see if a dose or two have been skipped. That’s a sign they’re forgetting to take their medications. Missing doses or taking too many at one time can be dangerous.

2. Unpaid bills. Letting unpaid bills pile up, not paying bills or paying them more than once, and losing or hiding money can be a sign of dementia setting in, but can also be a sign a senior is feeling increasingly overwhelmed.

3. Change in cognition. Exhibiting forgetfulness that results in unopened mail, newspaper piles, unfilled prescriptions or missed appointments can be troublesome. Making unusual purchases, such as more than one subscription to the same magazine, entering an unusually large number of contests or increasing purchases from television advertisements may be a red flag that you need to step in.

4. Mood change. Changes in mood that are unusual for the family member, such as a generally happy and upbeat person becoming suddenly sullen or irritable, can be indicative that they may be in need of attention.

5. Changing eating habits. A change in eating habits, weight loss, appetite loss and missed meals should not be ignored. You may also notice spoiled food in the refrigerator or you might realize the refrigerator lacks fresh foods, such as fruits, vegetables and meats. If your family member mostly eats frozen, boxed and canned food, it can be a sign that taking care of themselves is becoming a challenge.

6. Cluttered house. A noticeable change in home tidiness and sanitation is a signal that help is needed. Regular house tasks and cleaning get harder as aging adults lose mobility and vision. They may not be able to see the dirt and if they have trouble bending down, they may just let things that have fallen to the floor remain. However, a cluttered house is a hazard to their health.

7. Odors. Neglecting personal hygiene, including clothing, body odor, oral health, nails and skin is a telltale sign. Personal hygiene can become a lower priority for a variety of reasons, such as decreased mobility, dementia or trouble keeping up with laundry. Some older adults may not bathe for fear of falling.

8. Car dings and dents. As we age, our reaction time slows and turning your head while driving to monitor blind spots gets harder. Physical limitations and dementia can be the causes of fender benders or sideswipes in a parking lot. If you spot troubles on the exterior of your loved one’s car, it may be time for a conversation about driving.

9. Bruising or other physical injuries. Evidence of physical injuries, such as burns or bruises, may result from general weakness, forgetfulness, a recent fall, or misuse of alcohol or medication. Be on the lookout if they are holding onto walls or furniture as they walk through the house. This can be a sign that they’re unsteady on their feet or at risk for falls, and would benefit from a cane or walker.

10. Change in behavior or sleep. Exhibiting inappropriate behavior, such as being unusually loud, quiet, paranoid or agitated is an indication that support is needed. A decrease in or lack of participation in activities that were once enjoyable or change in sleep pattern may indicate an underlying condition that needs attention.

How to help
While older adults are still alert, oriented and able to voice preferences, it’s important to let them make decisions about the care and support they’ll want, even if you don’t agree with them. Discuss what’s not negotiable. For example, Reggev suggests it might be acceptable to live with some mess, but not to neglect the bills or put themselves and others in danger by driving.

“Have a kind, but candid, discussion without controlling the conversation or getting angry. Find out which tasks feel more difficult these days, ask how you can help and discuss available options that you think they may be most receptive to,” says Reggev.

If your loved one refuses to consider assistance, Reggev says it’s important to continue having these conversations. The fear of losing their independence may make them resistant to being open to change.

“Oftentimes it’s not a ‘one and done’ type of discussion,” she says. “The conversation may take place over a few days, weeks or even months.”

Reggev recommends being understanding, supportive and empathetic as you develop a realistic plan with all parties in agreement.

Learn about Senior Health Centers and Sharp HealthCare's unique model of health care for older adults. Agencies in San Diego, such as Area Agency on Aging, Adult Protective Services and ElderHelp of San Diego, also support the needs of local seniors.