We all value our independence. We appreciate the freedom to come and go as we please. To cook our dinner and choose what we eat. To dress ourselves, to manage our finances. However, the day will come for all of us when this is no longer possible. It's a part of life. It's a fact of ageing.
For children and other relatives, it can be challenging to see your parents as anything but the strong and capable pillars of your life. Even harder to take a decision on their behalf about their independence. The reversal of roles brings a sense of grief and guilt.
Yet living alone when it is no longer safe, comes with its own risks. Therefore, it is crucial to be aware of the dangers, the signs a loved one cannot look after themselves, and the range of options available.
Signs: What to look out for?
As we age, our faculties fade. Our minds dull and hands shake. For the person experiencing ageing, it can be a frightening experience. It's even more terrifying if you feel you must hide the decline, for fear of losing the normality of life. Therefore, it's essential to approach the subject gently. The more honest and open, the more you can make an accurate assessment of your loved one’s abilities.
Here are some signs to look out for:
Frequent falls: Falls are incredibly dangerous. They risk causing a severe fracture that can take months to heal. They often come with devastating complications like pneumonia, stroke, or kidney damage. If you see any bruising, enquire what the cause was?
Failing sight: We use our eyes for everything in daily life. Without it, elderly people are at risk of falls, a cooking accident, or taking the wrong medication (or wrong amount). Each of these can end in disaster and is a sign of being unsafe at home.
Shabby appearance/unkempt house: If someone has never taken care in their appearance or home, the change may be imperceptible. However, a sudden or significant decline in hygiene, cleanliness, clutter, and clothing, can be a sign that the elderly person requires assistance.
Low sociability: If your elderly loved one has become confined to their home, they may be feeling immense loneliness. Perhaps they are a widow(er) and have lost many of their old friends. Often, they may have given up their car. Sometimes the worst part about living alone is being alone. Conversely, their friends or neighbours might have expressed concern about their ability to look after themselves. If you have worries, use these individuals to get perspective on the situation.
Other signs to consider: sudden loss of weight, profound forgetfulness, continually getting lost, stacks of unopened mail, defensiveness, or sharp anger.
What are the options?
Having a conversation with your elderly parent about their loss of independence is difficult and painful. Older people can be defensive or respond angrily. They may deny there is anything wrong, for fear of acknowledging the reality of the situation. Deep down, they may know the truth, but accepting it means giving away parts of their life they will never get back.
However, having a calm and empathetic conversation is a good start. The aim should never be to drag someone from their home but to find a way to maintain their independence as long as possible. One of the stepping stones is assisted living.
Assisted living facilities are for people who can mostly look after themselves. However, they may need help with daily tasks: cooking, cleaning, and even showering. Typically, residents enjoy their own private living space, with a kitchen and bathroom. But, if they need help, it's close to hand. Couples can live together, and you are free to leave or to socialise with the other residents whenever you want.
For most elderly people, this is perfect. They don't lose the freedom they cherish but instead gain much-needed support and care.
The downside of assisted living is giving up a home full of memories and possessions. The middle ground is a home nurse. They will take care of any medical needs of the elderly person at home. At the same time, carers and other support workers can come at a specific time of day to help with certain tasks, such as cooking or washing. The elderly person gets to keep their home. However, if they are unable to maintain the property, this might not be a viable option.
Living with family:
In many cultures, it is normal for elderly relatives to come live with their children. In the West, it has gone out of fashion. However, if you or a sibling has space and time to offer that support, it is an option to be considered. With multiple people around, the responsibility can be shared. It also allows elderly people to enjoy their days amongst their loved ones.
Are nursing homes a viable option?
Nurses homes have become an undesirable option for many. However, for many facilities, this reputation is unfair. Nursing home staff work tirelessly to meet the needs of the residents. Here elderly people have access to 24-hour emergency care, all of their personal care is assisted, and they are provided with a room and meals. There are even social and recreational activities for the residents.
There are naturally concerns about funding nursing homes. The better the quality, the higher the costs. These will require a careful examination of your families and loved one’s finances.
Tips to help with the process
Here are some tips to consider, when dealing with a loved one who can no longer live alone.
Timeline: Try to maximise the independence of the individual. Constantly moving is tiring and confusing. Each of the steps should only be taken when the level of care can no longer fulfil most of their needs. Otherwise, try and find a way to adapt to the situation.
Power of attorney: POA provides you with financial control over your loved one's finances. It can be helpful if they are making unsound decisions, such as extravagant purchases.
Discuss in advance: Don't wait until the moment of crisis to have the conversation. Getting the opinions of the loved one beforehand can make future decisions easier.
Let them decide: You don't have to decide for them. Give the elderly person the options and let them decide what they want to do. This is particularly important with home care. No one wants their day planned out by someone else.
Seek expert advice: If in doubt, ask a general practitioner or elderly care doctor about the possibilities.