How do you know that changes you notice in your older family member need attention and are not just normal aging? You need to start with knowing what is normal for that person. You need to be concerned when you observe something abnormal. For example, a messy house may not be a problem if the person was like that in their younger years. When someone who was a meticulous housekeeper starts leaving dirty dishes and piles of laundry, you should be concerned.
Here are some examples of things that need action:
Changes in personal habits. This includes not showering or changing clothes daily or the way they keep their home environment. Check for body odor, urine odor or clothes that they seem to wear to much. Not keeping a clean environment can be due to not physically being able to clean, or a decline in mental status that makes the person unaware that they are not living in a clean home.
Changes in dietary habits. Does the person who never skipped a meal seem to not care about eating? Someone who was conscientious about healthy eating who is now stocking up on junk food is someone to be concerned about.
Issues with personal finances. Studies have shown that an early signs of dementia is inability to handle one’s own personal finance. Look for comments about how the utility didn’t mail a bill or multiple mistakes made by the ‘stupid’ bank. Be super vigilant about people trying to defraud your older relative and aware of comments about strangers they did not contact who are so nice.
Doing the same thing over too many times. Excessive calling or checking, telling the same story, or any noticeable repeat behavior could be signs of a problem.
Gait problems like trips and falls. A few trips or falls, even minor ones with no injury, in a short period of time should set off alarm bells.
Sleep and fatigue issues. Too much sleep, night waking, falling asleep without intending to do so are issues that have many underlying causes.
Trouble doing hobbies or rules of a game that were once second nature. If someone was a prolific knitter and says they have no interest anymore, that is a problem. If someone consistently refuses to play a game once learning the rules of a simple board game or to try an easy puzzle that can be a sign of some cognitive issues.
What is not a problem? Forgetting someone’s name (even a close relative) from time to time; forgetting a word; not remembering an obscure memory that hasn’t be brought up in a while; leaving behind coats, keys or purses (unless this happens with some frequency). Doing something once is not always cause for concern. It is a pattern of behavior that is troubling.
The first thing to do is to visit your relative’s primary care provider to discuss these changes. The root causes could be due to dementia, infection, mild stroke, medication, undiagnosed chronic illness or depression among many others. A primary care physician can discover the problem or refer to a specialist. If you know in your heart something is wrong and the primary care says nothing is, seek a second opinion.