Underestimating Elder Care Needs

How Much Help Does Mom Really Need? 5 Dangers
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One of the most common phone calls experts in aging receive comes from worried adult children who aren't sure that a parent's living situation is safe. "'Is Mom OK living on her own?' is the question I hear more often than any other," says social worker Maria Basso Lipani, who runs the website www.geriatriccaremanagement.com. But answering that question may not be as simple as it sounds, experts say; older adults often "cover" signs of decline because they're embarrassed or fear the loss of independence. It's also common, Lipani says, for older adults not to recognize signs of decline in themselves or to think that an issue is only temporary and will resolve itself. "People spend all their lives going up, getting better and better at everything, and it can be hard to grasp the idea that things are winding down," says Lipani. "They've saved their money for a rainy day, and it can be hard to convince them that it's raining now."

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Another problem with the "Is Mom OK?" question is that the answer may change from moment to moment, experts say. Too often the adult children posing that question are seeing only the tip of the iceberg, and they may implement "band-aid" solutions when a more comprehensive care plan is needed.

Here are five important issues that can arise when you underestimate the amount of help your aging parent needs.

1. My Parent Might Fall.

Falling is one of the biggest dangers for older adults, not just from a direct injury but because a fall can set in motion what experts call a "cascade" of health issues. Los Angeles-based geriatric care manager Bunni Dybnis says adult children often misunderstand the issues surrounding fall risk. "I hear, 'Mom fell, but she's doing OK,' when really the fall should be a red flag," says Dybnis, who's a spokesperson for the National Association of Professional Geriatric Care Managers (NAPGCM). "The statistics on falls are really scary."

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According to the National Council on the Aging, one out of every three seniors falls every year, and 25 to 30 percent of adults over 65 who fall suffer a severe injury such as a hip fracture or head injury. Of those who fracture a hip, 40 percent will never recover their independence and a fourth will die within one year. Luckily there are many things you can do to help reduce your loved one's risk of falling, from safety-proofing her home to providing her with an emergency response system to getting her in-home help or helping her move to a senior living community where she'll have assistance and supervision.

2. My Parent Might Become a Victim of Fraud.

When NAPGCM surveyed 325 geriatric care managers about their experiences with senior fraud and financial abuse, the results were startling. More than 70 percent of care managers said they'd noticed a growing problem with elder financial abuse in their communities. Almost 80 percent had seen a case of theft, either of money or of property, by a family member, friend, or neighbor, and 75 percent had seen theft by a provider of in-home care. More than half the care managers had worked with a senior who'd been victim of financial fraud, and 45 percent had seen a senior fall prey to a home-repair scam. Other types of elder abuse that care managers reported were getting a senior to sign over money or property via a will, power of attorney, or property deed. If you're worried your loved one is at risk of being defrauded, steps to take include checking their bank and credit card statements for unusual-sounding payments and expenses and itemizing their valuable property to make sure it's all there. You should also be concerned if a family member or friend (particularly a newfound friend) seems be exerting an unusual amount of influence on your loved one or encouraging dependence and isolation from others.

3. My Parent Can't Manage Medications.

When an older adult's doctor sends them home with a prescription, that's only the beginning of a complex process, says Dybnis. The first issue that can arise is that a senior may fail to fill the prescription at all, or not understand how to take the medication when she gets it home. Then, of course, there's the issue of your parent not remembering to take the medication, or -- sometimes even more dangerous -- forgetting she's taken the medication and taking it again, resulting in an overdose.

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"Medication issues can be very dangerous," says Dybnis. "You have to really check that your parent is taking their medication, even if it means counting pills. You can't go by whether they say they took it." Dybnis advises reading the labels and disclosures for any medication your parent is taking, and going over the directions with them carefully. Some adult children dole out pills in daily pill boxes. "I've seen a lot of adult children resort to stopping by in the morning to give a parent her medication, then stopping by in the evening to do it again, but that can get overwhelming," Dybnis says. "You need to come up with a solution that's sustainable."

In addition, medications may interact with each other or cause side effects, and adult children need to be on the lookout for those problems, too.

4. I'm Unprepared for a Crisis.

It's all too easy, when caring for an older adult, to assume that if things seem to be going smoothly, there's no cause for concern. Unfortunately, experts say, you can pretty much anticipate that a health crisis or emergency will occur in the future, and if you're not ready for it you'll be scrambling for solutions and getting poor results. Finding residential care, for example, is much more challenging if you haven't done research and made contact ahead of time, and you may be faced with fewer choices. If you're prepared with a plan, you'll be able to respond faster and more effectively.

5. My Parent Has to Move Suddenly.

If your plan involves helping your parent move, this is also something you don't want to do in a rush, says Mary Kay Buysse, of the National Association of Senior Move Managers. "Moving precipitously and hastily is not the answer, because it can be very traumatic for an older adult," says Buysse. Making a decision between in-home care, downsizing to a smaller home, or moving to a senior living community is a big one, and there are many issues to consider. "This decision can take weeks and months, and you want to give it enough time so your parent is comfortable with whatever you choose." If your loved one does decide to move, it will go better if it's not rushed, Buysse says. "It took 50 years to build that home to be what it is today," Buysse says. "It's much more effective if you have time to go through everything thoughtfully -- that way you prevent regret and remorse, for your parent and for yourself."

Melanie Haiken

Melanie Haiken discovered how important it is to provide accurate, targeted, usable health information to people facing difficult decisions when she was health editor of Parenting magazine. See full bio