Headlines
As reported by The Hartford Courant, December 14, 2004.
Holiday Visits May Reveal Aging Woes
Family Reunions Bring Fresh Observations
By Garret Condon
David Schulman, 58, of Avon noticed three years ago that his mother, now 86, was not coping well living alone in her home. Her husband, Schulman's father, had died a couple of years earlier. "She would hide the bills," said Schulman. "She wasn't eating properly and wasn't taking her medicines properly." She was later diagnosed with the early stages of dementia.
With the help of some long-term care insurance, a full-time aide and the assistance of the nonprofit Connecticut Community Care Inc., Schulman has managed to keep his mother in the West Hartford home she loves.
Thanksgiving and the winter holidays bring far-flung families back together, and, in particular, bring distant, adult children back in contact with their elderly parents or grandparents or with other older relatives. Mixed with the joy of family reunions can be the discovery that something is amiss in the home of an elderly person or couple.
"That happens more frequently around the holidays," said Molly Rees Gavin, president of CCCI in Bristol, one of three agencies that provides case-management services to help keep the elderly at home through a state program for low-income residents, the Connecticut Home Care Program for Elders. CCCI also runs a privately funded assistance program open to all.
Dr. George Kuchel, director of the UConn Center on Aging at the University of Connecticut Health Center in Farmington, said children and other relatives who come from afar for the holidays can often help spot changes in seniors. These changes might be missed by adult children who live with older parents.
Kuchel said a number of signs may indicate the onset of dementia, depression or other medical problems, but that it's important to know the individuals and ask: How is the behavior different from what they were doing before? "People have to be sensitive to change," he said.
Among the changes that Gavin and Kuchel say can indicate the need for help:
Nutrition: Check the refrigerator to see if an elderly person is eating balanced, nutritional meals. Kuchel suggests looking for changes in weight and in how the person's clothes fit.
Cleanliness and bills: Has a neatnick become a poor housekeeper? Are collection notices piling up? Gavin notes that family members or professional caretakers can often arrange to receive the second notice of certain bills, just in case. Kuchel said the elderly often squirrel away cash under pillows and elsewhere.
Social life: Gavin says that social support has been shown to be just as important for seniors as medical care. "Affinity with other people, purpose in life, what my role is in society at this point - these are the issues that motivate and inspire our elderly," she said. Isolation and inactivity can be bad signs.
Medications and appointments: Kuchel suggests a look in the medicine cabinet, which may reveal "tons of medications that have expired or that have not been taken." A talk with the family pharmacist may help, he said.
Moodiness, confusion and forgetfulness: If there are changes from what adult children consider normal, they could suggest dementia, depression, a problem with medications or another medical problem.
Driving: This is one of the thorniest issues involving the aged. Gavin suggests going for a drive to determine whether an older relative should stop driving. "Everybody shies away from making this decision," she said. Kuchel said that Connecticut law does not require physicians to report a driving problem to the state - although many do. Current testing of senior driving isn't too helpful, he said. The decision is important, he said, because in suburbanized Connecticut, the loss of a car can spell social isolation. "We're kind of caught," he said.
Kuchel notes that another holiday scenario may also be revealing. If an elderly parent travels to the adult child's home for a stay and, in the unfamiliar environment, becomes confused, especially at night, it can be significant. (A stay in a hospital can have the same effect.)
It's often difficult to see, or to admit to seeing, important changes in beloved family members. "It's human nature not to want to see something terrible like that in someone so close to you," he said. But for those who do, the first stop should be the family physician.
Kuchel said that older doctors may not have been trained in geriatrics, which is a relatively new medical discipline. The UConn Center on Aging, he said, can be a resource both for patients and for family physicians who are treating older people.
Gavin noted that each town in the state has an official who is an agent for the elderly. That official should be able to refer families to agencies and individuals who can help assess an older person's living situation and recommend various kinds of in-home assistance, if staying at home is an option. Her agency provides such a service. There also are private, for-profit practitioners who help manage in-house care and support for the elderly. The state's five nonprofit Area Agencies on Aging are important resources, she said.