Every year in the winter months, our Client Service teams see an increase in care inquiries from families. Holiday visits can be a wake-up call to declines in loved ones, highlighting the true hardships that older adults start to face regarding their health. You may have seen them struggling physically to complete tasks that they previously enjoyed doing with ease, or maybe you noticed a slight change in their emotional health. This can often be painful to see and may be even harder to address.
Winter brings on additional layers of health concerns with the flu, Covid, norovirus, and other infectious outbreaks.
The timing of these seasonal infections couldn’t be worse. Patients may be reluctant to go to follow-up appointments or even accept post-acute services in their homes because they were busy during the holidays, or now do not want to go out due to the cold or inclement weather. Non-compliance with medications and care plan items may have occurred while focusing on holiday fun.
There may have been dietary indiscretions over the holidays – because who can say no to another piece of pie? Exposure to visiting friends and relatives increases the risks of those pesky infections. Older adults, or anyone who has recently been sick, likely experienced excessive fatigue and weakness from holiday plans during the “most wonderful time of the year.” Let’s face it, we all get tired, distracted, and a little non-compliant during the winter, but for patients who have chronic conditions like CHF, COPD, or diabetes, straying from their normal regimen can mean an increased risk for exacerbations, complications, and even hospital admissions.
Whether you’re family of an older adult or a provider for patients or residents of a senior living community, it’s important to be able to recognize some of the warning signs of a winter downturn in health:
- Memory loss and forgetfulness: forgetting appointments or bills to be paid, repeating themselves, putting common objects in illogical places, forgetting to take medications at the correct times or in correct doses.
- Mobility issues: having problems walking or getting up from a chair, muscle or joint pain. Look at stairways, slippery floors, furniture obstacles, shower or tub thresholds.
- Eating issues: losing weight, becoming dehydrated, not cooking, forgetting to eat, unhealthy eating, loss of appetite. They may be having troubles cooking, reading recipes, holding utensils, operating a stove, or their sense of taste and smell may be impacted. Check the refrigerator for outdated items and make sure they’re drinking ample fluids to avoid dehydration.
- Detachment: low spirits, listless, lacking involvement in things like visiting friends or participating in community activities. Have their vision and hearing checked. And simply talk to them about this.
- Change in personal hygiene: not brushing teeth or combing hair, not going to the barber on a usual schedule, wearing the same clothing regularly, not bathing on a schedule. Talk to them as this can be a sign of physical problems, depression, or even dementia.
- Change in personality: talking too loudly or too softly, accusing people of doing things against them, wanting to check on children or displaying other odd behaviors. These may be common signs of sun-downing if the confusion is especially worse later in the day. Plan activities during the daytime to include sunlight exposure, keep a nightlight on to reduce agitation.
- Unusual clutter: dirty laundry, unopened mail, unkempt house especially kitchen and bathroom, unmowed lawn. Maybe home maintenance has become too much.
- Bruises, scratches, burns: these may be signs that there are balance and safety issues, and likely frequent falls.
After being independent and self-sufficient for so long, it's difficult for older adults to admit that they need help. But it's important to communicate with them – whether it is a loved one, a patient, or a resident of a senior living community – to let them know why you are worried and that you want to help. Then come up with a plan together. Try to answer some difficult questions, such as how can we help? Can we reasonably and successfully handle it? Is it time to have outside help?
Negative feelings are normal! You are going to have some guilt, frustration, sadness, and anxiety. For families, this change in dynamics can be very complicated. Understand that these intense emotions and thoughts are all completely normal! It is extremely difficult to suddenly take on the parent role for an older adult, especially a family member. Don't avoid the situation, and surround yourself with lots of support. Move at your own pace and be sure to take care of yourself.
Older adults may not be able to make too many decisions. A sad part of aging is that all that is left are choices about what to wear, what to eat for lunch, and how they can stay in their home or at their current level of care in a senior living community. It is important to acknowledge their fears regarding the future, and their disappointment with not being able to function independently. Let them know you understand how difficult this is. Empathize and let them share their sadness and frustration.
Choose your words carefully. Avoid “you need to” or “you should” statements. Ask questions about how things are going, or how they feel about the fact that they’re falling more often. It will not put them on the defensive like saying “I know you’re falling a lot.” And the best one is “how can we work together to keep you safe?”
Timing is everything! Don’t seize the moment in the emergency room to tell an older adult that they’ve fallen too many times and can’t live alone anymore. If your immediate reaction to news of an alarming incident is to make them feel that you are taking away their independence, they will fear telling you any important details about their health and safety, which could result in future incidents.
Implement a course of action to help this older adult receive the support that they need with their declining health. Address the status of any insurance policies, legal documents, daily needs, finances, and most importantly, living arrangements. Are there changes that need to be made in the house? Is their current situation suitable? Making these plans is not going to be easy, but with a good plan and proper support, it is something that can and must happen to ensure the well-being of an aging senior.
You do not have to take this responsibility on alone! In fact, you should be looking for outside help and support so that these older adults are taken care of in a positive manner. For family members it's important that your own well-being is sufficiently maintained. If you are in a patient care role or in a resident care role, having that outside support is also important to ensure that your patient/resident is safe and well supported to alleviate hospital admissions. Care Advantage can help coordinate and delegate what older adults need, both long term and on a daily basis.
If they want to stay in their home, discuss helping them evaluate what that would need to look like. Care Advantage exists for exactly this reason! Let the older adult be part of these conversations. Schedule a consult with our team, take a tour of some senior living communities. Look at various options to feel well planned for current living needs and for future considerations.
During the winter, help ensure an older adult’s home is maintained, and that hazards are cleared around the house. Make sure that they are dressing appropriately for the bitter temperatures and inclement weather. Stock a rescue kit in their car or consider dedicated transportation, and make sure they know how to use a cell phone and how to keep it charged and turned on.
This is a marathon, not a sprint. You won’t solve all issues over the course of one conversation. Do so in small chunks, revisit topics as needed, and set plans as you go. And be sure to celebrate wins along the way!
