With Christmas and New Year’s upon us, many adult children of seniors will be connecting with their parents again for these celebrations.
It is an opportunity to take a reading of their general health and independent living conditions, without being too obvious. Most moves into assisted-living homes come just after the holidays, specifically because of these family visiting traditions. The children see their parents and sometimes they come away concerned.
Spreading cheer is fine, but your parents’ well-being beyond the season can be sensed and safeguarded by being a bit more attentive than other visitors. The hope is for you to find no troubling issues, of course. But you will be able to make mental notes and set a baseline for future visits and be even more intuitive, sensing signs that your parents’ conditions are changing someday and when they will need more assistance.
As you arrive at their house, look for mail piled up in the mailbox, newspapers uncollected on the lawn, and any neglected maintenance to the grounds and the house. One of the earliest signs of dementia will be the inability to handle finances. Unopened mail and finding bills in a clutter on a desk somewhere will be important clues as you quietly tour.
In the kitchen, peek in the fridge to see that their usual mix of groceries are there. Look for repetition of an item that may have been bought several times, while forgetting it has already been done. Check expiration dates. Run the small appliances for a second, to see if everything is operational. Conversely, look for signs of use on the appliances you know they use the most.
Mostly you want to see signs of any diet changes, where the complex and delicious meals you remember as a child are changing to simpler and less nutritious dishes. Look for signs of more takeout foods. Is the calendar on the kitchen wall showing current social engagements and doctor visits? Do prior months show the same?
In the main rooms, you can quickly tell if there is any hoarding started, which is an early anxiety sign of dementia. Are the plants and pets in good shape? Nails trimmed and everything well-watered?
If they still drive, ask for a trip to the store. Notice any new dents or scratches on the car, and look for signs of preoccupation or inattentiveness while they drive. Presumably the car is running well and there aren’t dash warning lights on to indicate needing service.
With the last suggestions come the easiest data of all to obtain, and this begins with a hug. A good long hug! Signs of heightened frailty, a gain or loss of weight and an overall sense of any personality changes will help in your mission of assessing their well-being.
Someone beginning Alzheimer’s disease may be eating several times for a meal, forgetting they had just eaten, and be gaining weight. Or they may be making more carbohydrate-loaded meals that are easier to make but less nutritious.
Weight going down might be from depression or not shopping well enough anymore. How is the hygiene? How is their gait? Around the eyes, are the eyebrows thinning at the outsides, near the ears? This could indicate a thyroid problem. Are there any small yellow bumpy patches on the eyelids? High cholesterol is sometimes diagnosed at the eye doctor from these cholesterol fatty patches.
As for personality issues, a boisterous parent who still loves to tell jokes (and appears normal to others) may have adopted bawdier stories, and it may be early indications of disinhibitions. These small but out-of-character changes, which you as their child will best know, should be noted. These are the changes that are obvious later, in hindsight. But you want to be observant and catch them now.
In 2004, a lovely Ms. Evelyn Keyes, remembered best as Scarlet’s sister Suellen in Gone with the Wind, moved into the Peppers Estate in Montecito at age 87. She had been taken from her condo in North Hollywood where she was living completely on chocolate bars, and her thyroid was off the chart. Nine months of well-rounded meals and regular health routines laid the groundwork for her recovery. I’ll never forget her physician, Dr. Svedlow of Goleta, shaking my hand in approval till my shoulder hurt.
There is a lot of power in the daily basic routines that we take for granted. Our health depends on them. When they begin to fall away, the most loving thing is for someone to take notice, and the sooner is always the better in matters of our health.
My grandfather used to love Charlie Chan movies. “Even the great Sherlock Holmes paled by comparison,” he would say with deep insight. It was quite a twist when I later found myself channeling Chan’s and Holmes’ powers of observation, as it came time for me to keep an eye on granddad’s condition.
I sometimes wonder where I would have fit in for grandfather, when comparing Chan and Holmes. You should go and be a Chan or Holmes for your parents. Your nosiness and observant caring might be the best gift of all this season, and have happier holidays one and all.
— David Sullins owns and operates the Peppers Estate senior assisted-living home in Montecito.