Many families miss the signs and symptoms of when it is time to find help for a loved one who has dementia and is living at home. The following are a few things to look for:
If your loved one is living at home alone, s/he may not be as independent as you think s/he is. Some concerning cues to look for with someone who is living at home alone are:
1. Are you finding medications around the house or that the pills in the pillbox have not been taken every day or in the right order? There are high-tech electronic pill boxes that can dose out the right medications and will signal the individual to take them, but even these have their drawbacks – the person has to hear the signals or s/he may take the pills out of the box and put them down elsewhere, forgetting to take them.
2. Is your loved one still wearing the same clothing that you saw him/her in when you visited 2 days ago? Not changing clothing may be a sign that your loved one is not appropriately taking care of his/her own hygiene.
3. Is your loved one losing weight? Weight loss is a sign of malnutrition which means s/he is not eating appropriately. Other signs of your loved one’s inability to take care of his/her own nutrition are: perishable food sitting out on the counter for long periods of time; snack-type foods disappearing quickly, but food in the refrigerator or that needs to be cooked being untouched; your loved one telling you that s/he is eating “whatever is in the cupboards” or “the usual” but cannot tell you specifics regarding what s/he had for breakfast, lunch, or dinner; not finding dirty dishes, clean dishes sitting in the dish drain, or that the dishwasher has been used.
4. Is your loved one in bed every time you visit or call? This may be an indication that s/he is no longer capable of structuring his/her own day. Other signs of this are: ceasing to be involved in social activities that are in his/her regular routine; declining offers from friends or loved ones to go out or to get together – avoiding social contact is often a way of trying to hide his/her cognitive deficits; getting phone calls at odd times of the day/night – s/he may be experiencing some time confusion.
5. Are you finding odd things around the house where they don’t belong or is your loved one’s surroundings suddenly very messy when s/he used to be such a fastidious housekeeper? This may be an indication that your loved one is having difficulty taking care of his/her surroundings. Some things to look for are: garbage not being put in the trash can and/or trash not being taken out; wet, mildewing clothing being found in the washer or dryer; items belonging in the bathroom being found in the kitchen or vice versa.
(As a side note, many of these concerns may be an indication of depression as well so it is still very important that you seek help).
If your loved one is living at home with a caregiver, the signs of when help is needed may be harder to recognize because the caregiver tends to cover for the debilities and needs, and the caregiver is often not likely to admit that there are problems or that s/he needs any help. This is often because they feel that doing so is admitting failure. Some concerning signs to look for when your loved one is living with a caregiver are cues from your loved one and some are cues from the caregiver. These may include:
1. Is your loved one looking disheveled or have a smell to him/her? This may indicate that personal hygiene is becoming too much for the caregiver to handle.
2. Is your loved one in bed or sitting in the same spot each time that you visit? This could be an indication that the caregiver is having a difficult time managing either the physical care or the need for activity for your loved one.
3. Does the caregiver look worn, tired, or admit to not sleeping well? This is often an indication that the individual with dementia being cared for is not sleeping regularly and/or is very active, creating a situation that is wearing out the caregiver.
4. Is the caregiver complaining of increased medical issues or is s/he having increased trips to the doctor or emergency room for his/her own physical issues? This is a good indication that the caregiving is taking a physical toll on the caregiver and that s/he is trying to do too much on his/her own.
5. Is the caregiver telling you that s/he needs more help? If so, please LISTEN! Caregivers have a tendency to minimize their situation and to cover up the truth when it comes to their needs because they do not want to look like failures or admit that they cannot do it all. So, if a caregiver is asking for help, s/he desperately needs it and needs it NOW.
Where do you get help? From your loved one’s physician, your local Area Agency on Aging, your local Alzheimer’s Association, private Geriatric Care Managers, and personal care agencies. If you need help in finding any of these in your area, just contact me…I am happy to help!