The Home Care Discussion

You may have noticed things that are concerning: your loved one’s clothes have become baggy, there are piles of mail with overdue bills on the table, or they don’t attend their favorite social outings any longer. Does this mean it’s time to intervene? When is the right time?

It is never too early to talk to your loved ones about how and where they want to live. In fact, introducing this subject before facing the crisis of a fall, a fracture, or a hospitalization is ideal. Many seniors are fiercely independent and resist any type of assistance. Seniors may be afraid that if they accept help they will appear frail and thus end up in a nursing home. The opposite is true! Enlisting assistance can help seniors maintain their independence and remain safely in their homes for a longer period of time, or forever.

To help you decide whether or not there are concerns that need to be addressed, review your loved one’s IADLs and ADLs. Together, ADLs and IADLs represent the skills that people must be able to manage in order to live as independent adults.

IADLs (Independent Activities of daily Living) are the complex skills needed to successfully live independently. These skills are usually learned during the teenage years. These skills are necessary to successfully live independently. If you answered ‘yes’ to any of these questions in regard to a loved one, consider adding support to them in that area.

  • Managing finances: Are there unpaid bills? Bounced checks? Messages from creditors?
  • Handling transportation: Have there been traffic accidents, including fender benders? Are you uncomfortable as a passenger in their car? Have they stopped driving at all?
  • Shopping: Are they continually missing essential household items or do they have large amounts of the same item?
  • Preparing meals: Have they stopped making meals? Are they making poor decisions in what they eat on a consistent basis? Is there spoiled food in the refrigerator or cabinets?
  • Using the telephone: Do they answer the phone when you call? Do phone messages go unanswered?
  • Managing medications: Are they taking too many or too few of their prescribed medicines? Are they unsure what to take or why they are taking it?
  • Housework and basic home maintenance: Is the home so cluttered you are concerned they may fall? Has the furniture been dusted and floors vacuumed or mopped? Are there dirty dishes? Are there safety issues due to lack of maintenance, such as burned-out lightbulbs, or shaky hand railings?

Now ask yourself if your loved one has compromised activities of daily living (ADLs) which are basic self-care tasks. These are the kinds of skills that people usually learn in early childhood. They include the following:

  • Feeding: Can they feed themselves? Can they cut their meat?
  • Toileting: Are there issues with getting to the bathroom on time? Are clothes/bed sheets stained with urine or feces?
  • Selecting proper attire: Are their outfits appropriate for the season? Are the buttons closed appropriately? Clothes are not inside out?
  • Bathing and Grooming: Are there body odors? Are they taking showers or baths? Is hair washed and combed neatly? Are nails dirty?
  • Transfers: Do they need help to get out of bed or out of a chair?
  • Walking: Are they steady when walking? Have there been falls?

Difficulty managing IADLs is particularly common in early Alzheimer’s and other dementias. Assessing IADLs and ADLs can help guide a diagnostic evaluation, as well as determine what kind of assistance an older person may need on a day-to-day basis.

A quality home care agency is able to support the senior in many of these areas. Services will improve the quality of the senior’s life as well as relieving the burdens from their loved ones.