“I’m not sure my mother should continue to live by herself.”

“Every time I leave my dad’s house I start worrying that something will happen and he won’t know what to do.”

Sound familiar? Maybe you have made a similar comment about your loved one.

There comes a time when even a medical alert device is not enough. But how do you know when someone needs round-the-clock supervision? Common sense combined with a thorough assessment of your loved one and his surroundings should help you determine the answer to this vital question.

On your next visit, begin by greeting your loved one with a lingering hug. Do you notice a weight loss or gain? Is the hug returned or prevented by weak muscles or other frailty? Is there an unpleasant body odor that denotes a neglect of personal hygiene? Notice changes in appearance such as unkempt hair, being unshaven or dressing inappropriately. Is you mom’s gait steady or does she stumble, grabbing at furniture to keep her balance? Can she sit down and get up without difficulty?

Compare mental capabilities with those exhibited at your previous visit. Does your dad call you by name and know who you are or does he seem confused about your visit? Engage in a conversation that will reveal if he is thinking clearly. Ask about daily activities, what he had for breakfast, and if he has had any visitors. Disinterest in usual activities may indicate he is lonely. This is a common emotion, but many seniors are unwilling to admit it. Severe inactivity may be related to depression.

Look around the house for signs of neglect such as a stack of dirty dishes in the sink or unsanitary bathroom conditions. Is clutter becoming a hazard? These may just indicate a need for assistance with housekeeping. However, if they are ongoing and increasing in significance they may suggest your loved one is no longer able to live alone.

Check cookware for signs of scorching. Peek in the refrigerator with an eye out for spoiled or outdated food. If there are stacks of unopened mail, with permission, inspect them to see if bills are being overlooked. It is also a good idea to check for mail that may be sent with the purpose of scamming.  A daughter told me of a less-than-ethical organization that sent her mother an appeal every month. Thinking it was a bill, her mother wrote a check for the “suggested amount” shown on the “invoice.”

If your loved one appears to be doing well both physically and mentally, there is still one very important question to ask: would they know what to do in the case of an emergency?

If an electrical plug sparked and caught the drapes on fire, what would be their first reaction? If a tornado warning interrupted their favorite television show, would they know where to go? It may be possible to rehearse these scenarios and advise what actions should be taken; but you would need to make sure they are capable of actually following instructions. In case of fire, would they leave the house immediately or try to put the fire out? If their clothes caught on fire, would they be physically able to “drop and roll”?

If you have concerns about the living arrangements of your elderly parents, just worrying is not going to help the situation. It is your responsibility to make wise choices that will be in the best interest of their well being and safety.

Caring Quote: “If you learn to listen for clues as to how I feel, instead of what Isay, you will be able to understand me much better.” Mara Botonis in When Caring Takes Courage