Here’s what to look for and how to make decisions on care
Aging comes in stages: the mind, the body, and the world around you start to slow and shift, but sometimes, it takes a trusted friend or loved one to step in and point out those changes.
Identifying signs of aging or finding new living solutions is difficult and confusing, and due to the pandemic, noticing and interpreting those signs becomes more complex, experts said.
Bucks County senior care experts provided insight into these concerns and explained how families should respond and support their aging relatives with appropriate treatment and compassion.
When considering an individual’s wellness and functioning, nurses and other specialists make evaluations for a variety of categories. These could include physical and cognitive ability, medical conditions, level of socialization, and overall quality of life.
If an elderly person is unable to complete every day activities and tasks they normally would, it may be time to consider hiring help or looking into assisted living solutions, says Care Advisor Katie Reilly, who works at Abramson Senior Care’s Edna Young Gordon Healthy Brain & Memory Center in Bryn Mawr.
This sort of routine impairment, Reilly said, may be significant enough to warrant intervention, depending on the level of severity.
“It’s concerning when any change is really going to impact daily life, affect someone’s safety, impede their functioning or their ability to get from A to B,” Reilly said. “We often see age-related memory change, but we also can see other signs and symptoms that are a little bit more concerning that could be a form of cognitive impairment.”
Specific signs of cognitive decline can include short-term memory loss, problems with decision-making and executive functioning — planning and carrying out said plan — difficulty finding words, and challenges communicating. More concerning symptoms, possibly of dementia or other illnesses, would be personality changes and impaired judgement.
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Apart from mental acuity, physical impairments could also be obstacles to daily tasks. Those who have trouble dressing or driving, do not take care of their personal hygiene, or mismanage medication may also benefit from assistance.
The Bucks County Area Agency on Aging looks for these factors and more in their at-home assessments, which take into account an individual’s overall wellness, sometimes in the company of close family.
Questions can include concerns about the ability to acquire groceries, take medication independently, and handle physical injuries that may prevent daily care activities, including cleaning or cooking, from being completed.
The assessment also tests for cognitive functioning — individuals are asked to name the president, the calendar date, and similar cues of clear, rational thinking. Care advisors also look for physical disabilities, emotional distress or signs of abuse, and socialization.
That last factor is important, experts say. Behavioral differences as a result of the pandemic are not going unnoticed.
Crestview Center, a short-term and long-term care facility in Langhorne, is just one of thousands of nursing homes across the country that suspended visitation indefinitely last year.
For all, the pandemic dramatically transformed day-to-day life and how we interact with others, but such a change was profound for those living in nursing homes and similar facilities, Crestview spokesperson Lori Mayer said.
“Everyone has been impacted by COVID-19,” Mayer wrote in a statement, “but especially patients and residents in nursing homes.”
Without weekly visits from grandchildren or routine outings with other residents, people in long-term care were in isolation. That environmental change, over the course of several months, took a toll on some.
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William McTigue, deputy director of public affairs at Bucks County Area Agency on Aging, knows about such consequences firsthand.
The agency is affiliated with several senior centers, which hold activities and events for the elderly community. In speaking with some of the centers’ administrators, he’s heard a similar, recurring story.
“Some of the managers have said, ‘When so-and-so came back, I was really surprised at her inability to interact the way she normally does, she just didn’t seem as cognitively sharp,’” McTigue said. “Maybe five weeks later, they’re saying they’ve noticed quite a difference in the person’s behavior, I guess through the social connection.”
Addressing those behavioral or cognitive changes in a loved one, however, is not the easiest task.
While these conversations are important and families want what’s best for their older relatives, BCAAA Program Supervisor Lisa Hall said concerns and worries should be expressed gingerly. Talking about care options may “spook” elderly loved ones, who may fear they’ll be placed in a nursing home or lose complete independence.
When it comes time to address these topics, Hall advises families to stick to the facts and potentially call in a neutral party, such as the BCAAA assessment team.
“Older adults want to be treated as adults, even though they might become care dependent in some areas,” Hall said. “It’s important when you’re having a conversation like that to treat the individual with respect and the dignity that they deserve.”
Types of care exist on a spectrum, depending on an individual’s needs.
Assisted living, sometimes called personal care, allows older adults to “age in place,” Hall said. Residents there usually need help with bathing, dressing, meal preparation, and similar tasks, but the care is not as intensive as that in a nursing home.
If someone’s level of need exceeds that of an assisting living program, they may be discharged to a nursing home.
But for those seeking minimal help around the house, such as housekeeping, cooking, or other services, hired, out-of-pocket assistance is also an option, as well as senior day care.
Most older adults fear the idea of leaving their home to live elsewhere, perhaps for the rest of their life, but Reilly said the future of senior care will account for those hesitations.
“People want to stay in their own homes and their own comfortable environment, in their routine, as long as they can, or forever,” Reilly said. “I think we’re going to see more aging in place, for sure.”
Local resources are available through the BCAAA, which can provide information on different local programs — ranging from protective services to BINGO games — and make assessments to determine the best options.
Even if signs of aging aren’t readily apparent, Hall said it’s best to plan ahead.
“We always try to encourage people to think about these things a little bit,” Hall said, “before there’s a crisis.”