By Dr. Katie E. Golden, MD

Many aging adults and their families reach a point when they need to consider extra support. And this can be fraught with challenges. Older adults understandably don’t want to lose their independence, or a life and home that feels familiar to them. And it can be hard for caretakers to know when they need to take that step, or even what that step looks like.

But getting extra support doesn’t have to mean a drastic change in someone’s lifestyle or a new environment. More and more people are opting for an aging in place — an approach that provides the proper support at someone’s home. This way, older adults can get the care they need to stay healthy and as independent as possible.

How do you know when an aging parent or relative needs help?

It can be really hard to know when it’s time to consider more care for an older adult. In some cases a sudden change in circumstances can make it obvious — like a new medical condition or loss of a spouse. But many times, the clues are more subtle. 

Here are some signs that you can look for to know when an older adult may need more support:

  • Mobility. Don’t wait for a fall. Watch the way they get in and out of a chair, or how easy it is for them to get to the bathroom. Look for slower movement, moments of unsteadiness, or increased reliance on holding onto nearby objects to get around.
  • Hygiene. Many self-care rituals can be increasingly challenging for older adults. This includes regular bathing, wiping after using the bathroom, brushing their teeth, and changing their clothes. 
  • Eating. Families often notice when an aging relative is eating less or drinking less. This can be because they are having a harder time getting groceries or preparing a meal for themselves. It could also be related to loss of appetite or thirst drive that is common in older age. 
  • Mood. This is an important one, but easy to overlook. Look for signs that someone seems more down than normal. This could look like a lack of interest in activities they used to enjoy, being more withdrawn from friends or family, or increased irritability. 
  • Memory. Memory changes are usually a little easier to recognize. Every aging adult experiences normal moments of forgetfulness. But it is more concerning when someone’s forgetfulness interferes with their ability to perform daily tasks — like taking a bath, or remembering how to get to the store.
  • Daily Tasks. Some people might notice that their parent’s house looks less clean than normal, their fridge is less full, or the laundry machine has not been used in over a week. They may also start to notice unpaid bills, or unfilled prescription medications.

The most important point here is that you don’t have to wait until it becomes obvious you or a loved one needs help. If you are beginning to wonder or worry, that is usually a good sign it’s time to consider more support.

What is aging in place?

One of the benefits to starting these discussions early is that aging adults and their families can follow an aging in place approach. This means that support services allow someone to get the care they need so they can continue to live at home. 

Providers who specialize in this approach describe four stages of aging in place:

  1. Fully Independent at home. In this stage, older adults are able to fully and independently care for themselves at home. This includes personal care (like bathing), home care (like cleaning and yard work), and transportation (like driving  themselves to the store or appointments). 
  2. Declining mobility. Home care can be taxing work. Someone in this stage may have house cleaners, or services that help with yard work and home repairs.  
  3. Difficulty with personal care. This is a stage when someone needs more help with personal care, and it looks a little bit different for everyone. Some folks need help with groceries and meal preparation, others need help with bathing and getting dressed. In this stage, home health aids can often help perform many of these daily tasks.
  4. Increasing healthcare concerns. This is when someone has more medical care needs. It can be from a progressing condition — like dementia — to an acute medical illness — like a fall or injury. In this stage, support goes beyond just help with daily activities. It can also involve things like medication administration, skin and wound care, or physical and occupational therapy (to name a few). 

What other options are available for long term care?

Aging in place is not always an option depending on someone’s particular circumstances. But there is a whole spectrum of care that families can consider when making the best decision for each other. Other options include:

  • Moving in with a relative. Some families prefer to cohabitate rather than explore care communities. This can alleviate the financial burden of facility care, and be a natural solution for some families. But it can also place a significant strain on a caregivers professional and family life, as well as take a toll on their physical and emotional health. So it is important to weigh the advantages and disadvantages of this approach for all parties involved. 
  • Assisted living facility. These are communities of older adults that provide more supported environments than a standard apartment building. These facilities are designed to allow someone to have the independence of living on their own, but staff can often help with activities like personal hygiene and meals. They are often not equipped to provide on-site medical care.
  • Nursing facility. A ‘nursing home’ is designed to provide more support and medical care than an assisted living facility. This means they have healthcare professionals on staff 24/7 to help with daily medical needs, but also medical response in the event of a new illness or emergency. 

Every family’s situation is unique. And the best care for an aging family member takes into account their needs, as well as the needs and circumstances of those around them. But no matter what, the earlier you can start these conversations, the better. This way, you won’t have to make these decisions in the midst of a medical crisis.