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When Home Sweet Home Isn’t – part 1

Safety guide for geriatric careI have written about “aging in place” a number of times in the past, and that really is an apt way to frame the conversation that many of us who are caregivers will have with our aging loved ones.  It is about your loved one…and how well they can manage independent living as they age, and it is also is about how well their home (place) may be suited to their present needs.  In this posting, I am revisiting the first part of that with a short check list for those of you with an older loved one in your orbit.  I’ll provide the second half of the conversation, a home fitness test, in the next post.  (You can also get a downloadable version in the White Paper illustrated here.)

If you as a family are unsure about a loved one’s ability to safely live independently, you can start with an assessment of how that person handles the basics of what we call activities of daily living (ADLs).  Here is a checklist of the six basic categories of ADLs and how you can make an initial assessment yourself:

  • Hygiene: Do you see signs that they are not bathing, brushing, grooming as regularly as they once did?
  • Continence: Are there signs of “accidents” that they or their spouse may be trying to hide?
  • Toileting: Very simply, can they manage the bathroom on their own?
  • Dressing: Do they have the balance or strength to change in and out of clothes?
  • Eating: Do they have the dexterity to bring a utensil from the plate to their mouth, cut their own meat, etc.?
  • Transferring:  Can they get from a chair to the bed, from the bed to another location, in and out of a car, etc.?

Take the example of one of our clients; I’ll call her Rose. Rose was living independently.  The first sign she might be having trouble was when one of her adult children found a significant accumulation of soiled laundry at the foot of the basement stairs.  Rose had been able to take her dirty clothes and linens as far as the door to the basement, but navigating stairs up or down was not as manageable.  Fortunately, Rose also was unable to dust the floors, so the adult children could see a clear path through the dust to her favorite chair from her bedroom.  They also noted some “science projects” in the refrigerator that spoke to how well Rose was able to feed herself.  You can fill in the rest of the story.  The good news was that with scheduled home care from an agency, Rose could still remain safely in her home.

Had this been a story about “forgetting” to turn off her gas stove burner or consistently burned toast, and more, it might have been a different discussion and solution.  When going through the checklist, I recommend two members of the family collaborate.  It will be more “objective” then, and two can also better prepare for “that conversation” with mom than one.

Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago.  She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.


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