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Keep a watchful eye on aging parents

Families should talk openly about potential problems as loved ones get older, experts say.

July 21, 2010 at 7:17PM

300 dpi 4 col x 11.5 in / 196x292 mm / 667x994 pixels Michael Hogue color illustration of caregiver pushing an elderly woman's wheelchair. The Dallas Morning News 2004 With MED-ALZHEIMERS, The Dallas Morning News by Bob Moos KEYWORDS: krtbusiness business krtdemographic demographic krthealthmed krtnational national krtalzheimer alzheimer's disease alzheimer krthealth health krtseniorhealth krtseniors senior citizen krt old age sickness illness aging alzheimers coddington hogue moos da contributed edad elderly grabado illustration ilustracion negocios nursing home old age social security viejo wheelchair 2004 krt2004 (Dallas Morning News/The Minnesota Star Tribune)

Her name is (fill in the blank).

She's lived alone ever since her husband died.

Her adult children watch her anxiously, hoping that her last years will be happy ones.

But when she exhibits signs of confusion (or breaks her hip or has a stroke), her children panic. They don't know what to do.

"We cross our fingers, and our parents do, too," says social worker Nancy Wilson, a faculty member at Baylor College of Medicine in Houston. "It's as if we're in a conspiracy together that the worst-case scenario is not going to happen."

Instead of that pact of silence, Wilson, Dr. George Taffet and Anita Woods, all staff members at Baylor's Huffington Center on Aging, encourage families to talk openly about potential problems and likely solutions.

They also tick off some warning signs, indications that the older adults may need more help than they're getting.

For example, Wilson says, "Maybe your mom used to be very social but she doesn't go out anymore. Or she used to manage the finances but she doesn't now. When you go to visit, you see stacks of unpaid bills. Or she sent four cards in a row to mark the same event. Those could be signs of change in cognition."

There are physical signs of deterioration, too.

Maybe your dad is falling. Or making regular trips to the emergency room because of car accidents. Or struggling with incontinence.

Wilson said her mom wound up in the hospital because she bought a new car, then got so suspicious of the deal she had just agreed upon, she returned to the dealership and made a scene.

"Her suspicions were out of bounds, not normal consumer concerns," Wilson says.

After her mother was tested and found to have early dementia, Wilson and her mom sat down together and made a plan. The older woman moved into a community that allowed her some independence but also provided her with help and support.

"It's important not to react too quickly," Wilson says. "We were looking for a place that would gradually provide more care. I didn't want her to have to move again."

Taffet, associate professor and chief of the section of geriatrics in Baylor's department of medicine, mentioned other signs that might indicate trouble:

"Are they getting lost, particularly in familiar environments? Are they having medication issues? Do you notice that one prescription hasn't been filled for three months or that the pills are all mixed up? Sometimes someone will say, 'I took a handful this morning.'"

Woods, the Huffington Center's director of education and training, says signs of trouble for some clients can be as basic as remembering to shower and brush their teeth. Are their buttons fastened correctly? Are they dressed in a way that is normal for them?

Check the refrigerator, the psychologist suggests. If it's empty or the food is rotten, that's trouble.

Woods says her mom became susceptible to scams: "She was sending money to a lot of places she didn't need to be sending money to."

The goal, Woods says, is to honor a person's dignity and self-esteem and help the senior walk the line between independence and safety.

"The idea is to plan ahead of the crisis. I do think Americans get a bum rap about dumping older relatives. In my 30-plus years in this field, I've seen families go to the ends of their emotional and financial resources to do the right thing."