How to Know When It's Time for More Help
Obvious events may make it quite apparent it's time to move your parents or in-laws to a different level of care, but the more subtle the situation, the easier it is to miss or remain in denial that something has to be done.
One fall does not necessarily mean your Dad is no longer capable of caring of caring for himself or living alone, but it should be a loud warning and should not be ignored. A second fall means you really have to look carefully at the situation and make some changes. You may just need to get the grab bars installed now, remove obstacles and throw rugs, or add an alert system or make sure he has a phone with him at all times. You may also need to examine other possibilities such as in-home care or a move to a higher level of care.
Certainly if an event has caused an injury or frightened your parent, you need to sit down and discuss how to improve the situation and what the options are. The severity of the situation will dictate how drastic a measure you need to take. You have to be alert to the cues and willing to accept the fact your parents are aging and are going to need more and more help as they get older.
It's common to ignore signals or to minimize them, especially if you are overwhelmed with other responsibilities or are having a particularly difficult time coping with the fact that your parents are aging. Facing mortality is not a pleasant experience, but it cannot be avoided.
If other responsibilities have you overwhelmed, perhaps it is best to call in reinforcements from your siblings or other family members to give you a more objective opinion of the situation.
Besides obvious falls, other clues can include increasing forgetfulness or confusion, changes in eating habits or personal hygiene, household chores being left undone, bills going unpaid and utilities shut off, or pets being neglected or unkempt.
Changes in mood and sleeping habits can also signal a need for change. Everyone can have a bad day or two, but ongoing issues should not be ignored. These signs can also indicate a change in condition that could warrant medical attention and should be evaluated by the PCP.
Try Something Different
Some solutions can be simple and may work for a while, or they may be short lived but help buy some time to make other changes. Using a newspaper to make note of the date or a daily calendar to cross off the days and make note of what day it is can help reorient your parent to time and reality. Wearing a watch may help your parent remember what time it is and be more based in the present moment. Using a loud kitchen timer can help remind Mom the food is done and to turn the stove off, as long as she remembers what the timer was for and to turn it on.
Post-it notes, memos on a calendar, signs, and even a banner can be helpful to remind her about simple daily tasks. Again, remember that after a while the brain will ignore these reminders, so they should be changed or moved to improve the effectiveness.
A new habit can take three weeks to develop, and an action must be repeated at least twenty-one times before the brain recognizes the pattern. Telling Dad to cross off the days on his calendar each night is not going to sink in as a new pattern of behavior right away. You're going to have to remind him several times before evaluating whether this can be a helpful tool.
If all of your best efforts are failing to help, a change in level of care may be necessary. This could be temporary, or it could be the start of a series of progressive changes.