Signs of Decline in Elderly May Require Intervention


Within the next few days, airports will be overflowing with travelers heading home for the holidays. But adult children expecting a joyful family reunion may find an unpleasant surprise awaiting them: a sharp decline in the health of an elderly parent or family member.

The sad fact is that an older person’s circumstances can change quickly. A broken hip or an illness can transform a self-sufficient senior into a frail, needy person who requires constant attention.

Even if the changes are gradual, they can seem striking when family members visit just a few times a year.


Like most people, seniors don’t want to relinquish their independence by admitting they may be losing some of their faculties or abilities--a response that compounds the underlying health problem.

And adult children may try to deny the gravity of their parents’ or relatives’ condition, refusing to see that anything is wrong until an emergency occurs.

“But the sooner we can pick up clues, the less possibility problems will escalate into a crisis,” says Joy Loverde, a geriatric care expert. “Family members must be continuously proactive because the older generation is reluctant to ask for help.”

So how do you determine when it’s time to step in? Here are some warning signs elderly family members may not be coping with the ordinary demands of life.

* Empty cupboards and refrigerators. A lack of food in the house, or larders filled solely with TV dinners and canned soup, means they’re not getting adequate nutrition. It also may mean they don’t have the energy to cook meals or that they’re having mental problems.

“If you’re having memory lapses, it’s more challenging to put together a meal,” says Donna Benton, director of the Caregiver Resource Center of Los Angeles County, which is part of the Andrus Gerontology Center at USC.


* A change in eating habits. Accompanied by sudden weight loss or gain, this can signal the onset of depression. But loss of appetite could also be due to something as simple as the fact their teeth are bothering them. “Getting them fixed can miraculously restore their interest in food,” says Loverde.

* Poor grooming. If your immaculately dressed mother suddenly looks unkempt, that’s good reason to be alarmed.

Examples include clothes that don’t match, are stained or are soiled (a musty odor may suggest incontinence); nails that are dirty and jagged; and hair that is uncombed.

“These are hints of mental or physical deterioration,” says Benton. “They may be too weak to groom themselves or simply have forgotten to comb their hair or brush their teeth.”

* Deterioration in housekeeping. Stains on the carpeting or floor means they’re spilling or dropping things, an indicator of muscle weakness or problems with mobility. Scorched pots may be due to memory lapses.

Piles of unopened mail “means they don’t want to deal with it,” says Loverde. “They’re often unable to read the smaller print, and they’re afraid to tell anybody they are less competent in handling their own affairs.”


* Unexplained bruises. These marks can indicate recent falls. “Falls are a warning sign of such diverse problems as muscle atrophy, mismanaging medications, osteoporosis, or neurological conditions,” says Steve Barlam, vice president of LivHOME, a Los Angeles elder care consulting firm.

* Social isolation. Have they withdrawn from their social network, which is a symptom of depression? Has the phone stopped ringing because no one calls them? Do they watch television all day? Are there sweepstakes mailers around the house? Often, the telemarketers may be their only source of social interaction.

“Talk to neighbors and old friends,” suggests Benton. “They can give you a more accurate picture of what’s going on in your relative’s life.”

* Decline in mental abilities. Do they have a poor short-term memory? Difficulties with word recall? Do they constantly repeat themselves? Do they seem confused? Unable to follow directions?

“Cognitive problems aren’t always a sign of Alzheimer’s,” says Barlam. “They can also be triggered by poor nutrition, other neurological problems, like minor strokes, depression or even being over-medicated. And among older women, confusion can be a symptom of urinary tract infections.”

The good news, however, is that if an older loved one needs help, there’s plenty you can do, even long distance.


For further information:

Los Angeles Caregiver Resource Center: (213) 740-8711 and

Elder Care Locator, a service of the U.S. Department of Health and Human Services that provides referrals to local resources: (800) 677-1116; or the department’s Administration on Aging site at

National Assn. of Professional Geriatric Care Managers, which can furnish names of professional evaluators: (520) 881-8008;

Also, every U.S. county has an Area Agency on Aging that can refer you to local services. For information, call (800) 510-2020.