“How are you and dad doing mom?” “We’re fine.”
Sound familiar? People tell me they “are in the dark” when it comes to their parents’ health and how they are managing at home. Phone calls typically start and end with a series of questions and the response is “We’re fine.” If you are headed home for the holidays, here are three tips to determine if your parents need help to age-in-place:
- Observe
- Assess
- Ask
(Jump to Lessons Learned)
Observe: When visiting, don’t take over chores
Experts have found that it is usually the little things like not being able to shower, or use a can opener that end up being the reason someone cannot live independently. When you visit, don’t automatically take over cooking or cleaning. Yes, you can do it faster but take time to observe your parent’s ability to perform simple tasks like opening a jar or navigating the stairs. Don’t be surprised by big changes since the last time you visited. As mom’s part-time caregiver, I recently noticed she is not able to open jars as easily as she once did.
- Is there a drop-in housekeeping?
- Is there evidence of a car accident (e.g. damage to the car body)?
- Can they reach items without using a step stool?
- Are there trip hazards from throw rugs or inadequate lighting?
- Unpaid bills or missed appointments?
Assess: Are your parents able to carry out normal activities of living?
In your assessment, be aware if one (or both) of your parents are having trouble completing three or more of the activities considered “normal” for living at home. Doctors, agencies, and hospitals look at Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) to determine what type of help your senior needs. The ability to carry out ADLs and IADLs play a role in getting financial aid. If your senior is unable to perform three or more Activities of Daily Living and meet other criteria, they may be eligible for for VA Aid and Attendant Benefits.
Activities of Daily Living (ADL)
I first heard this term when the home care agency we were interviewing assessed mom and dad’s ability to carry out AM and PM activities that we normally do for ourselves. Activities of Daily Living include:
- Mobility – walking, going up stairs, getting in and out of the bath
- Personal Care – Toileting, bathing, personal hygiene like brushing teeth
- Self-Care – Feeding ourselves, dressing without help
Instrumental Activities of Daily Living (IADLs)
This term refers to tasks that allow you to live independently in your home. These are the tasks that dad could no longer perform, which is why we hired a home care agency (non-medical) for 6 hours a week.
- Household tasks – preparing meals, laundry, light housekeeping
- Household management – managing money, using the telephone, taking and managing medications
- Tasks outside the home – driving or public transportation for grocery shopping, banking, doctor appointments
Is one of your parents becoming more and more responsible for helping the other carry out these activities? Is it too much for them? If you decide your parents need help with these activities, it is time to have a what can be, a difficult discussion. (Help in Caring for Parents Using Community Resources)
Questions to Ask: Your parents know exactly which activities are proving difficult.
- “What do you need to be able to do in this house to live here comfortably?”
- If the answer is bathe, then be prepared to modify the bathroom as my parents did. If taking the tub out is not, consider options that do not have to be built in. (A lawn chair does not count as a shower seat!) Without these modification, our parents resort to taking “birdbaths”. Hygiene limited to standing at the sink can have serious health consequences. (Keeping Parents Safe at Home Does Not Have to be Expensive)
- A drop in beloved hobbies and a decline in socializing are clues that managing normal activities are getting more difficult.
- How is your bridge club doing, do you still meet on Tuesdays?
- How is So-and-so from church?
- ADL and IADL are not considered to be skilled care services, so they are not reimbursable under Medicare. Payment is private.
- Home care is defined as non-medical tasks that relate to housekeeping, meal preparation, shopping, laundry, cleaning or transportation services. It can also include companion care, which is someone sitting with your loved one for companionship, or so they are not home alone.
Disclaimer: The material in this blog is for educational purposes only. It is not intended to replace, nor does it replace, consulting with a physician, lawyer, accountant, financial planner or other qualified professional.
