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How to recognize signs of needs and effective family intervention

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People tend to reject help as they age, and your parents may not let you know if they need it. Therefore, attention to different signs and indicators is essential to detect whether older adults require assistance at home. As a family member, you may need to act as a detective and determine when to intervene.

Here are five ways to detect if an older adult may require assistance, followed by steps on when and how to intervene.

5 Ways to Detect Need for Help

Changes in Home Cleanliness and Organization:

  • Neglect of household chores
  • Clutter that could cause tripping hazards
  • Spoiled food in the refrigerator or pantry
  • Piling up of unattended laundry

Physical Health and Mobility Issues:

  • Difficulty moving around the house
  • Unexplained bruises or injuries
  • Sudden weight loss or gain
  • Neglecting personal hygiene

Mental Health and Cognitive Changes:

  • Forgetfulness, such as missing appointments or medication
  • Difficulty performing familiar tasks
  • Changes in mood or behavior
  • Signs of depression or withdrawal from social activities

Financial Management Problems:

  • Unpaid bills piling up
  • Overdue notices or disconnection warnings
  • Unusual banking activities or purchases
  • Signs of financial exploitation

Safety Concerns:

  • Inability to operate appliances safely
  • Leaving the stove on
  • Difficulty driving or recent accidents
  • Misplacing potentially dangerous items such as knives or medication.

Steps to Intervene as a Family Member

  1. Assessment of the Situation
    • Observe the changes and gather information discreetly.
    • Discuss your observations with other family members or friends to validate your concerns.
    • Consider seeking professional assessments from a doctor, nurse, or social worker if necessary.
  2. Communicate Openly and Respectfully
    • Approach the elder with respect and concern, not with judgment or anger.
    • Have an honest conversation about your observations and express your willingness to help.
    • Listen to their concerns and preferences to understand their perspective.
  3. Plan Together
    • Collaborate with the older adult to create a plan that respects their autonomy and addresses safety.
    • Include other family members in the planning process to ensure all perspectives are considered, and responsibilities are shared.
  4. Implement Gradual Changes
    • Start with the least invasive forms of help to allow for adjustment.
    • Gradually introduce professional help, such as home aides, meal delivery, or medical alerts.
  5. Monitor and Adjust
    • Regularly check in to see how the elder is coping with the changes.
    • Be flexible and ready to adjust the plan based on their needs and feedback.
    • Ensure ongoing communication to address any new concerns that arise.

When older adults refuse help, it can be a delicate situation that requires tact and understanding. Here are two ways families can approach the conversation and encourage acceptance of assistance:

1. Reframe the Help as Empowerment

  • Approach: Explain how accepting help can increase their independence rather than diminish it. For example, getting help with housekeeping or shopping could conserve their energy for more enjoyable and meaningful activities.
  • Communication Tips:
    • Focus on the benefits: Stress how the help will allow them to maintain other aspects of their independence longer.
    • Use positive language: Talk about “support” rather than “help” and “staying active” instead of “avoiding harm.”

2. Involve Them in the Decision-Making Process

  • Approach: Ensure they feel in control of their life and the help they receive. This could mean letting them choose who helps them or what kind of help they are comfortable receiving.
  • Communication Tips:
    • Offer choices: Instead of presenting help as a necessity, provide options. For example, ask if they prefer a professional caregiver or a family member to assist with specific tasks.
    • Be patient and listen: Allow them to express their fears and objections, and address these concerns respectfully and thoughtfully.

Thoughtful intervention can help maintain the independence and dignity of older adults. In some situations, trust your gut about intervening for their safety and well-being, even if they reject it. 


“My dad was in denial and kept pushing us away when he was diagnosed with COPD and cancer. We had to force our help. He finally expressed gratitude for our love and care during his end stage. I’m sure many of you have situations and personality differences; do it from your heart.” 

(Allen, S – Seattle)

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