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Help Does Mom or Dad Really Need?
Take a step back. There are times when that's
the first move you need to make when trying to determine how your parent
is doing. Look at the situation the way a concerned but objective
"Mom used to be so active . . . ."
"Dad's just rattling around that big, old
house . . . ."
"My parents are eating less than what I
feed my preschooler . . . ."
What do you need to be looking for when you're
trying to determine how your parent is doing? How your parent is really
The bottom line is this: Is your parent safe in
his or her present situation and able to do the things he or she wants
to do, and if not, what steps need to be taken to make that happen?
"To do the things he or she wants to
do" brings up the issue of quality of life. You need to remember
it's your parent— not you, not your siblings, not your parent's
siblings, not a concerned neighbor—who determines what that life will
Wait a minute here! If Dad refuses to go to the
senior center anymore and prefers to stay home and watch "The Young
and the Restless," "All My Children" and "General
Hospital" every day, don't you need to step in—for his own good—and
. . . .
Maybe. Maybe not. That's what assessing is all
about. It's looking carefully at each piece of the jigsaw puzzle to get
the complete picture, and not simply focusing on one or two pieces. The
complete picture needs to include information from basic areas:
physical, mental, emotional or social, and spiritual.
What can make the task even more difficult is
trying to look at each area objectively. It can be hard to put aside
emotions, and there's always the temptation to gloss over some area or
need because the truth can hurt so much. ("Well, yes, Mom doesn't
seem to hear everything that's said but . . . .")
And you need to base your assessment on what
you see your parent doing or not doing now. ("I know Dad's always
been able to . . . .")
Also, you can't dismiss an apparent problem
with a handy excuse. ("If he weren't tired today, I'm sure he could
. . . .")
It's best to begin any assessment with
reviewing some good, basic information on the aging process to get an
idea of what's normal. For example:
● Dad says he seems to be forgetting
things lately. Should I worry?
● Mom says her feet have gone numb. Is
● Dad has trouble reading the newspaper.
He's just sure the print has gotten smaller. What's that mean?
● Mom used to get up at the crack of
dawn. Now she's sleeping in till 8:00 or so. Is that bad?
Your parent's doctor is a good resource for
getting that type of basic information. So is the Area Agency on Aging.
It can be contacted through Senior Information and Assistance.
If your parent has been diagnosed with a
particular illness or disease and you want information of a more
specific nature, visit the web site for the national association that
focuses on it. Often there’s also a toll-free number. Or call
information (1-800-555-1212) and ask for any listing under that
particular topic. For example, "Parkinson's Disease" or
Once you have a basic idea of the aging process
and any diagnosed conditions you can better look at the major areas of
Your parent needs to see a doctor for a complete physical examination,
and you both need to listen to what the physician recommends.
You need a good—meaning clear—diagnosis.
Hearing "It might be this or it might be that or it might be
something else" isn't going to help. You may not get an exact
answer the first time. Keep asking, report any changes in symptoms and
be persistent. You also need to ask about the prognosis. The diagnosis
is the identification of the disease from tests and symptoms. The
prognosis is a forecast of what's going to happen because of that
particular problem. For example, how long will this symptom last? Will
other complications and problems follow? How soon? Will there be a rapid
deterioration in health or a gradual one? And so on.
Your parent's hearing and vision also need to
And take a look at your parent's daily routine.
How is Mom sleeping? Has she lost weight recently? Is she smoking? Has
she been drinking more? Should she be drinking at all with the current
medication she's taking?
What medications is Dad on now? If he has more
than one doctor prescribing more than one medication, does each doctor
know what the other has given him?
What about mobility? Can Mom get up from a
chair and walk around? Does she need some adaptive equipment, such as a
walker or cane?
Is there a problem with incontinence, the loss
of bowel, or more commonly, bladder control? This is difficult to talk
about. Although there are many television ads praising the benefits of
adult protective wear, the subject is still taboo in many households.
Yes, it can be extremely embarrassing to have to ask or answer questions
about incontinence but it needs to be done. And done respectfully.
And finally, listen when your parent tells you
his or her symptoms. It may be that day after day, week after week, it
seems to be the same litany of minor aches and pains or of problems
already being addressed, but there could be something new in there.
Something that needs immediate attention.
How is your parent's memory, both long- and short-term? Does Dad seem
confused? Can he remember Christmas 1955 but forget to eat? Can he still
handle his own finances? Can he make and stick to a decision or does he
seem able to say yes and no in the same sentence and mean both?
Is Mom showing poor judgment? Did she leave the
front door wide open all night—in a very unsafe neighborhood—because
it was hot out?
Does she know what day it is? What time of day?
Can she follow a conversation? Does she seem to
have trouble with her receptive language ability? (Her ability to
understand the words you use and follow the general train of thought in
everyday conversations.) Is there a problem with her expressive
language? (Does she use the wrong word or seem unable to come up with a
word for which she's searching?)
Is she using "suicidal phrases"? Does
she say things like "Life's not worth living anymore." "I
don't want to be here." "What's the point?" "I hope
it's over soon." "It would be better if I just died."
Is she aware of her mistakes, and does that
make her feel frightened and angry or is she oblivious to them?
Is there evidence of dementia—cognitive loss—a
deterioration in mental ability? Do you need to arrange for a
Emotional and Social
Again, what do you see? Is Mom depressed quite a bit of the time? Does
she not want to get up in the morning? Does she complain of having no
energy? Does she burst into tears?
Is she grieving? Has she recently suffered a
major loss? (The death of a spouse, failing health, an amputation and so
on.) Does she seem angry all the time? Frustrated? Resistant to any
Is she frightened most of the time? Is she
generally anxious or agitated? Is she afraid to stay alone at night or
does she panic when you say you have to leave?
Has her mood been taking wide swings, from
extremely angry to completely passive?
What about socially?
Does it seem that Dad is becoming more and more
isolated from the rest of the world? Does he get out and see other
people as much as he wants to? Have telephone calls and letter-writing
replaced visits, and is he content with that?
How does he spend his leisure time? Does he
just sit in front of the television during most of the day? Does he have
any hobbies? Does he have a pet?
Is he just not interested in anything anymore
or has he adjusted his interests to match his abilities? (For example,
he used to love gardening and now he reads gardening magazines and
watches gardening shows on TV.)
Does Dad know what he needs and if so, can he
get it for himself? If he wants to go some place, can he figure out how
to get there—by walking or driving, by taking a bus or taxi, or by
arranging to have someone drive him? Is he still involved at his parish?
If he can't make it to Mass, can he arrange for someone from his parish
to stop by the house? Does he stay for "donuts and coffee" and
visit with fellow parishioners.
How about Mom’s spiritual life? Does she practice her Faith the same
as in the past or has it faded away?
Does she continue to attend Sunday Mass? Has
she faithfully attended daily Mass, but now can’t or doesn’t want
Does Dad have access to the Sacraments? If he
can’t go to Mass, does he have a Eucharistic minister come each week?
Is his parish community involved in his life?
Is he on the list of the sick in the parish for the "Prayers of the
Faithful" at Sunday Mass? Does he still attend his monthly Knights
of Columbus meetings?
Has he talked to a priest lately? Would he like
to arrange an appointment for your parish priest to stop by for a visit?
Does he have a Bible near-by for reading? Would
he like other spiritual reading? Lives of the Saints? Daily devotional?
Do you and your parent pray together? Would he
like to? Would he like to say the Rosary?
Does he seem at peace with this time in his
life or is he frightened, bitter, angry and confused? Does he ever
express a desire to improve the spiritual part of his life?
From an evaluator's view
There may be a major concern in one of the areas that obviously needs to
be addressed first. It could be that nothing stands out, but there are a
lot of little problems which, added together, may mean a parent needs
some kind of help from you.
To evaluate a senior's living situation
considers the individual's "activities of daily living."
Without help, can she: eat, walk, use the toilet, take a bath, and get
We also need to look at "instrumental
activities of daily living." Can he: handle the finances, go
shopping, drive the car or take the bus, do the housework and laundry,
prepare meals and take the right medication, at the right time, and in
the right amount
Once needs are determined—and sometimes it's
best to do this with that outside, more objective help—then you can
investigate how those needs can begin to be met by family, friends,
neighbors, people from the parish and professionals.
But keep in mind that those needs may
fluctuate. Mom may have to have someone in to help with the cooking
and cleaning for a while after her surgery but later she can resume
those duties. Dad might have had no trouble writing the bills six months
ago, but recently there have been a lot of extra charges for late
Assessing a parent's need isn't a one-time
task. It's a job that needs to be repeated periodically to make sure
you're seeing all the little pieces in order to get a clear view of the
big picture: your parent's health, safety and quality of life.
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