Geriatric Care: Normal vs. Abnormal Aging

Your parents live on their own and every time you visit or talk to them, you notice things. Should you be concerned? Bonnie Gustufson, retired geriatric nurse, joined us at our March 7 meeting to discuss Normal vs. Abnormal Aging. Here is what we learned.

She began by sharing these verses which help us to see that God see no excuses for not to care for our parents.

Matt 10.37  Whoever loves father or mother more than me is not worthy of me, and whoever loves son or daughter more than me is not worthy of me.

Matt 15.3-6  He answered them, “And why do you break the commandment of God for the sake of your tradition? For God commanded, ‘Honor your father and your mother,’ and, ‘Whoever reviles father or mother must surely die.’  But you say, ‘If anyone tells his father or his mother, “What you would have gained from me is given to God,” he need not honor his father.’ So for the sake of your tradition you have made void the word of God.

Define Normal

As you observe your parents aging, you need to have a baseline. Ask yourself what is your parents normal behavior right now. If your parents are on a plateau it will make it easier to evaluate but the behavior may change. If both parents are living, they may not both be on the same plane requiring one to adjust to the pace of the slower one. If you are aware of this, it would be good to intervene and give them a break so they can go at their own pace for a bit of time.

In evaluating you want to look at how they are coping with everyday living. Our desire is to see our parents safe and comfortable enjoying their independence and freedom as much as possible. You must remember that you cannot be responsible to make them happy and content.

To get the best evaluation, plan to drop in at different times of the week and at different times of the day. This will give you a more well-rounded picture of what is happening in their lives. During conversation be sure to get down to what they mean by what they are saying. When your mom says, “I’m having a bad day.” inquire further as to what she means by “a bad day.”

Use Your Senses

One of the best ways to make observations is by using all your senses — hearing, sight, touch, smell, and taste.

Sight

As you approach the house, what do you see? Are there — advertising newspapers laying in the yard? weeks in the flower bed? mail in the box?  Then you need to verify what you see. Perhaps it is winter and the porch and walk were slippery so they chose to stay inside. That’s a good decision but perhaps there is an young person or adult neighbor who would be willing to bring these things in for them on a daily basis.

Are the railings secure? If not, these should be repaired.

Is the sidewalk or bricks uneven? If depth perception is off, they may not be able to see this and might stumble and fall.

Ring the doorbell. Does it work? Can they hear it or is the pitch too high?

Inside the house as you look at the floor, are there carpets and bare floors with rugs. Even if rugs are secure, the difference in depth and even color can be hard to be aware of.

Do they use the stairs to the second floor? Be sure the carpet is not worn and is firmly attached. If stairs are wooden, is there non-slip treads or tape? Again, is the hand rail secure? It’s even a good idea to have a hand rail on each side of the stairs.

Do your parents have a habit of stacking things on the stairs to take up or down with them? This can be a danger for falling.

Be sure there is a clear path from the door they use to enter the house to the kitchen where they’ll be taking groceries.

Smell

Smelling is another sense that can provide lots of insight. The one that first comes to mind is gas from a stove. If it is old and does not have automatic shut off or if they leave burners on, this can be a problem. Replacement to electric might be expensive but should be a consideration.

Do you detect body odor? Are they changing clothes and showering frequently enough?

Touch

In the kitchen, do the dishes in the cupboard feel clean? If not there could be a problem with their vision or perhaps the dishwasher is not working. They might not use soap when washing. Does the floor feel sticky or is it clean? May be spilling things. Do the pot holders have scorch marks?

Pay Attention to Changes

When there are interruptions to their routine, more attention may need to be given to their medications. Are they taking them as prescribed? Do they go only to one pharmacy for prescriptions? The pharmacist would be alert to drug interactions that are not good.

Physical changes that you might notice include:

• Skin –Is the color of their skin unusually pale?
• Ankles – Are they swollen? A little swelling is normal but when pressed should not leave a mark. Do shoes fit?
• Face – Is face sunken? Might not be getting enough food or water.
• Dentures – Are they wearing them? If not, why not? They might need relined.
• Eyes – Are they puffy, dark rings? Sometimes this can be normal, if it is unusual, they might need to increase fluids.
• Abdomen – Is it protruding? Could be there is a bowel problem.
• If they are heavy, they may need to use ointments in the heavy folds.

Additional Resources

These articles provide some additional information that you might find helpful.

• What is Normal Aging?
• Aging Parents: Spotting Health Problems
• Their Health and Well Being (booklet) pg. 8-11

 

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