How do caregivers determine if a situation is high risk?

Why won't my Mother accept help? My father won't stop driving and he has had numerous accidents this year. What should I do?

“Why won’t my Mother accept help?”

“My father won’t stop driving and he has had numerous accidents this year. What should I do?”

“My Great Aunt denies needing any help despite evidence of missed meals and unwashed hair. Can you get her to accept help?”

Sound familiar?

Unfortunately, there are no easy answers to these questions or a magical spell, for that matter.

Canadian society, as a whole, places value on maintaining control and independence. This doesn’t change with age and as long as an individual is cognitively competent, they have the right to make their own decisions.

When should caregivers intervene then? By this, I mean, how do caregivers determine whether the situation is considered high risk?

A caregiver or family member should step in when an aging loved one is behaving in a way that is not normal, or when a parent’s behaviour doesn’t fit with a required action.

For example, we received a phone call from a woman who was concerned about her neighbour. She noticed her frail elderly neighbour walking around at four o’clock in the morning, inappropriately dressed, looking for her husband. Her husband has been dead for 10 years.

This is an instance when immediate assistance is required. Probably the best course of action is to notify Home and Community Care in the Comox Valley at 250-331-8570.

Probably one of the most challenging situations is when an aging parent is in the early stages of dementia. Typically, the elder is aware that something isn’t right with their brain but can’t quite figure it out.

Missed medications, unhealthy weight loss due to missed meals, burning pots or causing floods are often red flags but unless combined they may not be considered a high-risk situation.

All situations involve a great deal of grey where some degree of risk exists. If you aren’t sure whether to intervene, often taking a step back and simply observing with objectivity is a good place to start.

If you feel you still can’t evaluate the situation objectively, consider engaging with a professional, be it a case manager with Home and Community Care, family physician or a private agency. Trained professionals can help make an assessment to determine the level of risk along with some ideas for planning next steps.

Trying to get at the root of resistance by patiently asking your loved ones will often shed more light into the situation. It may not result in acceptance of assistance immediately but may start to break down some of the walls.

Be compassionate and put yourself in their shoes. Would you react any differently? If you reach a deadlock, do not give up. Be patient and come back to the focal point, “What are the wishes of the older person?”

For some family members, being prepared to set firm boundaries and sticking to them is can be the best solution.

Ultimately, unless there is a major risk to others, or an aging loved one is deemed incompetent to make decisions for medical reasons, your aging loved one has final say regardless of how you feel about the decision they choose to make.

Wendy Johnstone is a gerontologist and is the founder of Keystone Eldercare Solutions. Her column runs in the Comox Valley Record every second Thursday.

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