In 2001, my 75 year old mother became a widow. She's a small woman, one who lived an hour and a half away from any of her children. She had always focused her life on caring for her husband and children, although she had worked outside of the home for more than 35 years. In fact, she had spent the previous 10 years of her life being the sole caretaker of my father who had Leukemia, Parkinson's disease, as well as significant arthritis and osteoporosis. It wasn't an easy job. Upon my father's death, my primary concern became my mother and how well she would cope and be able to care for herself. She had never in her entire life lived on her own. The isolation particularly had me worried.
What any individual senior needs at such a juncture in their life will vary greatly based on their overall health, emotional adjustment, resources, and a variety of other factors. But for many of us, having to examine the needs of at least one elderly parent is a certainty.
The following is a list of some of the types of things I had to consider over the next few years as my mother continued to live indepedently with support from family members. These aren't "professional recommendations" but they are my personal experiences.
-- Emotional Needs
Depression among the elderly is fairly high. Certainly, following the death of a much loved spouse, depression could be anticipated, even if only episodic. Some seniors might be willing to talk with someone about their feelings but obviously some will not. This was the case in my situation and I had to turn to some short articles which discussed coping with the death of a spouse to at least get my mother thinking through some of what she was experiencing. I was able to have a few brief discussions with her but generally had to wait until she said something to have any heart-to-heart time. Because of this, I just had to be sure I was available.
If depression seems to be a problem, I would also recommend talking with the physician as to whether or not an anti-depressant would be appropriate. I'm not an advocate of too many medications especially with older individuals who aren't monitored and have a number of other medications, but certainly there are times when it may be the best option.
-- Social Isolation
In addition to age and health related issues or the need to cope with the loss of a loved one, social isolation can compound the emotional issues that can occur with an aging senior. Over our life time we lose friends and family. For many older people who aren't working, social circles often diminish. Children frequently move away and social isolation can settle in for a long stay. Certainly, this can raise concerns for physical safety as well as emotional health.
Encouraging a relatively healthy elder to participate in groups, volunteering, neighborhood activities, and other events is a good idea. Many communities even offer affordable senior transportation for those who don't drive. My mother, being a life long introvert had no interest in such things. It took a bit of pushing, but eventually she was able to begin participating in a few of the activities she used to enjoy such as shopping, going out for lunch with family members, and doing just a little site seeing.
My mother was talked into buying a computer to allow her to chat and e-mail family members despite their distance. For seniors who are too timid about technology, there is also the option of the HP Printing Mailbox. This is an affordable device that allows a person to receive printed e-mails (and photos) without a computer. It's affordable and requires no tech knowledge. I also began calling my mother daily as a check in. It was part social and part safety check.
Another consideration for many families is where an elderly parent should live. I don't have a definitive answer for this but would suggest that there is more to consider than the immediate access to family members. For some seniors, feeling comfortable in familiar surroundings can be critical to maintaining independence. Moving to an unfamiliar town, disrupting long standing relationships with physicians, hair stylists, and others can be a hurdle for some. This is accentuated if life long friends and acquaintances are also involved. If familiarity is crucial, it might be better to find services within the community to help as needed and work to increase family contact through other means. Clearly, it's the senior themselves who must make this decision.
-- Physical Needs
Over a period of a couple of years my mother's physical strength, endurance, and her balance declined. Keeping seniors engaged in physical activity is important. Regular walks can be very beneficial and sometimes a small pet can help get them out each day. Many communities also have rehab centers, skilled nursing facilities, or community centers that offer senior specific exercise programs complete with appropriate equipment and monitoring all for a very low monthly fee. My mother attended rehab for a short time and was given exercises to complete at home. Just as in many communities, bus transportation was provided at minimal charge.
I learned over time to use my mother's physician to help in getting my mother to do some things she needed to do. Because my mother didn't drive any longer, I took her to her appointments and had the opportunity to prompt the doctor to make recommendations regarding exercise, diet and so forth that she otherwise would not have discussed with my mother. Physicians are busy people and many older patients are reluctant to question them, so being there to facilitate was very helpful.
At home, I worked to be sure things were accessible: that she had a long handle on her kitchen faucet that she could easily reach, that there were grab bars on the tub to assure she could get in and out, and that she had a very sturdy step stool that was light weight since I couldn't keep her from climbing up on things. I don't recommend many of the modern bathtubs that are built in with a deck surrounding them; they're very high and often create extra distance between where the person stands and where they actually step into the tub. I poured laundry detergents into smaller bottles to be sure she could handle them, and got her a special jar opener which could help her in the kitchen. I made sure rugs were secure and unlikely to trip her and that pathways were unobstructed so that the chance of a fall was reduced.
Medication dispensers became important too as she began to have more than one or two things to remember.
My mother's diet became a concern as well. Eating is often a social behavior and eating alone often results in eating less over time. During my weekly visit I took the time to prepare a few meals that she could just stick in the oven later in the week. I also targeted eating as an activity during visits and worked at rekindling a love of cooking we once shared together. We would browse cookbooks and magazines until we found a great recipe and would then get to work in the kitchen. I particularly focused on proteins which she typically avoided and the doctor recommended!
-- Mental Stimulation
I hated to see my mother spend hours just watching TV or piddling around her house. Over time, I was able to get her interested in reading, she had always loved mysteries. I would go to library book sales and buy them by the bag full. Crossword puzzles, jigsaw puzzles, solitare on the computer, and similar games were things she would do on occassion. I would take her for a drive to another town and ask her to be my navigator; anything to get her involved and thinking.
Certainly, as a parent continues to age their ability to live independently has to be continually assessed. For instance, if they are no longer able to cook or can't be relied upon to turn off the stove, moving in with family, relocating to an assisted living environment, or perhaps ordering "meals on wheels" would need to be considered. Being alert to physical and mental issues is critical to avoid catastrophe. Being present long enough to really evaluate how someone is functioning is critical. Not all seniors will report the difficulties they may be experiencing. Sometimes creativity and working with healthcare providers to identify appropriate community resources and adaptive aids can help seniors to live in their own homes longer.
