Check your parents when you see them at Thanksgiving

Warning signs that aging parents may not be safe at home can be recognized. Changes in usual behaviors and other signs portend a possible catastrophic event, such as a fall, swollen ankles, shortness of breath, unpaid bills, hygiene issues and memory lapses.

A list of signs and their causes includes:

  • Bruising of the hands, arms. This is likely caused by medication to prevent blood clots. Coumadin is the main culprit. It is difficult to keep a steady-state blood level, even if the person takes their medication at the same time every day and does not double dose (due to memory issues). Other culprits are Plavix, especially if the person is taking aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs, such as Ibuprofen, Advil, and Aleve).

  • Pale skin may indicate anemia, also common in the elderly. The anemia may be due to blood loss from blood thinners, as the blood is leaked into the gut slowly, malnutrition, or anemia due to the lack of activity in the bone marrow. Anemia is very common in the elderly, and is evidence by fatigue, loss of energy and pallor.

  • If the person’s tongue is dry, they are likely dehydrated. Elderly people lose their sense of thirst, and are generally dehydrated. Some avoid drinking fluids because they are taking diuretics and do not want to continually be going to the bathroom.

  • Difficulty doing the “Get Up and Go Test.” The test consists of having the person sit in a high backed chair (e.g., dining room chair) and then get up without using their hands, if possible. Then walk three feet, turn around and walk back to the chair and sit down. If the person appears unsteady when rising, when turning or when sitting down (need to hold onto something), they are at risk of a fall.

  • Repeated falls, or evidence of falls, include bruising of head or face and injuries to arms, legs, and knees. One in ten falls results in an injury requiring a hospital visit. One in ten Hospital visits require surgery for broken hip, leg, facial fractures, etc. And 50% of those people never return to their previous level of functioning, meaning that they cannot traverse stairs, drive a car, or may need to use a walker. Many elderly people who fall have symptoms of PTSD that interfere with attempts at rehabilitation. This also limits their function and increases the burden of care on the family.

  • Evidence of disturbed sleep patterns may indicate depression, substance abuse (especially Xanax or other benzodiazepines) or alcohol use. Alcohol takes twice as long for the elderly to metabolize, meaning that one drink is as potent as two in granddad.

Posted in Healthcare Advocacy, Uncategorized

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