Planning for the Care of Aging Parents

Source: AARP.org | June 19, 2003

Session 3: Assessing the Situation

While it is possible for families to complete assessments on their own using standard forms, there also are experienced professionals available who can help. Some hospitals and clinics offer geriatric assessment centers or evaluation units in which a medical/social work team looks at all aspects of an older person’s health and life. The center will counsel your parent and you about the results, as well as offer practical assistance, such as linking you with local services and housing options. Individual geriatric care managers (also called case mangers) provide similar services.

What you should assess

Professional assessments can take from three hours to several days to complete, and even filling out a form with your parent can take considerable time. What factors should you assess? Although different forms and professionals will offer slight variations, a thorough assessment should include the following topics.

Physical health. Selected factors to assess: Diagnosed with any chronic diseases (such as diabetes, high blood pressure, arthritis, emphysema)? Other illnesses (such as bowel or bladder problems, heart disease, stroke, cancer)? Allergies? Fractures or trauma? Weight loss or gain? Incontinence? Balance problems? Skin growths or color changes? Persistent fatigue or sleeplessness? Swollen feet or legs, or limping? Vision problems (such as cataracts, use of vision aids)? Hearing problems? Dental problems (such as gum disease, strong breath, ill-fitting dentures)? Recent hospitalizations? List current vital signs and health professionals currently being seen.

Mental health. Selected factors to assess: Diagnosed with any psychiatric disorders (such as depression, anxiety disorder, psychosis)? Diagnosed with Alzheimer’s or other dementia? Recent hospitalizations for any of the above problems? Alertness? Mood swings? Forgetfulness or wandering off? Confusion/disorientation? Sadness/loneliness? Decreased interest in reading, writing or communicating in general? Maintaining friends? Interest in life?

Medication use. Selected factors to assess: All medicines taken (prescription or over the counter), with times per day and doses. Ability to take medications as directed and to know how to avoid interactions. Barriers to proper medicine use (such as forgetfulness, expense, poor understanding of purpose or outcome of use).

Activities of daily living. Selected factors to assess: Mobility or need for adaptive aids. Special dietary needs, favorite foods. Ability to dress, bathe, get up from a chair, use a toilet, use the phone, climb stairs, get help in an emergency, shop, prepare meals, do housework and yard work, drive safely.

Home and community safety. Selected factors to assess: Neighborhood. Home safety (hazards, adaptive aids, presence of smoke alarms). Ability to avoid telephone and door-to-door fraud. Yard and house maintenance.

Support system. Selected factors to assess: Names, addresses and phone numbers of key family members, friends and neighbors. Does your parent have frequent visitors or see friends? Does he or she go to a senior center? Get out of the house for other social reasons? Belong to organizations, including faith-based groups? Do family members live nearby?

Appearance and hygiene. Selected factors to assess: Overall appearance. Personal hygiene (including brushing teeth, trimming nails, shaving, and washing and combing hair)? Dressed appropriately in clean clothes?

Finances. Selected factors to assess: What insurance coverage is in place? Does insurance cover custodial care? What are your parents’ total assets? Are there any legal documents such as trusts, living wills, and/or durable powers of attorney? Do your parents have a financial plan? How long will his or her assets last? Any sources of financial assistance? Does your parent pay bills on time and make informed financial decisions?

Interests/lifestyles. Selected factors to assess: Hobbies, reading preferences, favorite television and radio programs, exercise, musical instruments played, languages spoken, favorite conversation topics, travel experience, important life events, religious/spiritual background, accomplishments, social activities.

Glossary

Activities of daily living (ADLs)

Basic functional tasks of everyday life that include walking, dressing, bathing, eating, personal grooming and toileting.

Custodial care

Help and supervision with ADLs, such as dressing, eating, and personal care, but not medical services.

Dementia

Deterioration of cognitive ability usually characterized by memory loss, personality change and impaired judgment. Common causes include Alzheimer’s disease and stroke.

Durable power of attorney for finances (DPA for finances)

A document in which you appoint another person to make financial decisions on your behalf. The DPA either continues in effect once you become unable to manage your affairs or springs into effect at that time.

Geriatric care manager

A professional who performs an assessment of a person’s mental, physical, environmental and financial conditions to create a care plan to assist in arranging housing, medical, social and other services.

Senior centers

Neighborhood or community centers that offer a variety of activities designed for independent older adults, including recreational programs, social activities, health screening and meals.