Should you be worried if your mother forgot that you told her last week that you were going on a business trip? What if you notice she smells of urine one afternoon? Or if you see her drive over a curb? Should you be worried?
The answer is it depends. You cannot look at the incidences in a vacuum. You need to get more information.
Look for Sudden Changes
If someone is always very sharp and they begin talking nonsense, that is very concerning and could be a sign of a stroke. A person who is always able to control their bladder, who cannot control it at all one day could have a very serious problem. These issues are a drastic change and could be life threatening. Subtle, sudden changes may be a sign of a UTI if a person seems somewhat confused or more confused. The increased, sudden need to urinate more frequently could be a UTI or diabetes.
All of these scenarios require either a trip to the emergency department or a doctor.
Look for Patterns
No one gets Alzheimer’s disease in a week and goes from normal to forgetful. It is a gradual disease that evolves over years or a decade. If you consistently see evidence of worsening forgetfulness it is time to see a doctor. Confusing the names of your kids or grandkids is not necessarily a problem, even if it happens often. Being surprised you have an eight year old grandson named Charlie is a problem.
An auto accident does not automatically mean someone needs to stop driving – it depends on the circumstances. However, scrapes and scratches all over a car usually means that driving is becoming more difficult.
We all fall at some point and older adults are more prone to falls. One fall, even if a bone is broken, does not necessarily point to a problem. Two major falls with injuries in less than a year, or several falls without injury are a pattern and make one a fall risk. If you have more than one fall in a short period of time (less than a year), it is time to seek intervention.
Look for Things that are Out of Character
If someone is a fastidious housekeeper and you begin to notice that things are starting to get dusty and out of place, you should become more observant of other behaviors and discuss this with a doctor. If someone never misses a football game for their favorite team and they miss a game and don’t seem to care, that is concerning. Someone who usually gets up at the crack of dawn starts sleeping until 11:00 should set off a warning signal. In other words, look for behaviors or attitudes that are completely out of character for that person.
Look for a Drastic Change in Attitude
A social person who prefers to sit quietly in another room when family gets together, especially if it happens more than once, might indicate a problem which can range from hearing difficulties to dementia. If a grandmother always wants to hear about her grandchildren’s sports and now never even asks, you will want to look further into what is causing that. Depression is common in older adults, yet it does not receive enough attention from the medical world.
Annual Visits are Crucial
What may be normal for you is abnormal for me. It is important that you know someone well before making a judgement about them. Walking into a messy house of a stranger tells you nothing about whether they are having difficulty. Visit with your older relatives in their home on a regular basis.
It is equally important that your primary care provider know what is normal for you as well. The best way to do that is with annual medical check-ups. Most medicine now is not done by a local doctor who sees the entire family for everything. There are nurse practitioners, physician assistance, medical assistance and so on in most offices that we see for routine issues. However, if you stay with the same office, your records will indicate your medical history and any changes.
Put things in context
When issues occur in a vacuum, you lack proper information you need to make a decision. Compare any new issue with what was normal. Once you see an issue in context it will be easier to know whether you need to act.