Confusion and Dementia create danger for the Elderly
As the caregiver for your elderly parent, you may have to decide if it is still possible to leave them alone for an hour, an afternoon or an entire day. Will they be safe? Will they wander off? Will they let strangers into the house? Will they turn on the stove and forget to turn it off?
Making this decision can be a complicated and emotionally wrenching experience for you and your parent. It can be heartbreaking to recognize that the strong, self-sufficient adult you have known for years is no longer capable of taking care of themselves. It also means a real loss of freedom and flexibility and may require you to develop creative strategies to accomplish daily errands and tasks. For your parent, it can be equally difficult to acknowledge and accept that physical, emotional or mental changes have reduced their independence.
There are numerous factors to consider when making this decision. But first, it is important to understand that loss of sight, hearing loss, memory loss, confusion, incontinence and depression are not normal aspects of aging. In many, if not most cases, these are treatable conditions. Failure to identify them as being treatable could place your parent at risk of unnecessary functional decline. On the other hand, successful treatment can restore some or all of your parent’s capabilities of functioning independently.
Have you or your parent discussed their problems with a physician? And, if the first doctor dismissed them as being due to old age, did you see another doctor for a second opinion? (A surprising number of doctors don’t have the training to help aging adults overcome their problems.)
It is important to balance the safety of your parent with your needs to retain as much independence as possible. As a result, you should include as many people as you can in the decision-making process, especially your parent. You may also want to consult with other caregivers, such as family members and friends; paid caregivers who know your parent’s abilities and limitations; and elder care professionals such as doctors, nurses, and social workers.
Checklist on being home alone
Here are some questions that can guide you in making your decision. If the answer to any question is “no,” it may no longer be possible for your parent to be left alone, even for a short period of time.
- Do they understand how to leave the home if necessary? Do they know where the door is located and how to exit the building?
- Will they stay home or near the house rather than wander off?
- If they go outside, do they know where they live and how to get back inside?
- Can they identify signals, such as smoke from the kitchen or fire alarms, that would alert them to potential dangers?
- Do they know how to access emergency services? Do they know how and when to dial 911? Would they be able to communicate over the phone? Can they physically get to a phone no matter where they are?
- Do they have difficulty walking? Have they fallen — not counting a trip or stumble — once or more in the past year?
- Do they have frequent life-threatening medical emergencies that require immediate intervention? Do they know where any medication they might need is located? Can they reach it? Do they have the capacity to select the right medicines in the correct amounts?
- Do they have the judgment to identify who they should and should not let into the home? Will they know to allow family, friends and emergency personnel into the home?
- Can they prepare something to eat if they get hungry? Do they know how to use the stove, and will they remember to turn it off?
- Can they get to the bathroom and use the toilet on their own? If not, have alternatives been worked out?
- Are they afraid to be alone for an hour or more? Do they become clingy when you leave and make frequent telephone calls when they are alone?
If you decide that it is still safe to leave your parent at home alone, you should regularly reassess the situation. Caregiving is a dynamic process — you need to be aware of any and all changes in your parent’s condition and abilities. Even if you think they can be left home by themselves, pay attention to their desires; if they fear being alone, it could be a sign that at some level they know they are not capable of coping with any emergencies that might arise.
If you decide that it is no longer safe to leave your parent at home alone, you might first want to consider some form of respite care. That is, someone else could temporarily look after your loved one while you take a needed break. For example:
- If your siblings live nearby, they (and/or members their families, including adult children) could take turns.
- Their friends and neighbors might help out.
- Members of their church, synagog, mosque or temple might also be able to help.
- Perhaps your parent could visit a local senior center for a few hours. (Most communities have a senior center that likely has a van service one can call for a ride.)
- Adult Day Services may also be a solution. This is community-based care designed to meet the needs of functionally and/or cognitively impaired adults who, for their own safety and well-being, can no longer be left at home alone during the day.
- If you need to be away overnight or for a longer period, many assisted living facilities offer short-term respite services.
If these suggestions don’t work for you, then perhaps it’s time to consider moving your parent into an assisted living facility or nursing home.