How do I …? When should I…? What should I …?

Each of us who has provided daily care for an aging, ailing parent or other relative has had to answer these and other questions, often times with little or no preparation. We learned as we went along. “Baptism by fire” some would say. If we were lucky, we had the ability to consult with accommodating healthcare professionals. We might also have had the good fortune to talk with other relatives/friends who had previously walked a similar path. More often than not, we were on our own to figure things out.

Like first-time parents, being a first-time family caregiver is usually accompanied by more questions than answers. There is a heightened insecurity about taking on the demands of caring for a loved one who is not yet ill or dependent enough to warrant placement in a care facility, but who is also not healthy/ independent enough to remain at home alone. How do you know when you need to step in and offer to “take control” of things? That’s a good question. And there are countless ways to respond.

Abraham Maslow was an American psychologist who was interested in basic human needs (physical, biological and mental) and the impact that fulfillment or neglect of them had on a person’s condition. Maslow’s Hierarchy of Needs provides a good structure for assessing when you may need to get involved in the care of your parents or other loved ones. The foundation level relates to physiological needs (food, water, sleep) and these become important for elderly loved ones, especially those who live alone.

Does your loved one have access to proper nutrition? Is she able to prepare her own meals? Is she losing weight because she’s not eating? What medications is she taking and is she taking them correctly? Can she afford her medication? Does she have automatic refills or expired prescriptions? Does she take herbal supplements that may interfere with her prescription medications?
Is he able to bathe/shower himself? Is his bathroom equipped with grab bars and no-skid shower/tub to avoid falls?
Does she drink enough fluids during the day? Is she getting restful sleep? Does she have difficulty sleeping?

The second level of needs focuses on shelter, safety and security:

Is her housing adequate and appropriate for her level of function? Is she able to move easily from one room to another (e.g., bedroom to bathroom) without assistance? Are there grab bars in the bathroom? Is the house in need of repair?
Does he have a personal alarm system in his house to call for emergency assistance if he cannot get to the phone? Is the lighting adequate for aging eyesight? Are there area/throw rugs on the floor that might cause a fall?
Are her bank and credit card accounts secured? Is she able to manage her financial affairs? Are bills unpaid or overdue? Does she know her passwords and account information? Are her insurance policies, investment accounts, and legal documents finalized and organized?

These first two levels of Maslow’s hierarchy are often called “basic needs”. Basic needs are usually the first areas in which aging parents begin to falter. More often than not, adult children see decline in these areas before their parents recognize it in themselves.

If you’re seeing a decline in any of these areas, it is a good time to approach your loved ones and offer your assistance. Power of Attorney documents should be prepared; one for financial matters, and one for healthcare decisions. Your offer to help will likely be met with some resistance. No one likes to give up control of their property or their person.

Always approach with love and from a place of concern for their safety and well-being. Gather everyone who will lend a hand of support in some way. If there is disagreement among siblings, put that aside if you can. Call a family meeting to talk about concerns and next steps. Preparing for the changes brought about by aging and faltering health will take commitment and sacrifice, from your parents … and from you.

Caring Choices can help families have conversations about basic needs and preparing for the best quality of life as home and health needs change.