It’s a well-known scenario: family members who live in several different cities gather for a special event or holiday. Over the course of the visit, they begin to notice signs that their parents are not functioning as well as before. Some of the core tasks of living have become much more difficult. The level of concern grows; is it still safe for our parent(s) to be on their own?
When adult children face these concerns, it is often difficult to know where to start! One helpful tool is an objective assessment to determine how a person functions in the activities of daily living (ADL’s), and the instrumental activities of daily living (IADL’s). ADL’s are physical tasks that a person must do regularly, such as bathing, eating, dressing, toileting, and safely moving from one place to another (referred to as transfers). The mom who uncharacteristically wears the same clothing for several days, or the dad who maneuvers across a room by grasping counters and furniture to steady himself, is signaling that the ability to perform daily activities is declining.
Instrumental ADL’s are skills necessary to manage one’s affairs independently. These include tasks such things as keeping up with bills and paperwork, shopping, preparing meals, using good judgment, and cleaning house. Spoiled food in the refrigerator, delinquent accounts, or sending money to solicitors are among the signs that self-management may be declining.
A recent story from one of our clients demonstrates how these two measures work together to give an accurate assessment. A 97-year old woman was driving her classic, collectible automobile in town. She was approached at a stoplight by a man who had been following her for several blocks. He offered her cash on the spot for her car, but requested that he be able to take a test drive. The woman got out of her car, leaving her purse on the seat, and stood on the sidewalk as the man drove off!
Note that this woman passes the ADL test with flying colors! She is able to operate a car, walk, and transfer, even in her late nineties. Her instrumental ADL’s, however, expose her to terrible vulnerability! Incredibly, this story had a happy ending: the man actually returned, and the purse was untouched. But the adult children realized that their mother’s physical vigor did not translate into self-sufficiency.
When we perform a free, in home assessment, we discreetly observe and listen for signs that a senior is compromised in their ability to routinely perform ADL’s and IADL’s. The realization usually comes that the way to maintain future independence at home is to accept assistance in some current areas of challenge. This isn’t just “spin” to make the idea of home care more palatable; it is a reality that we see in the lives of clients every day. Forgoing help in the necessary activities of daily living puts one at a significantly higher risk of losing independence. The sensitive caregiver knows how to come alongside a senior to assist where needed, without taking over in areas of ongoing competence.
If you know of someone who may be at a tipping point where some assistance is needed, call us for a caring and diplomatic in- home assessment today!
©Linda Rudat, 2012