well hello everyone i'm dr leslie kernelson board certified geriatrician and the founder of the website betterhealthwhileaging.net and in this video i want to address a super common concern that people ask me about all the time which is what to do if you have an aging parent and you've become worried about them especially if you're noticing worrisome changes in a parent who's up to date been pretty independent and doing pretty well and you're now thinking that your parent needs some kind of help or needs to make some kind of changes so this is a super common
situation and now what do i mean by worrisome changes so there are lots of ways that aging parents can worry their adult children but often what people ask me about or get worried about are things like noticing changes in memory or their parent looking frailer or maybe having some falls maybe having trouble with driving or maybe finances or maybe sometimes it's just this nagging feeling that they seem less able or less with it than before so if you have found yourself worried about this then chances are you've tried to bring it up with your aging
parent or maybe with other family members and often people find that it doesn't go as well as they had hoped and so people often find it really hard to move forward because on one hand it can be hard to know just what to do and sometimes it's hard to know whether what you're seeing is a normal aging or not and whether it's worth worrying about or not and then the other challenge is that often the aging parent is resistant or reluctant to talk about it or acknowledge it or make the changes that their family thinks
that they should make so people often find themselves in this kind of stuck spot for a while and i don't want you to say suck as a geriatrician i have helped lots of families through this i've had training i've had experience and in this video i want to share with you what i know i want to help you get unstuck by teaching you a step-by-step process that i have worked out it's based on the process that i was using initially myself for patients that i was evaluating and then i made a version of it for
families and i now teach it to families so i want to teach you a step-by-step process that you can use to figure out what's going on with your aging parents and how you can help and what i'm going to teach you in this video is also going to help you reduce the conflicts and arguments with your aging parent about your concerns so if you're going to be visiting your aging parent anytime soon or maybe you just visited them and you're worried thinking what am i going to do this video is for you and i'm excited
to share this helpful information with you and specifically in this video here is what i'm going to go through first of all i'm going to tell you the most important thing to stop doing right away in case you've been doing it which many people have and i'm going to then take you through what to do instead and why i'm going to go over three types of problems that i do recommend you check your parents situation for and i'll go over specific signs that you can look for or work with your siblings to check for then
i'm going to talk about the better way to talk to your parent about this a way that's going to generate more understanding and solutions to move forward instead of keeping you stuck in conflict and then i'm going to finish with some suggestions on how you can put together everything that you find out so let's start with what to stop doing in my experience when people get worried about an aging parent they start to do a lot of explaining to their parent they start to explain why they're concerned explain why they think their parent should change
this or that explain why maybe their parent needs to get more help and those explanations which are often coming from a place of us trying to get our parents to understand something that we either want them to understand us and our concerns or we want them to understand what we see as the situation that tends to not be productive and to go nowhere so what you want to do initially is think about how you've been talking to your parent about this and if you have been trying to explain to them get them to understand get
them to agree i want you to let that go for right now so stop trying to get them to do something or understand something we are going to come back to potentially trying to get them to change things eventually but now is not the time to do it and families find that once they stop focusing on those explanations it makes it possible to do a lot more things and the truth is that even though you're worried about your parent and you want to take action right now it's really too soon to take action so instead
what i recommend you do is spend some time on what i'm going to teach you in this video which is called taking stock and that means spending some time finding out what is going on and what specifically you are dealing with and we do that through looking for certain specific things and i'm going to take you through what to look for and the other aspect of taking stock is to learn more about how your parent sees the situation and how they feel about it so people's usual approaches they notice something concerning they want to jump
in and make it better but what we want to do is when we notice something concerning we want to take a deep breath and we want to say let me first take stock let me gather information through observations and talking to other let me talk to my parent with the aim of listening and understanding them before i try to get them to understand me and then after we do that still before we take action then we would take aim which means look into the options for addressing whatever came up when you did your investigation in
taking stock what are kind of the known better ways to help an older person with whatever was observed or came up and then after that we can put it all together into taking action so another way you can think of it is that you first want to go through a detective phase then you want to go through a research phase and then you put it all together into a taking action phase now for the rest of this video i'm going to focus on the taking sock part what is most useful and important for you to
be looking for during your detective phase if you want to go into more depth on the steps afterwards taking aim and taking action i do have a book that i wrote because so many people i see being stuck in this stage it's called when your aging parent needs help a geriatrician step by step guide and i'll have a link to it in the the description so there'll be more information there but now we're going to focus again on how do we find out more about what's happening with our aging parent and how our aging parent
sees it and sees their life in general so let's first start with what exactly is going on so this is like the observational data gathering part of this and generally i recommend people check for three kinds of problems the first is are there any signs of problems with memory or thinking and the reason for this is because not every older adult who is worrying their family is having memory or thinking problems but especially as people get into their 80s and 90s it's fairly common and it's really important that we not miss that if that's happening
because on one hand it's going to change the way we talk to the older person and it also changes a little bit the scope of how involved we can get the truth of the matter is that people have the right to live their lives in ways that make their families uncomfortable they have the right to not do things that are good for their health and lots of older adults might choose to do this and they do have a right to do this provided they are actually what you know colloquially is called in their right mind
in my profession we would call it uh you know having capacity mental capacity to make those kinds of decisions so i always when i hear about an older person who's wearing their families i always want to find out are there signs of memory or thinking problems so that we know whether we're going to go down that route or not or potentially if it's unclear and often it isn't then we want to really see how we can push to get a good evaluation for what might be affecting the older person's memory and thinking so that's one
of the three types of things we want to check for um the next uh type of problem that you'll want to check for are what kind of specific daily life tasks is your aging parent having difficulty with or are they having difficulty with any of them and so i'll go into what those are in a moment in my profession we call them activities of daily living and instrumental activities of daily living and identifying when an older person is having trouble with that one if they are having difficulty we want to find out why is it
a problem with memory or thinking is it a problem with physical health but it also points the way towards like what kind of help or supports do they need to remain as independent as possible and as active in their life as possible so we'll talk about um specifics that you can check for there and then the third kind of problem to check for are safety problems like and in a moment i'll take you through the short list of safety problems that i'm usually checking for or any of these safety problems occurring again if they are
then it becomes a little bit more important potentially to step in so these are all things that you find out not by asking your parents so much although you might a little bit but really that you can find out just by knowing what to observe for and look for so get out a piece of paper and take some notes and if you've been worried about your parent these are things you can check for next time you visit them or spend time with them so let me now take you through a few details on each of
them checking memory and thinking let me start off by saying that the idea here is not that you're going to attempt to diagnose your parent with some kind of condition affecting their memory or thinking that's not the goal the goal is for you to learn what is considered concerning or warning sign what is more than normal aging or what should not be considered normal aging and what should be brought to the attention of a health provider preferably one who has experience in evaluating these kinds of of problems and i will say that a lot of
general practitioners have told families that something is normal or just aging when geriatricians and neurologists and people who are experts would disagree so it's good for you to do your own research and no and and when you know how to identify these you can bring them to the attention of a health provider and you can speed along the process of your parent getting an evaluation if it seems like that is indicated so what is normal with aging i find a lot of people are not sure so what is normal is for things to slow down
a little bit but they should still work so what's normal is a decline in mental processing speed and inflexibility so that means it might take older people a little bit more time to think about something or to figure it out it's also normal as people get older for them to have more trouble focusing in busy or distracting environments so if you did want to have a talk about can they still manage the big old family home with all the steps you wouldn't want to do that in a busy restaurant where there was lots of noise
and things going on somewhere quiet where there aren't distractions is going to be better for your parent it's also normal for to take increased time and practice to learn a new skill but these slow downs should not be significant enough to keep people from doing their daily life tasks to keep them from doing things like grocery shopping and making meals assuming they have made meals earlier in their life uh or doing uh their finances um what's also not normal is to have a poor short-term memory i have people tell me this oh yeah my parents
fine they just have you know really bad short-term memory but that's normal for their age that is not normal at any age so other things that should not be considered normal and that you would want to notice are things like delusions believing things that other people don't believe to be true or hallucinations seeing things that other people don't see sometimes hearing things that other people don't hear or new paranoia or suspicion this is something else that people often ask me about when a parent starts accusing other people of taking their things of stealing of being
out to get them that's concerning another thing that's concerning is when people repeat themselves a lot like repeating the same question or story uh in the same encounter personality changes are also you know something that should be noticed and brought to the attention of other people so somebody who's historically been kind of quiet becoming really outspoken or vice versa losing interest in activities that they used to enjoy that would be concerning or if they seem unable to enjoy activities that they used to enjoy uh difficulty managing finances that's concerning to you or daily struggles with
memory and thinking so some those are some of the top ones i actually have a longer list of 21 right now in a cheat sheet that i created to help people check for worrisome signs and behaviors that could indicate problems with memory or thinking and that probably should be evaluated by a doctor so i'll be making another video that goes over those and that cheat sheet is also available as part of my book if you want to learn more about that so how do you actually do this check on your parents memory you're thinking um
so i think what you need is some kind of list of what to check for so you could take notes on what i was just saying here and then you want to observe your parent and just ask yourself well so that worrisome sign am i seeing it uh sometimes often or never and if there is a worrisome sign or behavior you want to ask yourself when did it start so this is something that you can do yourself discreetly when you're visiting your parents um or you can look over the list after you spend time with
your parent and ask yourself did you notice any of that i also recommend talking to others who regularly interact with your parent like another sibling or if your parent is living with your your other parent or a spouse you could check with that person um i think in general it's a good idea to be discreet and somewhat diplomatic uh at this stage it puts a lot of people on edge if they feel like their children or family members are questioning their mental abilities you should also know that it's actually really common for older adults to
be having some difficulty with memory and thinking and seem to be completely unaware or vehemently deny it when um it's uh brought up so if you're noticing that know that you're not alone that is super common that's a good thing to make note of um and keep in mind as you move forward later on as well let's now move on to the second uh type of issue that we want to be checking parents for if we've been worried and that is what are they having difficulty with so how are they doing with daily life excuse
me daily life tasks also known as activities of daily living and instrumental activities of daily living so what these terms mean the way i think of it is that the activities of daily living the adls are like the skills you learn in early childhood so um there are things like getting dressed uh using the toilet and managing your continence issue feeding yourself walking um bathing also counts and then you know what we call grooming which is shaving if you're a man fixing your hair whatever was kind of normal uh for that person are they still
doing it to the same degree and then the instrumental activities of daily living or iadls are what i think of as the teenager skills so these are higher level skills that usually we learn when we're teenagers and that are required to live independently as adults so they are things like managing finances managing transportation food shopping and meal preparation dealing with communication technologies such as the phone the mail and now probably email as well managing home maintenance managing medications also is usually considered an iadl and many older adults do have medications that they have to manage
as well so if you've been worried about your parents then i would encourage you to look at how are they handling those various life tasks and which specific things do you see them struggling with because that later on will be really useful information if you are trying to get them help in the home or if you are trying to get them evaluated by a health provider so the third group of things that we want to check for are safety issues now here what i encourage people to think about is what things are you actually observing
happening especially focus on that i mean the truth is that as people get older they become at risk for all kinds of things and we can get really worried about the risks but really focusing on what are actual incidents that are happening so i often think of them in a couple groups so memory related ones that i think about would include wandering for getting the stove on or having really flagrant safety awareness that is often putting them in a physical danger you know like walking into the road and not noticing that there's traffic coming then
there are driving related safety issues which i would consider things like accidents really close calls getting lost driving having many tickets passengers becoming so worried they don't want to ride with the person then there are finance related safety issues like unpaid bills falling for scams and actually losing money or signs of somebody financially exploiting the person and taking their money or taking advantage of them for living situation related safety issues a common one would be dangerous amounts of clutter especially if somebody has fallen or gotten hurt because of that for medication-related safety issues not taking
medications as directed or having medications pile up having difficulty affording them and then i think of a couple house ones such as frequent falls frequent visits to the emergency room and repeated hospitalizations i would consider those like real safety red flags so that pretty much is the detective observational work that i recommend you do so again it's checking for signs of memory and thinking problems it's asking yourself what daily life tasks are they having difficulty with in terms of activities of daily living and instrumental activities of daily living and then there is safety issues or
any safety incidents actually happening and you can go through my little list if you want to check now let's move on to the other part of this taking stock phase so we've done our observational detective work and the next part which is really important is the interviewing detective work the part where you get your parents take it's really important to take a step back and ask yourself what is my aging parents perspective on these things and in case you're wondering this is something that i as a geriatrician always do before i make recommendations to an
older patient i try to get their perspective on the issue and i try to find out how they see it and what they are most concerned about so you'll want to have a conversation or more likely a series of conversations with your parent and what you'll want to do is make your focus listening and understanding them instead of trying to be understood by them or trying to persuade them of something the idea is to get their take on whatever it is that has been cons concerning you so first of all are they aware of it
and second of all how do they see it do they see it as a big deal not that big a deal and what are their concerns and desires when uh it comes to this what do they want most so through this kind of listening conversation a couple things are going to happen one is that you're going to gain really useful information by finding out how your parent sees the issue that has been worrying you so much i mean even if they see it as a non-issue or can't remember that they did things that other people
observed as really worrisome that's really useful information and also if you're able to listen to them and help them feel heard and understood that's going to increase a sense of connection between you and them that's going to increase your relationship capital and that's going to make it easier for you to take action later on so let me now give you a couple specific tips on how to have these conversations i think there are kind of two openers that you can use one is to start off with a broad one which is kind of like how
are things these days or how's the house just see what they say and then afterwards say tell me more how do you feel about that see what bubbles up the other is that if there's a specific issue you're worried about i would not have a conversation when you go into all your concerns and justify why you're concerned but you can start off by just saying i notice and you insert a very specific observation like i heard from the neighbor that you had some trouble getting home while driving the other day and seemed to get lost
for a bit i was wondering if you could tell me more about that or i noticed your fender is dented i was wondering if you could tell me more about that or i noticed that there seemed to be some unpaid bills i was wondering if you could tell me more about that just one little observation see what they say and once they get started you use open-ended phrases like tell me more or how do you feel about that and so again the idea is to really get a sense of their take on it and also
hopefully find out what are their concerns or fears or desires about it right if your parent is realizing they're having some accidents they may be worried about what are they going to do if they can't drive and we want to create the space for them to voice that and potentially explore what they might see as possible solutions and also validate that worry and frustration that it might be causing them so uh a few more tips to help you with these conversations um for many people they find that having a one-on-one conversation is better than like
the squad of siblings facing the parent you know to uh interview the parent uh it often takes more than one conversation this is something that people find that if they kind of chip at it also just be alert listening to your parent if they bring something up like a complaint or something that's an opportunity to sort of ask them to tell you more and get a perspective on it if your parent does get upset or defensive for some reason back off come back to it later and when they're upset try to not explain away they're
upset but again think about how can you provide some empathy and validation it's also really important to not argue if their version of reality is different than what's been observed you want to make note of that disconnect it's really important but don't try to correct the reality it's it generally doesn't work it just creates more conflict and it's not going to help you learn more about them or implement the changes that they might need so again the focus is to better understand their fears and desires and those are the key points for taking stocks so
in short if you've been worried about your aging parent you've noticed some concerning changes and you're not sure what to do next remember one stop arguing or trying to explain or trying to get them to change something and instead take a step back and become a detective take stock of the situation spend some time gathering the facts on the ground and spend some time having some nice conversations with your parent where you're gonna try to learn more about them and get their perspective this can actually be a really nice opportunity to connect with your parents
and learn more about how their life is right now what's most important to them what they want their dreams their fears so that you can later have this foundation that's going to allow you to step in and be more effective in assisting them if that is what they need and the truth is that if you've gotten worried about your aging parent you are probably at the beginning of this journey that they're going to go through as their life changes and you're going to accompany them on it and i will tell you right now it is
usually not going to be your job to fix everything for them one it's very hard to do and two it's not necessarily what serves them and your relationship best what your parent actually needs most of all from you right now is your presence and you accompanying them on this journey and so this taking stock process is meant to help you prepare for that and get going on that so i hope that this video has been helpful again if you would like to know more um i am going to try to make a video soon about
those 21 signs to look for if you're worried about memory of thinking because i know that's a super common concern otherwise they are all in the book and with that i'm going to wrap this up thank you so much for watching if you liked this video please go ahead and subscribe will be i plan to make more videos about helping aging parents and also about some other common age related concerns come visit us at better health while aging and uh lastly thank you so much for what you're doing for your aging parents and older loved
ones we geriatricians couldn't do what we do without you so we'll be seeing you in the next video
