Signs to look for when you visit your aging parents.
As our parents get older it’s always important to notice if you’re seeing changes in their behavior or abilities, even the way they dress. They could just be having an “off” day but it can also be signs of bigger issues.
Dr. David Murdy is a Geriatrician at Baylor Scott & White Health and specializes in taking care of older adults.
He talks to Kim & Mike Barnes of Parenting Aging Parents about what to watch for, what to do if you see concerns and how to talk to your parents about those concerns.
Read the full transcript
Transcript of Interview: “Tips from a doctor: How to tell if your parents need help”
Mike Barnes:
With the holidays coming up and Thanksgiving going on right now, it’s a great time that we’re going to see parents, and we want to think about the things that we might be paying attention to and noticing potentially in our aging parents.
Kim Barnes:
Today, we are inviting Dr. David Murdy, who is a geriatrician, to come talk to us and give us some of those ideas. Dr. Murdy, as we’re seeing our family, in some cases it may be that we haven’t all been together since before COVID. What are the things we should be keeping an eye out for?
Dr. David Murdy:
Many things can have changed in the time that people have been isolated. Frankly, a lot of them have just been more depressed simply because of being isolated, so that’s always an important thing to assess. Their eating and their mobility are very important to be assessed. Simple things like how well are they getting around, do they seem to need help with more things, and potentially more cognitive issues. Are they more forgetful? Do they misplace things? Are they more fearful? All of those are things that common sense evaluation can bring up, whether that’s a concern that needs to be further addressed or something that can hopefully be set aside so the holidays can be enjoyed.
Kim Barnes:
If there is something that we notice that we haven’t seen in 2020 or 2019, the last time that we saw our parents, is there a no-no, something that we definitely should not do?
Dr. David Murdy:
I would be careful trying to come to any conclusion right off the bat on a brief visit of a few days. Part of it is that there’s a lot of dislocations as people have had to adapt to often being by themselves. We need to be aware of and perhaps not too judgmental of these. But once you’ve had a chance to see what’s going on, it’s reasonable to ask simple questions: how have you been doing? How well has this gone? I see this as a problem in the house or where they’re at. How have they been doing for socialization? Ask some simple questions and try to elicit their cooperation and your concerns, whatever they happen to be.
Kim Barnes:
I like what you said about trying to get them involved. What happens when they try to downplay it? I would imagine when they’ve started noticing some of those things or those things have been pointed out, it’s probably a little bit scary for them.
Dr. David Murdy:
Of course. They worry about their independence and that this is a potential serious finding, whether it be something like dementia or another illness. If there’s been a significant weight loss or even just the stigma of dealing with depression if people have been isolated for a long time without a lot of social support. It’s important to come alongside aging parents and be a partner with them in trying to approach what this is. Don’t necessarily try to label it with a diagnosis and say, “You have to do this,” or “You have to make the doctor do this for you.” Instead, try to bring them into the fact that you’re concerned, and there are things you can do to help the process. It may involve working with their doctor, and sometimes it may just involve getting them more help for day-to-day things.
Mike Barnes:
You mentioned the diagnosis. Other than the incorrect way of going on Google and making the diagnosis yourself, do we suggest to our parents to just go to their normal doctor, or do we say, “Oh no, you need to go to this doctor or this specialist”? Do we worry about specialized doctors right now, or just say, “No, let’s just go to our family doctor and get a check-up and an evaluation”?
Dr. David Murdy:
I think the first place to start is with the doctor who knows them best. Work with them on what areas of concern you might have. If your parents are reluctant to pass that information along directly from them to the doctor, it is not wrong to provide collateral information in the form of a note to the doctor, saying, “Hey, we saw mom and dad, we noticed these things that weren’t there before, we asked them to come and see you, and we wanted you to know what we saw.” Doctors typically take that information in. I don’t normally refer to it, but I use it to tease out additional facts from patients and family members about what this might mean and then go from there. If they do need specialized help, they’ll probably be more likely to go and get it and cooperate with it than saying, “Oh, I think you have dementia, you need to see this type of specialist.”
Kim Barnes:
The other hard thing we often hear about is when parents don’t want their help or don’t think they need help. How do you navigate when you want to be an advocate for your parent and help take care of them and ensure they are in good condition, but they don’t want your help?
Dr. David Murdy:
The normal motivational interviewing process for an aging parent is to point out to them the risks of not getting help: the risk of a fall, not eating properly, being hospitalized for an accident or illness, and then facing the prospect of requiring rehabilitation and loss of their independence. Most people respond favorably to wanting to be as independent and safe as possible. Most older patients will tell you they don’t want to be a burden to their children. Supporting those efforts on their part are generally ways to win their cooperation.
Mike Barnes:
It’s an important time right now with Thanksgiving, especially the Christmas holidays, because we’re going to see people for the first time in a long time. Now is a big time for us, the adult children, to make sure that the parents are taken care of.
Dr. David Murdy:
It’s also hard for the parent to realize they may need help from their children. It’s also difficult for the children to realize they may need to help parent their parents. Both are very difficult adjustments to make. I tell people to be kind to themselves in making those adjustments. If they focus on the importance of safety, respecting the dignity and independence of their aging parents, and pointing out practical things that could help, they can elicit cooperation that will allow them to deal with more difficult situations if, God forbid, they come up: end-of-life concerns or serious diagnoses that need regular care. These are the kinds of things we’re concerned that people may have put off during this long process of trying to get out from underneath the COVID epidemic.
Kim Barnes:
This is just one example of the many conversations we need to get comfortable having with our aging parents. Would you agree that this is just the start of taking care of them, and it’s good practice over the holidays to start that dialogue?
Dr. David Murdy:
Right, and a lot of times when people have been separated, even if they’ve been talking on the phone or on video chats, it’s hard to communicate these more difficult issues or see them when you’re not necessarily in their presence. I urge people to be kind about those things but to keep track and maybe even write some notes down. A lot of times, the diagnosis can be better made by that type of contemporaneous information than an office visit. The patient is at their best during an office visit; they dress their best, they’re prepared, and they want to appear as healthy as possible to not attract unnecessary attention. That additional information is key to taking care of aging parents and ensuring they’re safe, independent, and happy.
Kim Barnes:
Would some of that information include noticing changes in habits and behaviors, like if mom isn’t bathing or dressing as nicely as she used to, or the house isn’t as clean as it normally is? Are those things we can share with the doctor?
Dr. David Murdy:
Absolutely. Home safety issues are critical. You may detect something serious for them that we as medical practitioners may not be able to detect because we don’t make house calls as often. We don’t normally know how tidy or untidy they might have kept things. You can say, “This is not the way mom or dad normally would handle this.” We want to respect that intuition on your part because it’s often very helpful in the diagnosis and management of aging parents.
Mike Barnes:
Great tips, Dr. Murdy. Thank you so much. It gives us a lot to look for and look out for our parents over the holidays. We really appreciate it.
Dr. David Murdy:
Happy to help. We want to keep everybody healthy this holiday season.
Kim Barnes:
Great things to think about as we are with our extended family and aging parents over the holidays. Keep your eyes open and don’t make snap decisions or diagnoses, but at least it gives you some information to move forward.
Mike Barnes:
That’s right. Great talking to these experts. If you have any experts you want us to talk to, let us know at Parenting Aging Parents.
*This transcript is auto-generated. Please excuse any typos or mistakes.
