Caregivers for older adults need to understand when and how to get assistance. In particular, non-medical caregivers should be clear on when to refer to a registered nurse, and when to call 911 in an emergency.
Identifying Changes in an Older Adult’s Condition
When you are a caregiver, things can happen any time and you always need to be prepared with a plan of action in case of emergency. The older adult may stop breathing, have a heart attack, stroke, a diabetic complication or other physical or mental emergency.
If you ever feel that the older adult or you are in any immediate danger, you need to call 911.
You may also consider completing a first aid or CPR course, which can be enormously helpful.
Early Identification is Key to Best Response
Early identification of changes in an older adult’s daily routines, behavior, ways of communicating, appearance, general manner or mood, or physical health can save his or her life. When you have spent time with a person, you get to know what is normal and usual for them, and you will be able to tell when something has changed.
Some of the changes you can observe yourself, and others the older adult themselves will complain of.
What is most important is a CHANGE in the patient’s condition, or something different than usual.
Look for changes in their functional ability, body, mental status and environment.
How to Spot Physical Changes in Older Adults
For physical changes, you should first ask yourself:
Are there any changes to any part of the older adult’s body that you notice?
Physical changes in older adults to pay attention to include:
- Overall: fever, lethargy (tiredness), chills
- Head & Neck: headache, stiff neck, dizziness
- Skin: redness, swelling, cuts, rash, new numbness or tingling
- Eyes: redness, drainage, swelling, reports of pain or burning
- Ears: pulling at the ear,ringing in the ears, diminished hearing, drainage, dizziness or pain
- Nose: runny discharge, rubbing the nose, congestion
- Mouth & Throat: eating less, redness, white patches at the back of the throat, hoarse voice, fever, toothache, facial or gum swelling, bleeding, pain when swallowing
- Muscles & Bones: limited mobility in a leg or arm that the older adult could previously move, stiffness, pain, limb out of alignment with the rest of the extremity, joint swelling
- Heart & Lungs: chest pain, new or changing cough, shortness of breath, wheezing, new numb or cold hands or feet, swollen ankle
- Abdomen: abdominal pain, nausea, vomiting, loose stools or diarrhea, constipation, blood in vomit or stools, painful or burning urination, changes in urine color
- Women: new or changing vaginal discharge, itching, unusual odor, burning, bleeding
- Men: discharge from penis, pain, itching, redness burning.
Paying Attention to Mental and Emotional Changes in Older Adults
For mental and emotional changes, you should ask yourself the following questions:
Does the older adult appear to be “himself" or "herself”? Has their ability to communicate change? Have they lost interest in taking care of themselves or doing any activities they previously enjoyed? Has their mood changed and do they want to be alone more?
Mental & Emotional changes in older adults to pay attention to include:
- Overall attitude: An older adult who is usually very friendly becomes quiet and to themselves; an older adult who is usually very talkative suddenly wants to be alone more.
- Behavior: an older adult who is usually calm is more irritated or aggressive than usual. It could also be the opposite - they may become less active than usual.
- Ways of communicating: an older adult who usually is talkative stops talking; speech becomes garbled or unclear; the older adult doesn’t seem to understand you, but they usually do.
- Relationships: The older adult may act distant or afraid when certain family members, visitors or professional caregivers are around.
Changes in the older adult's home environment to pay attention to:
- Finances: see if their are any obviously unpaid bills, utilities cut off, and if there is sufficient food available.
- Cleanliness: Ensure the older adult is able to continue their previous level of housekeeping chores
- Home maintenance/safety: See if there are any repairs that need to be done that could cause a health or safety hazard.