How to support your elderly parents with cognitive decline that live at home alone 

Americans are fiercely independent.  Some seniors decide to move into a senior living community, especially after their spouse passes; and many do not. Some live with only a spouse or partner, while others will seek out relatives or companions. In the U.S., 27% of adults over 60 years old live alone.  We often get phone calls from adult children of these seniors, worried if their mother is safely able to live alone in her own home. Once people reach the age of 90, more than 40% have some degree of dementia.

Frequently we find that older adults do not know their memory is impaired. 

Dr. Corinne Self

The inherent difficulty of trying to support a senior with a neurocognitve disorder, is that, due to impaired judgment and cognition, they are no longer able to make sound decisions.  Because of this, trying to convince, plan, and reason with them often ends in a power struggle with no resolution.  

Common issues that arise for seniors with cognitive decline

Many seniors with cognitive decline live in a limited supervised environment where they:

  • do not eat enough
  • do not take their medications
  • have unwitnessed falls
  • develop social isolation

In extreme cases they may have paranoia and delusions, may forget to bathe, or may leave the house and get lost. 

Depending on the risk tolerance of the children and the family dynamics, there are a number of opportunities and options to help manage these difficult situations. 

  1. First and foremost, we recommend not engaging in a power struggle with the senior, but rather, putting support in place without asking for direct permission. 
  2. Support systems include privately paid caregivers, friends, and family members to provide companionship, chefs for seniors, meal delivery, healthcare and financial oversight. 
  3. Technology such as electronic medication sets, GPS tracking devices, cameras, and fall alert bracelets can also be considered. 

Seniors with cognitive impairment are often resistant to the support that could help them stay home safely. 

Families feel they have no choice but to move their loved one into an adult care community against their will.

With the right framework and support system in place, families are often surprised by how well the transition goes. Many families find that the structure and routine of an assisted living facility, in-home caregiver can decrease stress for everyone overall.

If you’re elderly parent lives at home alone, look into resources in your area that can help! If your senior parent with cognitive decline lives in Tucson, consider ElderHealth as their primary care provider (PCP). Our services include safety assessments, fall prevention, concierge medicine, doctor and nurse home visits, and telemedicine consultations. If you live elsewhere in Arizona, consider booking a geriatric telemedicine consultation with us.

Families often struggle to find the right balance of honoring wishes and reducing risk. Since the “right” thing to do is not always clear, I recommend that you see it as a collective, collaborative effort; with openness and the power of patience.

Dr. Corinne Self

Dr. Corinne Self is a geriatric physician based in Tucson, AZ. She is the founder of ElderHealth, a medical group specializing in home-based primary care, memory care, and telemedicine for older adults. Dr. Self enjoys lazy gardening, sunshine, springtime, traveling, and spending time with her kids.

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