Need Help?
Getting older means always wondering if you are still of sound mind. When words are harder to find and names more difficult to put to a face the question arises: "Am I losing in? How do I know when I need help?" It is difficult to self asses since we often can manage fine with those subtle memory losses and may not realize the impact on daily life. Some changes may be "normal aging" while others may be early signs of dementia or treatable medical problems. Having a complete medical, neurological work-up is essential. Sometimes those close to us may notice problems but may be reluctant to mention it.
Most important to planning is talking with family and/or friends to help plan for something still unknown. Would you want to know when others think you are having problems? At what point would you give up driving or have someone else take financial responsibility?
There are four major categories for how one lives in the world and when help is needed described below to guide planning for yourself or by others.
Living In The World, Living At Home, Personal Self Care
There are tasks which have been categorized to help anticipate when and how one might need assistance with activities of daily living.
Advanced Activities of Daily Living: Living in the World
Activities expected to achieve
Working for compensation
Social interaction with people through face to face encounters such as letters, email, using computer and internet
Driving a vehicle and traveling away from home
Engaged and interested in activities outside the home
Clues of potential problems
Changes in spontaneity or inhibition
Retreating from doing things as before
Change or loss of interest in activities previously enjoyed
Unable or procrastinating in completing a task
May lose previous flexibility and adaptability
Instrumental Activities of Daily Living: Living at Home
Activities expected to achieve
Managing money
Administration of medications
Shopping for essentials and pleasure
Using the telephone
Using transportation
Preparing meals
Doing housework
Clues to potential Problems
Difficulty managing check book and money
Missing medication or not getting refills
Not calling on phone when would previously
Choosing not to drive when previously would
Diet changing to prepared foods rather than preparing meal
House unkempt
Basic Activities of Daily Living
Activities expected to achieve
Personal Living and Self Care
Executive functions as : attention, visuospatial skills, memory
Ability to self care: bathing, dressing, continence then eating and grooming, transferring, toileting
Clues to potential problems
Difficulty selecting clothes to wear or being unable to dress
Not wanting to eat because "they just did" or not sure how to use utensils
Reluctant to shower, potentially too complicated
Incontinent
Unable to organize to put toothpaste on brush and brush teeth