The chances of one of your parents ending up living alone is fairly high. But that doesn’t mean that they can or should live alone. Physical and mental deterioration is very common and almost unavoidable as we all grow older. But what should you be looking for? How do you make that determination and how do you speak to them about it?
If you are asking yourself, can my elderly parent live alone? The 10 signs to look for to determine if they shouldn’t be living alone are:
- they have fallen more than once
- they seem to never leave the house
- they are unable to keep the home clean and tidy
- there are stacks of unopened mail
- they are missing payments and deadlines
- they are losing weight
- they are neglecting their hygiene
- they are getting lost when walking or driving
- they forget or miscalculate their medications
- they become defense and/or paranoid
I will go over each of these signs and how they may impact your parent and you as you both work towards a decision as to whether or not your aging mother or father should continue living alone or move on to an assisted living facility, a nursing home or move in with a relative.
When A Parent Shouldn’t Live Alone
It happens all the time, all of us can look back on certain events and see the signs. But, while we’re living through an event, it seems that the signs are not as clear to us.
A friend’s parent is showing signs of dementia but my friend doesn’t (or won’t) recognize it. My cousin’s child is showing signs of depression but my cousin doesn’t (or won’t) acknowledge it.
Unfortunately, when seniors struggle with basic tasks such as self-care, transportation or household chores, they don’t always talk about it. They could be embarrassed or afraid of losing their independence or homes. Still others might not realize anything is amiss, particularly if they’re in the beginning stages of dementia. – Indeonline.com
There’s a reason why medical personnel and physicians are not technically allowed to treat relatives and friends. It’s because they are too closely involved emotionally and historically with that person.
Those factors cloud their judgment and reasoning. It’s only human nature.
So, for the sake of your aging parent, I ask you to read this list of signs that may indicate your parent should no longer be living alone and to ask a third party to help you – to look at the situation through their unbiased eyes.
And by the way – if your conclusion is that your senior parent is not safe to be left alone any longer then you may be interested in the following information:
- Does My Elderly Parent Need Assisted Living? (9 Signs To Look Out For)
- Housing Options For Seniors 55 And Older
- When To Put Elderly Parent In A Nursing Home
10 Signs That Your Parent Shouldn’t Be Living Alone
Here are my top 10 signs that you and your family or any caregivers should be watching out for to help you determine if your parent is no longer safe to live on their own.
1. Your Parent Frequently Falls
My mother fell a total of 4 times before we came to the conclusion that she could no longer live alone and that she really shouldn’t be left alone for any length of time. All her falls were while she was doing regular household activities. There was nothing that she tripped over or bumped into. She simply lost her balance.
That last fall that she had resulted in a large bruise on her face and a small injury to her shoulder that she never recovered from. We were lucky that she did not injure herself to the point of becoming incapacitated or worse.
You can’t always rely on your parent(s) to tell you that they fell – you have to be a bit of a detective. Here are some signs to look out for:
- you begin to notice that they have cuts or bruises anywhere on their skin
- any new dents or scrapes on their car
- items on the floor that shouldn’t be there (they may avoid bending down to pick up some items for fear of losing their balance)
2. Your Parent Has Become A Hermit
It’s certainly not uncommon for many seniors to stay home more than they used to.
For some, it’s simply too difficult a task to “get out” to events, meet friends or even just to go to the grocery store.
For other seniors – issues such as anxiety and depression are the factors that make it too difficult to get out of the house.
3. Their Home Is Messy And Unclean
Daily chores are not as easy to manage when you get older. Pushing around a vacuum cleaner can become very labor intensive (especially if they still have the same vacuum cleaner they did 30 years ago!).
It’s also much more difficult to reach high and low places so dusting becomes much harder.
These little signs of disarray are not what you should worry about.
Instead, what should send out an alert is if you see stacks of dirty dishes in the sink, dirty clothing piled on the washer or the floor, bugs in the pantry or worse, the refrigerator.
When I was an Occupational Therapist I once did a home assessment for a woman who was living alone. She was scheduled to go home within a week but of course, we had to make sure that her home was safe and that she was going to be safe in it.
When we arrived, everything seemed fine. She had been gone for 4 weeks so we expected to see some dusty furniture, etc. When I asked her to show me how she would prepare a meal, she opened the refrigerator and to my horror it was filled with roaches! But, that wasn’t the worst part. What happened next was that she just reached into the fridge, took out some bread and some cheese (which had a good amount of mold on it) and began to make a sandwich!
Needless to say, we had to advise her family that she could not live alone any longer.
4. You See Stacks Of Unopened Mail
Normally, what goes along with an untidy home and unkept hygiene is the accumulation of “stuff” such as mail, garbage, etc. Neglecting these issues is oftentimes a natural part of the person’s aging process depending on their circumstances.
The reasons for this type of neglect include Physical Difficulties, Depression, Cognitive Decline and Sensory Decline.
Your parent may be suffering from one or several of these issues and as a result, they abandon the daily rituals that they’ve been practicing for decades. Rituals such as tending to the mail every day, tossing out the junk mail and filing or taking care of other mail.
5. Your Parent Is Missing Payments and Deadlines
My mother was extremely fastidious about paying her bills and meeting deadlines for Medicare enrollment, getting her physicals and all the maintenance issues in her home and auto.
After she turned 88 year old it became apparent that she was having a difficult time keeping up with these matters. We noticed bills sitting on her kitchen counter, unopened for days and at one point, she missed depositing a check into her bank account which resulted in a bounced check payment to the gas company.
It was then that we knew we had to intervene and help her with these types of daily chores. I do wish we had done it sooner but, like most elderly parents, my mother was not willing to let go of control so easily! But, I do urge you to try as soon as you can to not necessarily take over, but to help with the tasks.
6. They Are Losing Weight
Weight loss in seniors is normally a sign of neglect.
Getting to the grocery store can be difficult. Preparing a full meal can be difficult. As a result, your elderly parent may not be eating enough and probably not the right kinds of food to maintain their health.
Another contributory factor is sensory decline. My mother began eating more sweets and that was something she never did. Instead of eating a protein and a vegetable for dinner, she would opt for a small boiled potato and a large piece of apple pie. Although that sounds great, it’s certainly not nutritional.
7. Your Parent Is Neglecting Their Hygiene
Just as they would neglect their mail and their home, it’s very common for elderly individuals living alone to neglect their hygiene. Again, it could be a result of cognitive decline, sensory decline (they may not smell their own body odor) or it’s simply too difficult to perform these tasks physically.
8. They Are Getting Lost When Going To Familiar Places
When I talk about “getting lost” what I mean is becoming disoriented either in their own home, a friend’s home, driving to their drugstore or grocery store, etc. Basically, finding areas that once were familiar now seem foreign.
Now, if it happens once or twice, it’s not necessarily an issue, yet. And it may not become an issue, so don’t panic. But, I do strongly recommend that you schedule an appointment with the doctor for a cognitive test to determine what kind of dementia may be happening.
But if you find out that your mom or dad is getting lost often – then it’s time to take some precautions. Unfortunately, at this point, depending on it may not get better, it may only get worse depending on their diagnosis.
9. They Forget Or Miscalculate Their Medications
Hopefully, your senior parent is using some type of pillbox to keep track of their medications. If you notice that today is Friday and their pillbox has meds in it from Thursday and Wednesday, it’s a very good sign that they are not remembering to take their medication or simply are no longer able to comprehend that they should be taking it.
10. They Become Very Defensive And Paranoid
I saw a friend’s father, at 96 years old, become very defensive and slightly paranoid as he began delving into conspiracy theories and collecting newspaper clippings of these types of stories.
Unfortunately, it’s very common but is usually a sign of cognitive decline and possible dementia or Alzheimer’s disease.
How Can I Help My Elderly Parent?
I am fully aware that offering help to your elderly parent may not be an easy task for you or your parent(s). Believe me, I have experience in this matter.
My mother was a very strong willed and independent woman and getting her to accept help was an uphill battle. If you are struggling with this issue as well here are 4 strategies that my family used to deal with our difficult mom.
- Lay down the groundwork early by talking with each other (and our mother) about options that we could use as our mother grew older.
- We included our mother in as many discussions and decision making processes as we could.
- We went with her to any new doctor, therapy, activity, etc. to help ease her fear of doing something new.
- We accepted the fact that what we could not change was ultimately her decision, her life.
Read more about how we dealt with this issue and how it may help you in your situation.
Okay, so I’ll go through each of the 10 signs that I mentioned above and this time address how you can help your elderly mother or father in each of these situations.
If your parent has fallen once, take it as a serious sign (even though they probably will not). Have them assessed by a physician or better yet, a physical therapist who can give them the STEADI which is a series of balance tests specifically for the geriatric population.
Don’t wait until it’s too late. Make sure to talk to your mother or father and stress to them the importance of informing you if and when they fall.
Note: If you don’t trust that your parent will tell you when/if they fall – I would recommend to look into the list of fall detection devices that are available today. There are several that you can look into but just to give you a few to start looking at.
Also – know that Apple Watch now has a “fall alert” option on their watches.
Besides these techy tools – you can certainly check your parent (as discreetly as possible) for signs of bruises, cuts and scrapes. Although these don’t always indicate that they have fallen, it does give you cause for suspicion.
Of course, even if they don’t admit that they have had a fall (my mother did not) and you suspect that there are frequent falls, I would then strongly recommend to give them a medical alert system that they can wear at all times. Even if they are living with someone. It’s unlikely that the two of them will be in the presence of each other every minute of every day. So, a medical alert is just the sensible thing to do.
My mother in law, who is 98 years old and lives alone, uses the Touch N’ Talk Medical Alert and has been using it for a few years now. It’s worked out wonderfully to give her the peace of mind that just in case anything were to happen, help is nearby.
Familiarity and security are very big issues for the elderly and staying home is sometimes the only way they can achieve that.
The other and more probably factor in older adults becoming reclusive is depression and anxiety. If you can get your parent to go for a psychological exam to assess whether or not they are suffering from depression and/or anxiety – I strongly recommend that you do that. I know it’s not easy.
My siblings and I dealt with my mother’s denial of her own depression and anxiety for over a decade and all that did was to leave a sour note in our hearts about our mother. Yes, it made it easier for us when she passed away (emotionally) but we lost more than 10 years of having a good relationship with her – and that we can never get back.
Besides the professional psychological intervention you can also begin a routine of taking them out every Sunday for brunch or whatever OR you can get more visitors to their home. It could be family, friends, neighbors, volunteers (you can check out ElderHelpers.org).
My mother was very private and refused most anyone coming to her home but by asking some of our friends to visit every now and then, and with the great help of Hospice – she had visitors almost every day of the week which truly resulted in lifting her depression.
(Note: There is a great mis-understanding about Hospice. The thought is that if you call them you are dying within a few days. The truth is, Hospice is palliative care for anyone with a terminal illness. It doesn’t mean they are dying immediately, it simply means they have an illness that cannot be cured. For my mother and us, her children, we could not have been happier with the love, care and attention we got from that great program. They truly were amazing. )
Messy Home Environment
If your parent is unable to keep their home clean and tidy due to a physical disability – the best solution is to either come in and do the work for them or to hire someone to do it. Of course, the degree of disability will dictate how much you or an aide needs to do.
If your parent just needs a little help, check out the list of tools that I recommend. Some of them may be useful for him or her.
Pile Of Unopened Mail
If you can identify the cause, you may be able to get help for your elderly parent but some issues such as cognitive or sensory decline will require intervention vs. just treatment.
Missed Payments And Deadlines
Take the time to check the mail your parent is getting. Late and Final notices are a strong sign that they are not attending to their bills as they should.
Don’t wait for the gas, water or electricity to be shut off!
And I’m not saying that you necessarily need to “take over” paying the bills for your parent, that decision depends on how much cognitive impairment is evident in your mother or father.
At the very least, speak with him or her about helping them with the task, working together. You can even schedule it so that, for example, you could both work on bills and mail every Monday. Put it on the calendar as a reminder.
Weight loss in any elderly person is of concern and it can be a result of one or combination of any of the following:
- Reaction to medication(s)
- Cognitive decline
- Physical problems with swallowing, dentures, loss of smell and/or taste, etc.
- Having difficulty preparing meals (due to physical and/or cognitive issues)
- Medical condition such as GI problems, cancer, etc.
- The natural act of dying
Most medical professionals define unintentional weight loss as a 5% – 10% decrease in body weight over 1 to 12 months, and more specifically, a 5% loss over a 6-month period. Medline Plus
But, I do have to say that personally, I have worked with hundreds of elderly in their final months (including relatives) and honestly, nutrition is not on the top of the list as far as caregiving. I know for myself, if I was in my final months or years I would like to indulge in my favorite foods as much as I desire.
My point is, speak with your parent’s doctor first and just don’t make THAT big a deal about nutrition.
If the issue is that it’s difficult for your parent to prepare their meals you will then want to look at what the actual problems are.
- Are they having problems accessing items in the kitchen? If so, check out our tips on how to make the kitchen more senior friendly.
- Are they having physical problems such as standing, bending, endurance issues?
- Are they having cognitive problems that keep them from staying on task, remembering how to cook?
If the issues are more related to physical then I can recommend a service like Blue Apron which can make it much easier for your parents to get fresh food items into the house and an easier method to prepare their meals.
If you notice a decline in your parent’s hygiene – muster up the courage to speak with them and try to find out what the problem is.
If it’s a physical problem that is keeping them from caring for themselves, there may be some tools that you can purchase and/or install to help them.
If it’s a cognitive problem, you will need the help of a physician and either a Cognitive or Occupational therapist to help you.
How To Talk To Your Elderly Parent About Hygiene
What you really want to find out from your parent is what’s keeping them from keeping up with the daily chores to wash themselves, change their clothing and underwear, brushing their teeth, etc.
They may or may not be able to tell you but it’s worth the discussion.
Understand that for your aging mother or father, acknowledging that they may be having a problem with self care can be devastating. It basically means that they are no longer able to care for themselves and that they will be requiring help from another person.
It’s not only frightening to know that you are losing your independence, but it’s also very disturbing to admit that you will, more than likely, from now on need assistance and that you are just that much more closer to your final days.
So, be gentle with the conversation. Avoid being accusatory and try not to focus on any level of incompetence. Keep the conversation focused on the idea of helping them and making things easier for them.
Following are some problems that may be causing the neglect for self care and what can be done to help.
Problem: It’s physically difficult for them to perform any one or all of their daily self care tasks.
Solution: Sometimes tools like sock aids and long reach grabbers can help if mobility is the problem.
Sometimes changing the routine to smaller tasks can help.
For example: my mother suffered from pulmonary fibrosis – she was unable to perform any task that took more than 10 minutes without losing her breath – even with oxygen. So, we broke up her daily morning tasks so that she would spend no more than 5 minutes or so on each task and then rested for 10 – 15 minutes in between. It worked very well.
Recognize that if physical factors are impeding – and tools or altering how these tasks are done don’t help – then it may be time to consider having someone (even hiring an aide) to help.
Problem: Depression can play a very big role in maintaining personal health.
Solution: This will require the help of a physician or psychiatrist and possible counseling. Don’t ignore your elderly parent’s depression – there are medications that can help them to live their remaining years with much more satisfaction.
Problem: Cognitive decline can easily disconnect your mom or dad from the routines that they’ve been performing for decades.
Solution: Decreased cognition is NOT just memory loss. It’s also loss of rationale, loss of judgment. This is when you may see an elderly person using a toothbrush that is so old it cannot truly be cleaning their teeth. Or when they keep food in their refrigerator or pantry that is years beyond it’s expiration date and worse, eat it!
If you suspect that your aging mother or father is having cognitive problems, don’t expect them to be able to tell you. Get them to a physician where they can order cognitive testing.
A Cognitive therapist or an Occupational therapist will be able to help provide you with some techniques and/or tools to help you and your mom or dad.
There are some things that you can do to help your aging mother or father if they are consistently showing signs of confusion.
- Within their own home – you can certainly put up visual cues such as signs on doors. (i.e. Bathroom on the bathroom door, Master Bedroom on their bedroom door, etc.)
- In someone else’s home – alert the host of your parent’s condition so they don’t leave them alone and just assume that they can find their way to another room in the house and find their way back again.
- When driving – it’s very important to get a doctor’s recommendation on whether or not your parent should continue driving. The company AAA has a program where they provide professional assessment of driving skills. It’s quite comprehensive and worth a look at.Of course, I know that it can be very difficult for anyone to give up their freedom (i.e. their car and driving). For more information and help on this topic read our article on When Should Seniors Stop Driving?
Unable To Manage Their Medications
The use of a pillbox to keep track of what medicine to take when can be very handy for anyone, not just seniors. So, I would recommend starting with that. Just make sure that it is a box that they can open. Oftentimes, with severely arthritic hands, opening some types of containers can be difficult and frustrating.
The trick with managing medications comes when new or different medication is prescribed. You want to make sure that your parent is following the recommendations on the bottle.
I remember sitting in a patient’s team conference with their other therapists and their physician and the doctor told me that he asked the patient to read the medicine bottle and they were clearly able to do that so he concluded that there was no issue with them being able to follow the instructions on the bottle.
I took the doctor to that patient – asked the patient to read the medicine bottle (which they did very well) and then asked the patient “What does that mean?”. To the surprise (and probably embarrassment) of the doctor, the patient did not know.
Because making mistakes with medications can cause severe problems – I recommend that if you suspect (or know) that your elderly parent is having a problem (physical or cognitive) that either you, an aide or caregiver monitor and/or dispense and be in charge of the medication.
Become Defensive and Paranoid
If your parent is becoming, or has become defense, paranoid, hostile, etc., please know that I am sorry. I have dealt with many individuals in this situation and it’s not easy, especially for YOU.
The best advice I can give you is…
- know that their outbursts are not directed at you – it’s not personal.
- make sure to step away on a regular basis (every day spend a few hours away) because it can emotionally drain you.
- keep your voice calm and remain calm – that most often helps to diffuse the situation.
- redirect the conversation or situation to something else.
- get help – it’s extremely difficult to deal with someone in this stage alone.
What Percentage Of Older Adults Live Alone?
According to MerckManuals
In the US, nearly 29% of the 46 million community-dwelling elderly live alone. About half of the community-dwelling oldest old (≥ 85 yr) live alone. About 70% of elderly people living alone are women, and 46% of all women age ≥ 75 yr live alone. Men are more likely to die before their wives, and widowed or divorced men are more likely to remarry than are widowed or divorced women.
That’s just over 13 million elderly in the USA living alone.
How To Tell A Parent They Can’t Live Alone
Having “the talk” with your mother or father about any issues they may be having and your worries about those issues is difficult, without a doubt. I know with my own mother, she would just get up and walk away and refuse to discuss it.
What helped me and my siblings was to get her doctors (who she trusted more than us) to speak to her about it. I would recommend that you try something similar.
It can be a doctor, a relative, a friend, etc. It’s certainly worth a shot.
Following are some approaches that may help you when talking to your parent about either getting a caregiver or moving to an assisted living facility.
- Don’t spout off facts – instead use stories. Perhaps you know someone (or your parent knows someone) who ended up in an unfortunate situation simply because they were alone. Remind them or tell them of that.
- Target the conversation towards what they want (instead of what YOU think they need). An example is about independence. Everyone wants that. But, if something happens (like a fall or they accidentally set the house on fire) they will lose that independence. So, I would tell my mom something like “What can we do to make sure that you stay as independent as possible?”
- Alleviate their fears of going into a nursing home. Again, use stories to tell them how others avoided this by hiring a caregiver to come in and do whatever needs doing.
Note that if the decision has been made that your elderly parent cannot live alone any longer – there are several options available that don’t require moving to an assisted living facility or nursing home.
Recently, there has been a growing trend of “aging in place communities” that are increasing in number around the world. These communities come in a variety of flavors.
- 55 plus communities (the kind most of us associate with senior living – mostly in Florida and Arizona)
- Faith based communities – these are senior care facilities focused on and/or owned by a specific religious faith. You can find a list of them here.
- Village communities – this began in 2001 in Boston and is a grassroots movement that has grown worldwide. Basically, communities establish a membership group to create a “village” and all members of that village work to help each other. Members stay in their own homes but because their village is in their community – they all work together to help each other as needed. You can read more about the Village Movement here.
- Senior cohousing – this type of community can include condos, townhomes and single family homes. Individuals are matched for compatability and they share a home. There can be private kitchens for each person along with public spaces within the home. But all costs to maintain the home are shared amongst it’s residents.
These are just some of the innovative and new types of housing arrangements that are sprouting up around the world. As the aging population will be increasing from 2020 through to 2030 – cities, communities and families and elders are all working together to come up with creative housing options to help seniors who can no longer live alone.
Can A Person With Dementia Live Alone?
The answer to this question really depends on the level and type of dementia.
My friend’s father had slight to moderate dementia and he was living in an assisted living facility but did not require any assistance with self care. The only amenity he took advantage of was the meals they provided, which was only breakfast and dinner. Otherwise, he lived alone in his apartment and took care of himself.
But Alzheimer’s is a different story. And again – it depends on the stage of the disease they are in.
Normally, people with dementia of any kind do best when there is a strong structure in place. They are living in the same house they have lived in for years, they are doing the same thing at the same time, every day. Structure.
In the early stages of any form of dementia – it’s perfectly fine to live alone but it does not necessarily mean that they are healthy and safe.
I strongly recommend to begin implementing a system of caregiving. Not only will your aging mom or dad become accustomed to this new “structure” before their dementia or Alzheimer’s gets worse but it should give you peace of mind and help them to live safer longer.
How To Get Help For The Elderly Living Alone
You may not be aware of the many programs available for the elderly and their caregivers, but they are out there. Here’s a list of resources you can reach out to for help and/or information.
- Senior Companions
- Meals On Wheels
- Medicaid will cover non-emergency medical transportation (i.e., visits to doctors for schedule appointments)
- Medicare will cover emergency visits that require 911
- For all other transportation needs Uber and Lyft have been working well –
- There are 3rd party programs like GoGoGrandparent program and GreatCall that are specifically designed for caregivers and seniors.
How do you declare an elderly parent incompetent? There are 5 steps to declaring someone incompetent.
- You must consult an attorney
- You must file for guardianship
- Your parent must undergo a psychological evaluation
- The evaluation is then submitted to the court
- You and your attorney attend the hearing where a ruling is made
How to combat loneliness in old age? Some tips to combat loneliness can include getting them a pet that is easy enough for them to care for. Getting them involved in a weekly event, even if it’s just Friday night dinners at the local diner with some friends. Arranging for weekly family and/or friend get-togethers in their home such as Sunday dinners. Encouraging them to volunteer their services such as knitting blankets for babies in the hospital, helping out at the local women’s shelter, etc.