Is Your Parent Still Safe Living Alone?

The National Institute on Aging (NIA) says the best way to know what someone needs is to ask them, but that a call or a text is not always the best way to tell whether an older person is struggling. Some people do not want to worry their children. NIA groups the signs it describes into four kinds:

• Changes at home: meals not being cooked safely on the stove, not bathing or not dressing for the weather, a home that is no longer clean or is cluttered, medicines missing or not being taken.
• Mood: an older person with depression may brighten up for a short call or visit, so serious mood problems can be easier to see over a longer stay.
• General health: big weight gain or loss, poor hygiene, confusion, falls, loneliness or isolation, trouble walking or getting around.
• Memory and thinking: more than occasional forgetfulness, changes in personality, or poor decisions, which NIA says could point to a serious condition that needs medical attention.

Stay long enough to see an ordinary day, not just a visit where everyone is on their best behavior. Then walk through the home with fresh eyes.

In the kitchen, open the fridge: is there fresh food, or spoiled food and little else? Look for burned pots or scorch marks near the stove. Check the mail for unopened bills, late notices or a pile of solicitations. Count a few pills against the dates on the bottles, if your parent is comfortable with that.

Look at how your parent moves. NIA's home safety tips point to loose rugs, poor lighting at the top and bottom of stairs, and the lack of grab bars near the toilet and in the shower. Ask whether they have fallen recently. The Centers for Disease Control and Prevention (CDC) says less than half of older people who fall tell their doctor, so you may need to ask directly.

Notice the car, too. New dents and scrapes are worth a gentle question. These are signs to talk about, not proof of anything: there may be a simple reason.

The CDC says more than one out of four people aged 65 and older falls each year, and falling once doubles the chance of falling again. It also says many people who fall become afraid of falling, cut back their activity and grow weaker, which raises the risk further. An older person who falls and hits their head should see a doctor right away, the CDC advises, especially if they take a blood thinner.

The CDC suggests asking the doctor to assess fall risk, asking the doctor or pharmacist to review all medicines, including ones bought without a prescription, for any that cause dizziness or sleepiness, having eyes checked at least once a year, and exercises that improve leg strength and balance. For what care homes can and cannot do about falls, see fall risk in assisted living.

NIA suggests raising your concern without sounding critical, for example by asking whether your mother is having trouble getting to the store rather than saying the kitchen is empty. Then try to honor what your parent wants, with practical help: grocery delivery instead of giving up cooking, a ride to appointments instead of giving up the doctor.

If you are worried about physical or mental health, suggest a visit to the doctor, and offer to book it or go along. NIA also lists home help such as an aide who visits regularly, transportation, and a geriatric care manager to coordinate care. If you live far away, NIA suggests asking neighbors, friends or local relatives, with your parent's permission, to call you if they notice something.

If those steps are not enough, or your parent's needs keep growing, it may be time to look at the signs it is time for assisted living. Our guide on talking to a parent about assisted living covers how to raise the subject.

Every California county has an Adult Protective Services (APS) agency. The California Department of Social Services says APS helps adults 60 and older, and dependent adults 18 to 59, when they cannot meet their own needs or are victims of abuse, neglect or exploitation. That includes people living in their own homes and apartments.

To make a report, the Department says to call 1-833-401-0832 and enter your ZIP code to reach the APS agency in that county, 24 hours a day, 7 days a week. APS services are available regardless of income.

If anyone is in immediate danger, call 911. If your parent already lives in a licensed care home and you have a complaint about it, contact California's Community Care Licensing Division at 1-844-538-8766.

Hamssa Benrekia is a placement specialist in Torrance who helps families in the South Bay and Harbor area of Los Angeles County find licensed assisted living communities and board and care homes when living alone is no longer working. She can talk through what you have seen and what kinds of homes may fit. To start, contact Hamssa, or explore the California Assisted Living Placement Guide.