It is easy for friends and family to be unaware that their parent, friend or other loved one is in crisis. Family and friends fall into what I call "conversational patterns" meaning that basically the same things are discussed all the time. An elderly person with dementia knows the socially acceptable answers to these types of questions.
It is impossible to have a clear understanding of what is happening with your elderly friend without spending a substantial amount of time with him/her/them.
Signs of problems:
1. Weight Loss for no apparant medical reason. Even bringing prepared food to the elderly person doesn't seem to help. The food goes bad in the refrigerator. Basically, the elderly person "grazes" or eat bits and pieces.
2. Gets medication mixed up or quits taking medication. The helper finds all kinds of medication in drawers, on the cupboard, etc., but often it isn't what the elderly person should be currently taking.
3. The elderly person starts falling. Now, I often hear family or friends immediately want to put the elderly person in assisted living or a nursing home when they've had a fall or two. If someone is going to fall, he/she will fall there, too. The thing to do is work with the doctor to try to determine the cause. It is not uncommon that an elderly person who falls for no apparant reason has a urinary tract infection (bladder infection) and once it's cleared up the falling stops.
4. Not allow anyone in or allowing everyone into the home. This is a safety issue.
5. Wears the same clothes for weeks on end.
6. Unable to pay their bills on time or at all. This can lead to financial exploitation.
I've been called in to assist an elderly person because a friend or family member, who has been helping out, can no longer assist due to the decline in their own health. The helpers will tell me that the prospective client only needs a limited amount of assistance but when I see the home and talk with the client it is obvious to me that the client is in crisis. Sometimes the prospective client is no longer safe to stay alone at home.
When I run into this situation, I try to find out if there is a Power of Attorney document and contact the person designated so that I can work with the person responsible for the client to make the home a safe place for the client. Sometimes that means hiring caregivers to come in for a few hours a week or daily (depending on the need), accompanying the client to medical appointments and sitting in on the appointments to get a clear view of the medical issues.
If there is no Power of Attorney, the next step is to get Adult Protective Services involved. The 800 number for your State is in the State section of your local phone book. If you still cannot find the number, call your local law enforcement and they will give you the phone number. Adult Protective Services can help get resources in but they work under strict guidelines and cannot remove anyone from the home without a court order.
Sometimes a client needs to move into a facility. Typically, approaching the topic as a temporary situation is more easily accepted by the client than talking about the move as a permanent arrangement.
I realize that this is a simplistic way to resolve a crisis but each crisis is so varied that I will illustrate some in future posts.