NEW BRUNSWICK - ’Tis the season to gather with a limited number of friends and family, warmed by the glow of our hearts and hearths during this lingering pandemic.

It is also the perfect opportunity to check in with elder family members, many of whom have been socially isolated and stuck at home since March.

There are eight red flags that you should be aware of during your holiday visit with elders, according to Samara Elias, a social worker for the Parker Adult Day Center. Parker Health Group, provides aging services including nursing care, assisted living, memory care and post-acute rehabilitation in Piscataway, Highland Park, New Brunswick, Somerset and Monroe Township.

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These red flags will help to identify signs of decline in physical health and functioning, mental health and/or cognitive / memory loss

1. Inability to maintain physical appearances.

You may not think twice about a stain on grandma’s favorite holiday sweater, but it could indicate that there’s a larger issue. 

“Often, it’s an indicator that they’re no longer able to maintain their physical appearance,” Elias said. “They may be struggling to do the laundry or maintain good personal hygiene. 

2. Weight loss or weight gain.

Elders can have a well-stocked refrigerator and pantry, but they might not remember to regularly eat their meals. Or, at the other end of the spectrum, they may not recall eating a short while ago and then have another lunch.

 “I think it's probably more common that someone would notice weight loss,” Elias said. “But certainly, if somebody is having some cognitive changes and they don't remember that they've eaten a meal, they could make themselves another one. As people start to have challenges, they gravitate toward the things that they know they can do. They might think I don’t remember if I ate, but it seems like maybe it is time to,’ and so they make another meal. 

3. Changes in mood or behavior.

 “Look for an unpleasant change in their mood,” Elias said.  “If you notice that your loved one is depressed it may be time to speak with their doctor.” 

This is a tricky one to spot because these changes can be triggered by something as common as a change in the weather or someone experiencing pain or discomfort. But it could also indicate declining mental health.

4. Unpaid bills.

If last September’s credit card bill is sitting under a stack of mail or if the check for the electric bill was mailed to the cable company, they could be warning signs that someone is struggling with executive functioning.

“It’s an early indication that they’re having a harder time managing everything,” Elias explained. “Maybe they can no longer do such tasks as writing a check or balancing a checkbook. They will need help.”

5. Messy house.

Take a look around their home. If it’s uncharacteristically disorganized with clothes strewn on the bedroom floor or dirty dishes left on the table or outdated food in the refrigerator, those are signs of concern.

6. Damage to the car.

The body of your loved one’s vehicle can tell a story. If there are scrapes, scratches and dents that you haven’t noticed before, it may be time to make the difficult decision to take the keys.

Age-related changes can affect memory and decision-making processes, the ability to see and hear, reaction times and other skills and abilities needed to safely operate a car.

If they are struggling to drive safely, it may indicate that other skills are deteriorating. So it’s something to be mindful of.”

7. Inability to manage their medications.

Americans ages 65- 69 take an average of 15 different prescriptions per year, and those ages 80-84 take an average of 18, according to a recent study by the American Association of Consultant Pharmacists. 

It could be a tall task for anyone to keep track of that many pills. It is important to double check that your family member is taking prescribed medications correctly.

“If it’s somebody who always had a pillbox to keep everything organized, and now there's bottles around and they're not using the pillbox, that could be a warning sign,” Elias said. “Or, check to see if they’re using expired medications.”

Not taking medication, or taking it incorrectly, can expedite the deterioration of the body and mind, which is why regular checks in the medicine cabinet are warranted.

8. Inability to follow conversations.

“Are they having a harder time following the dinner conversation?” Elias said. “Is this somebody who always used to be super involved and engaged in conversation and maybe they're taking a little bit more of a backseat? Are they asking repetitive questions and can't seem to follow the string of the conversation or hold on to information from the beginning to the end?”

The inability to follow a conversation from beginning to end could indicate a number of issues.

“If you spot any of these warning signs, you should consider consulting with a physician,” Elias said. 

One resource is Parker Health Group, who can consult with you and your loved one to determine if a helping hand is required. Parker can assist with strengthening muscles through services like Rehab at Home, which offers rehabilitation services such as speech, occupational and physical therapies virtually or in the comfort of your home.

The Visiting Nurses Association, a partner of Parker’s, can provide a full range of assistance in your home. Additionally, Parker Navigator provides service-coordination for seniors and can assist with applying for home and community-based services and funding. Parker can also assist in helping you determine if your loved one is ready for an assisted living memory care or nursing care community.

Additionally, there are many resources available in the community to provide education and connect your loved one with support. If you feel your loved one could benefit from activity engagement, the Alzheimer’s Foundation of American has virtual programs available, with more information available on their website.

If you feel in person assistance or companionship is needed, your local town or county office on aging can help provide you with home care agency names as well as many other resources. Many organizations, such as Alzheimer’s New Jersey, have moved their support groups and educational programs online. For those providing support from a distance, care managers or care navigators such as Parker Navigator can serve as your eyes and ears to ensure that your loved one’s needs are being met.