**2022 Christmas - our first Christmas as a family of three ft. 9mo Cece and my beautiful partner Ben. I know December and the ‘Festive Season’ isn’t everyone’s favourite time of year. For some it can be incredibly stressful and overwhelming; carrying the extra mental load of presents, timing the pavlova assembly, or working out how on earth your social battery is going to make it through all the events. For others it can be full of joy and celebration. For some it can remind them of loved ones no longer with us or bring up complex family dynamics. For others it can be a time to reunite, re-connect and reflect on the year that was. And for most people, it’s a mix of all these things. I want to acknowledge upfront, that whatever your feelings towards the festive season are, they’re valid. Regardless of your unique situation, commonly people see loved ones more regularly throughout December and January. If you have ageing loved ones in your life, it’s often a good time to check in and really take stock of how they’re going. For this reason, the theme I’ve chosen for December is ‘Annual Check In’.
The concept of an ‘Annual Check In’ is that it gives you a dedicated time to really pause and observe how your loved ones are going. Sometimes if you see someone regularly, you can miss the gradual decline that occurs over a 12-month period. Or perhaps if you don’t see them very often, you can notice a marked change. I thought it would be helpful to unpack: a) what are the signs of decline AND b) what to do if you notice a loved one declining ——————————————- SIGNS OF DECLINE Whilst there are many different clinical tools and metrics used to assess older people’s health and function, I find it most helpful for loved ones to observe their loved ones in various situations. You know your loved ones best, so it’s important to remember that when ‘assessing’ these areas, you compare it to their normal. What I mean by that is that if your loved one has always lived in a fairly messy house and not cared about the clothes they’re wearing, then that’s not a reason for concern. However, if they were previously very house proud and immaculately dressed, but now have piles of letters stacked up, overflowing washing baskets and are wearing a soup-stained jumper… that could a red flag. It’s also important to note that this shouldn’t feel like a formal assessment. I always like to keep in mind how I’d feel if someone came into my home and started asking me why my fridge was empty. I don’t want you to sit your loved one down and interrogate them on all these aspects of their life. Think of yourself as a little private investigator if you will… You’re more subtly observing the following areas and if suitable, asking gentle questions. Lastly, the ‘could potentially mean’ section of the categories are broad suggestions. This does not mean your loved one is necessarily experiencing one of these things and there are a myriad of other reasons these behaviours can occur. CATEGORIES Personal appearance Look for - changes to presentation including clothing, hair, nails Possible Q’s - Mum, you usually have such lovely painted nails. How come you haven’t been doing them as much lately? Could potentially mean - difficulty performing ADL’s (activities of daily living) or decline in eyesight Weight change Look for - any significant weight loss or gain Possible Q’s - Dad, are you still making those amazing curried sausages? I used to love those. Could potentially mean - difficulty preparing meals/accessing groceries Mobility Look for - how they move around an environment e.g. Are they holding furniture to stabilise themselves? Can they get up off a chair okay? Possible Q’s - Aunt Polly, how do you feel getting up off the lounge? It’s looking a little bit harder than it used to. Could potentially mean - physical decline Engagement Look for - ability to engage in a conversation and how they interact with others Possible Q’s - Mum, how are you finding it to hear everyone in here? Could potentially mean - decline in hearing, lack of self-confidence, social isolation, early signs of dementia or anxiety/depression Social/community participation Look for - if they’re getting out of the house much Possible Q’s - Dad, have you still been going to choir on Thursdays? Could potentially mean - decline in self-confidence, social isolation or anxiety/depression Memory/recall Look for - difficulty answering simple questions, high level of confusion or repetition in stories or questions Possible Q’s - Uncle Alby, what did you end up making at the Men’s Shed last month? Could potentially mean - early sign of dementia, decline in self-confidence, sign of infection Medication management Look for - missed days in a Webster Pack or medication stored in a disorganised way Possible Q’s - Mum, I’ve been shocking at remembering to give the cat her morning tablet! How do you keep up with yours? Could potentially mean - cognitive decline, decline in fine motor skills Home maintenance Look for - significant change to how the home is presented Possible Q’s - Dad, I know you love your garden, but I feel like it’s starting to get a little overrun by weeds! Is it getting a little harder to maintain? Could potentially mean - physical decline, cognitive decline SO WHAT DO YOU DO IF THEY’RE DECLINING? Number 1 - don’t panic! Depending on the severity of the decline, there are so many different paths we could go down. Sometimes it doesn’t require the initial ‘panic stations’ that it might feel like when you realise their condition has changed. CALL ME Seriously, I work with a lot of families who notice their loved ones declining and don’t know what to do next. I’d be more than happy to talk you through your options. This doesn’t mean you have to become a paying client - for some people I can give them some pointers over the phone and they’re set. For others, it’s helpful for me to take the lead and guide them through the process. ACAT ASSESSMENT If your loved one hasn’t been assessed by ACAT, now’s the time to do so. When you start noticing even small changes in abilities, e.g. difficulty changing bed sheets or pulling up weeds, it’s worth getting them assessed. All assessments are arranged through My Aged Care. SPEAK TO HOME CARE PROVIDER If your loved one already has access to a home care package, speak to their provider about your observations and concerns. They may be able to work with you to gradually increase services and further support your loved one. SEEK RESPITE IF NEEDED If the situation is more urgent and you are concerned for your loved one’s immediate safety at home, you can seek respite until a more permanent plan is created. They will need to be assessed and approved for respite care (again, through My Aged Care), but if they have the codes, you can begin contacting facilities for vacancies. Again, this is often something I do for clients - because knowing who to contact or where to start can feel overwhelming. Feel free to give me a call if you’re not sure what to do.
I will be discussing these themes in greater depth in my December episodes of my podcast. The podcast is called ‘The Truth About Ageing’ and can be found in your favourite podcast app (Apple Podcasts, Spotify) or at www.navigateagedcare.com.au/podcast In the meantime, if you want some quick tips or want to stay up to date with all things Navigate, come follow me at: Facebook - @navigateagedcareau Instagram - @thetruthaboutageing Thank you again for being part of the Navigate gang. I hope you have a cup-filling Sunday - whatever that looks like for you. Have a beautiful December and I’ll be back again on the 7th of January! Big love, Kate.
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