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The AARP Poll Have you discussed with your loved one how to handle finances?

Assessing the Situation: How are Things Going?

Emma, a 60-year-old retired newspaper editor living in Savannah, Georgia, is an only child who took on the care of both her parents. “A year before things came to a head,” she says, “I visited my parents in Atlanta, about an eight-hour drive away. Various comments had gotten me worried. My father was then 88, my mother 84. I realized at once that they’d lost a lot of ground. They’d aged enormously.

We had as much of a discussion as was possible. They rejected any idea of assisted living, making the common mistake that their insurance would be adequate for home care if they needed it. They also made the mistake of giving each other power of attorney. However, when I asked my father whether my mother could find her way about if he should suddenly die, he said, ‘She couldn’t find her way to the front door.’

So we went to the family lawyer and arranged for me to have a durable power of attorney. If I had not had this, things would have been almost impossible when the situation deteriorated late in the summer of 2001.”

Adapted from Caring for Your Parents

As parents grow older, adult children face changes they may not know how to address. They may support their parents’ desire to continue living independently, but have concerns about their safety and well-being—and wonder where the line should be drawn. Fortunately, comprehensive assessment tools and professional consultants are available to help older people and family members decide when an older adult needs assistance.

A good plan can mean fewer accidents and illnesses, a longer and improved quality of life, and greater independence.

The Goal of Assessment An assessment is a comprehensive review of a person’s mental, physical, environmental, and financial condition to establish his or her ability to remain safely independent. It identifies risks and helps determine options to reduce them. A thorough assessment will result in a comprehensive plan for meeting needs and addressing problems. The findings may help you decide whether change is necessary for your parents’ safety and well-being, such as making new housing arrangements or getting in-home assistance. It also may lead to solving problems and allowing a parent to remain independent longer. A good plan can mean fewer accidents and illnesses, a longer and improved quality of life, and greater independence. It is also very important to include your parents in the discussion and decision-making about their options.

While it is possible for families to complete assessments on their own using standard forms, there also are experienced professionals available who can help. Some hospitals and clinics offer geriatric assessment centers or evaluation units in which a medical/social work team looks at all aspects of an older person’s health and life. The center will counsel your parent and you about the results, as well as offer practical assistance, such as linking you with local services and housing options. Individual geriatric care managers, also called case mangers, provide similar services.

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What To Assess Professional assessments can take from three hours to several days. Just filling out a form with your parents can take considerable time. What should you assess? Although different forms and professionals will offer different approaches, a full assessment should include the following:

  • Physical health.
    Selected factors to assess:
    Diagnosed with any chronic diseases (diabetes, high blood pressure, arthritis, emphysema)? Other illnesses (bowel or bladder problems, heart disease, stroke, cancer)? Allergies? Fractures or trauma? Weight loss or gain? Incontinence? Balance problems? Skin growths or color changes? Persistent fatigue or sleeplessness? Swollen feet or legs, or limping? Vision problems (cataracts, use of vision aids)? Hearing problems? Dental problems (gum disease, strong breath, ill-fitting dentures)? Current vital signs? List of health professionals currently being seen? Recent hospitalizations?
  • Mental health.
    Selected factors to assess:
    Diagnosed with any psychiatric disorders (depression, anxiety disorder, psychosis)? Diagnosed with Alzheimer’s or other dementia? Recent hospitalizations for any of these problems? Alertness? Mood swings? Forgetfulness or wandering off? Confusion or disorientation? Sadness or loneliness? Decreased interest in reading, writing, and communicating? Maintaining friends? Interest in life?
  • Medication use.
    Selected factors to assess:
    All medicines taken, prescription or over-the-counter, with times per day and doses. Ability to take medications as directed and know how to avoid interactions. Barriers to proper medicine use, such as forgetfulness, expense, poor understanding of purpose or outcome of use.
  • Daily living.
    Selected factors to assess:
    Mobility or need for adaptive aids. Special dietary needs. Favorite foods. Ability to dress, bathe, get up from a chair, use the toilet, use the phone, climb stairs, get help in an emergency, shop, prepare meals, do housework and yard work, drive safely.
  • Home and community safety.
    Selected factors to assess:
    Neighborhood safety, home safety, hazards, adaptive aids, presence of smoke alarms, ability to avoid telephone and door-to-door fraud, yard and house maintenance.
  • Support system.
    Selected factors to assess:
    Names, addresses, and phone numbers of key family members, friends, and neighbors. Do your parents have frequent visitors or see friends? Do they go to a senior center? Get out of the house for other social reasons? Belong to organizations, including faith-based groups? Do family members live nearby?
  • Appearance and hygiene.
    Selected factors to assess:
    Personal hygiene and overall appearance including brushed teeth, trimmed nails, well showered and shaven, combed hair, clean clothes, appropriately dressed.
  • Finances.
    Selected factors to assess:
    What insurance coverage is in place? Does insurance cover custodial care? What are your parents’ total assets? Are there any legal documents such as trusts, living wills, and/or durable powers of attorney? Do your parents have a financial plan? How long will their assets last? Any sources of financial assistance? Do your parents pay bills on time and make informed financial decisions?
  • Interests/lifestyles.
    Selected factors to assess:
    Hobbies, reading preferences, favorite TV and radio programs, exercise, musical instruments played, languages spoken, favorite conversation topics, travel experience, important life events, religious/spiritual background, accomplishments, social activities.

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Some of this material appears in slightly different form in Caring For Your Parents: The Complete AARP Guide.

© 2003, 2004, 2007 AARP. Reprinting by permission only.

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