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3 More Signs of Functional Decline

by Ryan Malone, Inside Elder Care

In the last blog, I discussed some of the warning signs that your loved one could be experiencing functional decline, including difficulty communicating and the disturbance of everyday functions and tasks.

These kinds of hardships may be symptoms of a more serious functional decline, in which your loved one is losing the skills needed to maintain basic independence.

In the previous blog, I gave a detailed account of physical, perceptual and cognitive changes that can indicate a functional decline.

Now here are three more areas to monitor if you believe your loved one may be experiencing functional decline.

1. Hearing and Vision Loss

Hearing loss is hard to hide; it’s often one of the first indications your loved one is in need of assistance. Here’s a list of things to note:

  • Saying “What?” over and over again during conversations, or repeating what you just said, as if to confirm what they heard.
  • Turning the volume up on the television repeatedly, until the neighbors may be able to hear it – while your loved one still complains it’s ‘too low.’
  • An inability to distinguish certain sounds, such as f, t, and z, resulting in misunderstandings and miscommunication.
  • Nodding frequently during conversations, as if to confirm that they are participating fully in the dialogue.

And then there is eyesight – often the first of the senses to be noticeably affected by age. Focusing on small details becomes difficult; self-grooming becomes challenging – and who can write out the checks to pay bills when you can’t see the numbers?

As with hearing loss, compromised vision is also a safety issue. What are some of the signs of decreased visual acumen? Just ask yourself these questions:

  • Has your loved one lost interest in reading, playing cards, or other hobbies where clear vision is required (embroidery or television viewing, for example)?
  • Are their clothes, shoes or socks frequently mismatched?
  • If they still drive a car, are they getting lost more often (because they can’t see the street signs)?
  • Has your loved one started to fall, trip or bump into things more frequently?

Once again, a primary concern here is one of safety. How safe can your loved one be, if they can’t clearly hear or see the world around them? And if they’re driving, it can be catastrophic.

2. Frequent Falling

Certainly, frequent falling may not be related simply to poor eyesight; it could be the result of medical conditions related to poor physical health. Or repeated falling in the home environment could be the result of poor safety habits: loose throw rugs, a cluttered living space, exposed wiring, no handrails or poor lighting. There are also those elderly who refuse to use their assistive devices such as canes, walkers and wheelchairs – even refusing to wear their eyeglasses!

Whatever the causes, the consequences are serious – and should be addressed by your family or geriatric physician. Here are some things to watch out for:

  • Unexplained cuts and bruises, or explanations for these injuries that seem far-fetched or implausible.
  • Hesitancy when walking or climbing stairs.
  • Reticence to leave the familiarity and relative safety of their home.

3. Psychological Changes

May Lamberton Becker – the journalist and literary critic once said, “We grow neither better nor worse as we get old, but more like ourselves.” What she’s describing is the process called disinhibition, where those personality traits that may have once been charming or quirky slowly become exaggerated as we age. Aunt Rosemary used to be rather bossy, but now she’s dictatorial; your father, who used to simply be self-reliant, is now completely resistive and argumentative.

It seems that the natural process of disinhibition is magnified when aging is coupled with fear and unhappiness. If it is complicated even further by depression or anxiety, your loved one will completely cling to those coping strategies that served them so well in their younger days – to the point they completely interfere with an independent life.

So, whatever you do, don’t delay in taking action. Start actively assessing all six areas of your loved one’s strengths and abilities as soon as possible. If there are signs of a serious functional decline, then you may want to consider a transition to assisted living.


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