Chapter 4: Caring for an Older Adult

Changes that are NOT a part of aging

As a caregiver, you will see changes in your loved one. Some of these changes might just be a part of getting older and some might happen because of illness. Have your health care provider check your loved one when you notice these changes.

  • physical pain: can be a sign of disease (like arthritis) or injury. Heart disease might also cause chest pain.
  • falls: can happen when there are problems with medication, blood pressure, vision and mobility.
  • leg swelling: can be a sign of heart disease like angina or congestive heart failure or lung disease such as chronic bronchitis or emphysema.
  • problems passing urine: can happen when a person has a bladder infection or a man has prostate problems.
  • leaking urine: weak bladder muscles can cause your urine to leak.
  • forgetting names of close family and friends or names of objects: conditions like Alzheimer's disease and dementia can make a person forget things. It is normal to forget where they put their keys but you need to worry if they forget common words like fork or getting lost in their own neighbourhood.
  • double vision, seeing circles around lights or sudden blurred vision
  • tiredness
  • anxiety
  • problems with eating and drinking: might be because of pain, missing teeth or poor fitting dentures. Bone and joint disease make it hard to prepare food. Depression can also lead to changes in appetite.
  • shortness of breath
  • weight changes
  • changes in how they look: do not take care of themselves, smell bad, are dirty, wear dirty or inappropriate clothing, house is a mess.

If you notice any of these changes in your loved one, try to get them to see their health care provider. The health care provider might not be able to "fix" all of their problems, but they will be able to monitor the situation and know how to help.

Mental health

Late-life depression is a serious and growing mental health problem1

About 20% of older adults 65 years and older, who live in the community, have some form of mental health issue.2 The Canadian Study of Health and Aging, for example, revealed that 12.7 percent of long-term care residents aged 65+ suffer from major or minor depression.3

About 5% to 10% of older adults will have depression that is serious enough to need treatment. And the rate of anxiety and depression increases to 30% to 40% for older adults living in long-term care facilities.

Most people with depression (over 80%) respond well to treatment and will have a complete and lasting recovery. Sadly, 90% will NOT seek out the help they need or their depression will be missed or ignored. Depression in the elderly can be very hard to recognize. You may think depression is a symptom of another medical condition or you might make the mistake of thinking it is a normal part of aging.4

Watch for changes in your loved one's mental health and talk to them about it. There are treatments that can help but many older people suffer because they never get the help they need.

Emotional changes that are NOT a part of aging

Here is a list of things that you can watch for:

  • drinking more alcohol or using more drugs (prescription or non-prescription)
  • feeling sad or depressed, for more than 2 weeks5
  • crying easily
  • personality change: an easy-going person suddenly becomes suspicious or easily gets angry
  • not going out much, not seeing friends
  • mood swings for no obvious reason
  • forgetting everyday words and saying things like "I need the thing I eat with" instead of saying "I need a fork"
  • feeling overwhelmed or unable to cope with daily life
  • not coping well after a loss of someone or something  special to them
  • increased fears or suspicions
  • talking about things that do not make sense or have no logic

Talk to your loved one about the changes that you have noticed and try to get them to see their health care provider. You can offer to make the appointment and go with them. You might be surprised to find out that they want you to go with them.

Thoughts of suicide

The suicide rate for people age 65 and over (especially men) is higher than any other age group.6

Mental changes in your loved one can get worse even if they are receiving help. They can become suicidal and want to end their life.

Know the signs of suicidal thoughts so you can help your loved one right away.

Signs to look for:

  • they say that they feel useless and hopeless
  • they say things like "I wish I could go to sleep and never wake up"
  • they give personal possessions away, like their jewellery
  • they suddenly put their personal and financial affairs in order
  • they withdraw from social activities and isolate themselves
  • they are not able to get over a loss of someone or something they liked or loved

Get help immediately if:

  • your loved one says that they want to hurt or kill themselves
  • your loved one looks for ways to hurt themselves (collecting knives or guns or pills)
  • your loved one talks or writes about death, dying or suicide

Never leave a suicidal person alone. Call 911. Stay with them until health care providers are there.

Give us your feedback

Please share your comments or concerns on this section of the Guide. Your comments are important to us. We appreciate and thank you for taking the time to complete this short Feedback Survey. If at any time, you wish to speak with a nurse at Ottawa Public Health please call 613-580-6744 TTY/ATS: 613-580-9656 or email us at healthsante@ottawa.ca.

References

  1. Blazer DG. Depression in Late Life, 3rd edition. New York:Springer; 2002. 
  2. Butler-Jones, D. The Chief Public Health Officer's Report on the State of Public Health in Canada, 2010: growing Older-Adding Life to Years [Internet]. Ottawa (ON): Public Health Agency of Canada; 2010[modified 2010 Oct 28: cited 2013 Jul 26]. Available from:http://www.phac-aspc.gc.ca/cphorsphc-respcacsp/2010/fr-rc/cphorsphc-respcacsp-06-eng.php
  3. CMHA Ontario Division: mental health for all [Internet]. Canadian Mental Health Association; c2013. Minding our elders: Mental health in long-term care; 2007 [cited 2014 Jan 7]; [about 6 screens]. Available from: http://ontario.cmha.ca/network/minding-our-elders-mental-health-in-long-...
  4. Mood Disorders Society of Canada [Internet].  Guelph (ON): Mood Disorders Society of Canada; c2011.  Depression in Elderly; 2010 [cited 2013 Nov 20];  Available fromhttp://www.mooddisorderscanada.ca/documents/Consumer%20and%20Family%20Support/Depression%20in%20Elderly%20edited%20Dec16%202010.pdf
  5. CAMH, Centre for Addiction and Mental Health [Internet]. Toronto: CAMH; 2012 [cited 2013 Jul 26]. Available from:http://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/depression/Pages/default.aspx
  6. Centre for Suicide Prevention. Plus 65: At the end of the day [Internet]. Calgary, Alberta: Canadian Mental Health Association; 2012. [cited 2013 Jul 26]. Available from:http://suicideinfo.ca/LinkClick.aspx?fileticket=cmFwRL4DMJw%3D&tabid=563

Normal Changes That Happen With Aging

This section talks about what is a part of normal aging. Aging is not a disease; it is normal and natural. Aging is an individual process that happens at different rates for different people. This depends on genetics, health conditions, and lifestyle.

Here are some changes that you should know about as a caregiver.1

  • hair gets thin and turns grey.
  • skin gets thin and can bruise, burn and tear more easily. It becomes drier and sweats less.
  • eyesight: It can be harder to focus or see where an object ends and where the background begins. It is harder to get used to different light levels.
  • hearing can decrease.
  • taste buds become less sensitive, dull.
  • sense of smell decreases and food might seem less appetizing.
  • muscle mass and strength decrease. It can take longer to do normal daily tasks and they can be harder to do.
  • memory: It can take longer to remember things and find the right words to describe something. Some forgetfulness is normal at any age.
  • sleep pattern changes. They might sleep less at night and nap more during the day.

Give us your feedback

Please share your comments or concerns on this section of the Guide. Your comments are important to us. We appreciate and thank you for taking the time to complete this short Feedback Survey. If at any time, you wish to speak with a nurse at Ottawa Public Health please call 613-580-6744 TTY/ATS: 613-580-9656 or email us at healthsante@ottawa.ca.

References

  1. VON Canada. Community Respite through Neighbours Helping Neighbours - A Training Guide [Internet]. Ottawa: Victorian Order of Nurses for Canada, 2009 Third edition, 2011: 44  [cited Jul 26]. Available from: http://www.von.ca/doc/neighbours/EnglishNHNmanual.pdf

Elder abuse

Talk to a health care provider if the stress of taking care of your loved one is more than you can handle.

Signs of stress:

  • feeling impatient, irritable and frustrated
  • feeling exhausted, overwhelmed
  • feeling guilty or blaming yourself for problems
  • drinking more alcohol, using more drugs (prescription or non-prescription)
  • feeling isolated from friends
  • feeling angry and resentful towards your loved one
  • feeling trapped

There are times when you can lose your temper and might even hurt your loved one. Sometimes the stress of the caregiving is too much and you act differently. Get help if you are getting close to that point. See Chapter 3: Caring for You...the Caregiver for ideas on how to avoid getting to this point.

Elder abuse, or hurting an older adult, is serious. It can be physical, emotional, verbal, financial, sexual or neglectful. It puts their health and well-being in danger. Elder abuse can take place in the home, in a residential setting, or in the community.1

For more information about elder abuse, read this fact sheet2 from the Government of Ontario.

Warning signs of elder abuse

  • injuries like bruises, broken bones, bleeding or other injuries
  • sudden loss of weight
  • family or friends will not let you see the person alone
  • your loved one is hostile towards their family or friends
  • you see a family member or friend threatening or trying to control your loved one
  • items or money is missing from your loved one's house
  • sudden loss of income (pension) or retirement savings
  • you see someone talking or tricking your loved one into giving away their property

If you know your loved one is being abused, talk to someone you trust. Keep talking until somebody listens. Abuse usually gets worse when it stays a secret.

Tips

  • if your loved one is in immediate danger: call 911 (Ottawa Police)
  • for intake, evaluation, information, consultation, referrals and support:call the Elder Abuse Response and Referral Service (EARRS) at 613-596-5626, ext. 230
  • to report a case of elder abuse, call the Ottawa Police Service Call Centre at 613-236-1222, ext. 7300
  • to access a 24 hr confidential hot line for abused older adults: Seniors Safety Line at 1-866-299-1011
  • for crisis counselling, call the Victim Crisis Unit: 613-236-1222, ext. 5822 

Advocacy Centre for the Elderly (ACE)
Ontario Network for the Prevention of Elder Abuse (ONPEA)
The Office of the Public Guardian and Trustee (OPGT)

The Ottawa Police Service Elder Abuse Unit, in partnership with the Victim Crisis Unit, is launching a new consultation phone line for members of the public who have questions/concerns about elder or vulnerable adult abuse.

The new consultation phone line will improve the processing of requests and referrals. You can contact a member of our team at 613-236-1222, ext. 2400.

Give us your feedback

Please share your comments or concerns on this section of the Guide. Your comments are important to us. We appreciate and thank you for taking the time to complete this short Feedback Survey. If at any time, you wish to speak with a nurse at Ottawa Public Health please call 613-580-6744 TTY/ATS: 613-580-9656 or email us at healthsante@ottawa.ca.

References

  1. World Health Organization. Report on Violence and Health [Internet]. Geneva: World Health Organization; 2002 [cited 2013 Jul 26]. Available from:http://whqlibdoc.who.int/publications/2002/9241545615_eng.pdf
  2. Ontario Network for the Prevention of Elder Abuse [Internet]. Toronto: Government of Ontario; What You Need to Know About Elder Abuse; 2009 [cited 2013 Jul 26]; [about 3 screens].Available from:http://www.onpea.org/english/pdfs/InfoSheetWhatYouNeedToKnow.pdf

Give us your feedback

Please share your comments or concerns on this section of the Guide. Your comments are important to us. We appreciate and thank you for taking the time to complete this short survey Feedback Survey. If at any time, you wish to speak with a nurse at Ottawa Public Health please call 613-580-6744 TTY/ATS: 613-580-9656 or email us at healthsante@ottawa.ca.

Chapter 4 survey

Resources

Municipal

24 hour Crisis Line: Distress Centre Ottawa 613-238-3311

Elder Abuse Response and Referral Service (EARRS):

Geriatric Psychiatry Community Services of Ottawa : 613-562-9777 Maintains seniors in their home by managing challenging behaviours and implementing treatment strategies to avoid unnecessary hospitalization and placement

Mental Health Crisis Line: 613-722-6914

Ottawa Police: Elder Abuse reporting and help for victims

Ottawa Public Health Information Line (OPHIL): 613-580-6744

Provincial

Elder Abuse Victim Support Line across Ontario:
Toll-free: 1-888-579-2888

Government of Ontario: website information about elder abuse including scams and fraud

National

Advocacy Center for the Elderly (ACE) and Community Legal Education of Ontario (CLEO): provides clear, accurate, and practical legal rights information

Centre for Addiction and Mental Health: a website with information about depression, suicide and other mental health issues.

Community Respite through Neighbours Helping Neighbours: A Training Guide: Victorian Order of Nurses. [PDF]

Senior Safety Line: The Senior Safety Line provides information, referrals, and support 24 hours a day, seven days a week, in over 150 languages. The hotline is a toll-free, confidential resource for seniors suffering abuse, including financial, physical, sexual and mental abuse and neglect.
Toll-free: 1-866-299-1011.

The Ontario Network for the Prevention of Elder Abuse (ONPEA):  is a non-profit, charitable organization that raises awareness about the abuse and neglect of older adults

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