Of all the unexpected changes, diminutions, and just plain annoyances that aging inevitably brings with it, those in the know agree that the hardest is losing what they’ve come to cherish most: their independence. Perhaps independence is so hard to give up because it’s so hard-won. Most people spend their youthful years longing for the time they can make their own decisions and live their own lives — and reaching out to others for help in the process just goes against the grain. Independence is considered a rite of passage. No wonder then that losing it is what many seniors say they fear most about the aging process.

Those underlying emotional dynamics also help explain why many seniors — 90 percent of whom say they wish to stay at home as they get older — often deny the facts that point to their increasing need to get outside help to do so. Ignoring the early warning signs that a senior needs help may lead to what that person feared most: dependence on others. And it may prompt a crisis, such as an injury or hospitalization.

It often takes some careful sleuthing by family members, friends, or caregivers to divine whether an individual senior needs to make some changes to continue living safely and independently. But investigating this delicate matter may not be easy, even for those in frequent touch with the older person, who may be living in denial. And note that most seniors will strive to put their best feet forward during group gatherings for holidays, birthdays, and other celebrations.

The Roots of Change

According to Lakelyn Hogan, gerontologist with Home Instead Senior Care, major life changes that impact peoples’ lives as they age that can be harbingers of the need to get additional help to live fully and easily.

That includes changes in:

• Social networks — loss of friends and isolation from family members;
• Social roles — including retirement or taking on caregiving responsibilities for a friend, spouse or partner;
• Physical health — worsening hearing and eyesight, arthritis and other painful health conditions, unsteadiness causing falls; and
• Mental health — often manifested as depression or suicidal ideation.

Paradoxically, Hogan says these changes may be even tougher to track when two older adults live together, as the two frequently become used to “filling in another’s blanks,” which only masks the reality of their struggles.

The negative effects that can flow from major life changes often derive from a common root: reactions to some type of loss. While all older people cope with loss differently, common feelings that surface are fear, anger, guilt, and confusion. Left unaddressed, these emotions can also become physically debilitating.

Signs Help May Be Needed

Family members, friends, and caregivers can often step in and help stem the tide of negative feelings and limitations an older person is experiencing. But it takes patience, sensitivity — and a willingness to step into that person’s shoes — to be proactive in preventing a future crisis in care needs.

There is a wide range of signals that a senior may be experiencing changes that may also signal the need for more help at home.

A few to look out for:

• Physical signs — including a persistent loss of energy, problems in gait and balance, limitations in mobility, loss of appetite, and changes in hearing or vision
• Emotional signs — such as a loss of interest in social events or drastic mood changes
• Changes in attentiveness — to appearance and grooming that may indicate challenges in bathing or doing the laundry; while driving, such as missing turns or slowed response time; and to focus and concentration that may surface as mishandling medications or missing appointments or favorite TV shows
• Environmental clues — spoiled food in the refrigerator, dirty dishes on countertops, tripping hazards on the floors, bills left unpaid.

How to Help

In offering support, gerontologist Hogan says it’s important to be positive, to encourage older people not to compare themselves to what they once were and to slow down and face the days and changes one at a time. It is also essential to reassure the senior that the emotions he or she is feeling are normal and shared by many others. “There really is great comfort in knowing others are in the same boat,” Hogan says.

When confronting seniors about a potential need for help, reassure them that your motivation is concern for their safety, and that there are usually solutions you can explore together. Engaging them in the solutions early on makes it much more likely they will embrace them.

There are a number of steps family members and caregivers can take when confronting a senior about the possible need to enlist more help to remain living independently.

Step 1: Share your concerns, but allow the seniors to talk and air their feelings, so they don’t feel attack or respond by shutting down.

Step 2: Schedule a medical check-up, and insist on a complete review of medications, to be sure untreated or mistreated conditions are not the cause of some symptoms.

Step 3: Create a safety plan that addresses issues in the home, such as the need for ramps or grab bars.

Step 4: Consider home care or home health care if additional help is needed.

Step 5: Understand what community resources may be available; the local Area Agency on Aging should be able to provide nearby referrals that meet specific needs.