I want to Stay in my Home – Cognitive Difficulties

This week’s blog continues the discussion of an aging adult who wants to stay in his or her home.  The introductory installment (on February 11, 2016) discussed the emotional turmoil that can face the adult children in deciding whether to accede to the aging parent’s wishes to stay home.  The February 18, 2016 installment discussed home modifications that may make it easier for an aging adult to stay home.  The February 25, 2016 installment discussed medication management.  The March 3, 2016 installment discussed hiring someone to help with activities of daily living.  The March 10, 2016 installment discussed whether aging in place is an appropriate choice for someone suffering cognitive issues.  The March 17, 2016 installment discussed services that can make it easier for an aging adult to stay home.  The March 24, 2016 installment discussed the aging parent moving into an adult child’s home.  The March 31, 2016 installment discussed an adult child moving into the home with his or her aging parent.  Today’s installment will discuss whether aging in place is an appropriate choice for someone suffering cognitive issues.

Someone with a physical ailment can make changes to his or her physical environment to make aging in place workable.  As we’ve discussed over the last several installments, physical limitations can be overcome.  Cognitive issues are a different story, however.  Home adaptations and in-home care may not be enough to allow someone with memory loss or cognitive decline to stay at home.

First, the safety issues are different.  Someone with cognitive difficulties probably cannot stay live alone.  He or she may not be able to stay home alone even for short periods of time.

Wandering is a huge risk.  Someone with cognitive difficulties might leave the home and get lost in just a few minutes.  Unless the family wishes to keep the home’s doors locked, like the exit from a secured memory care community, the loved one suffering cognitive decline can easily walk out.

Even without wandering, homes have many risks for someone with cognitive impairment.  Someone with dementia might not recognize the risk of lighting a cigarette from the flame of a gas stove right after using hair spray.  Someone with dementia and an unsteady gait might not remember to use his or her walker, creating a risk of falling.  Someone with dementia might not remember how hot the hot water is as it comes out of the tap.

There are safety risks to the home caregivers as well.  Someone with dementia might not recognize a family member or professional home caregiver and react violently, for example.  As the dementia sufferer becomes less connected to his or her surroundings, a constant anxiety or even a paranoia might set in.  (Do you know that anxious feeling you get when you get lost in the car?  Imagine feeling that way all the time.)

None of this is meant to imply that aging in place is impossible for someone in cognitive decline. While the cognitive decline is mild, aging in place is likely very possible.  The issues surrounding the attempt to age in place are very different, however, when the aging senior has cognitive issues rather than physical issues.

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