If a regular elderly patient you see does not seem to quite have the same bounce in his step on his scheduled routine visits, something might be amiss. It can be attributed to many reasons and some are not as it presents itself. A change in behavior in the otherwise stable elder might be a call for concern as it can be an indicator of something more serious.

Here are three more warning signs in the elderly that should set off some alarm bells:

1. Elder abuse

Elder abuse is the act of causing harm and distress to elderly individuals. Unscrupulous people in the elder’s surrounding, who see windows of opportunity to be taken advantage of, can do this physically, emotionally or even financially. The elderly are highly dependent on their caregivers, thus making them easy targets by this group.

Signs of physical abuse are easiest to spot. Bruises and injuries might turn up that cannot be explained, or the explanations do not match up with the findings. The caregiver will also spew out inconsistent stories if abuse has taken place. It can also be in the form of neglect, where assistance to carry out daily tasks like bathing and cleaning are intentionally not rendered.

All of this might scar the elder emotionally, in addition to the possible belittling or threatening behavior by the caregiver. It may not be easy to spot right off the bat, but if a healthcare provider has grown close to the patient after a few routine visits, these traits may be easy to pick up on. Financial abuse on the other hand is harder to notice, but frequent outstanding medical bills for example, may raise an alarm about the elder’s financial condition.

2. Increased dependence on drugs and alcohol

Elders turn to drugs and alcohol in their later lives due to pains related to health and also loneliness. It could also be that the elder has always had the drug or alcohol problem and is only getting worse with time. Whatever the reason, alcoholism and drug dependence in the elderly are often well hidden, overlooked and misdiagnosed.

During visits, signs such as slurred speech, smell of alcohol on breath and change in appearance could ring warning bells. Many prescribed and over-the-counter medications can be dangerous or even deadly when mixed with alcohol.

As for drug dependence, the elders are subject to plenty of drug prescriptions for the conditions that they have. In addition, they may also acquire over-the-counter medications and health supplements. To a certain point, this might turn into an addiction. If the elderly patient frequently requests for prescriptions to conditions that they sometimes may not be able to explain, a review might be warranted.

3. Preoccupation with death and suicidal thoughts

Suicide rates sometimes increase with age as thoughts of death may take centre stage in their minds. One sign is that such elderly patients may begin to frequently mention it in conversations. A will might also be suddenly revised and rushed to complete it. This could be an indicator of depression, related to ill-fated diagnoses, recent loss of spouse and loved one or severe and chronic pain.

If an otherwise steady elderly patient has seemingly lost interest in his surroundings and does not enjoy the usual hobbies and activities, further insight needs to be gained. Statements of hopelessness and difficulty in committing to routines like “I don’t know if I can go on” or “I don’t know if I’ll be around to come in for the next visit” should be taken seriously.

Although South Korea is one of the world’s richest countries in terms of GSP, almost half of its population over the age of 65 lives in poverty and most are left to live alone. Against this backdrop, it is unsurprising that depression is rampant and its elderly suicide rate is the highest among OECD countries.

Calling this “shameful”, National Assembly Health and Welfare Committee chairman Yang Seung-Jo said: “Various problems arise when they live alone. They have nutrition issues, and they have to deal with long periods of loneliness. They do it (commit suicide) so as not to be a burden.”

To tackle the problem of isolation, community Suicide Watch units which telephone the elderly to ensure they are in stable condition have been set up in Seoul, while Gyeonggi province piloted a programme of community houses for the elderly in 2013 where the elderly who live alone can come together and cook, sleep and care for each other. MIMS

Read more:
Specialist Spotlight: Geriatricians
Oral health for nursing home residents – collaboration with healthcare institutions
Addressing abuse in Singapore healthcare institutions