There are at least ten unusual behaviors to be aware of that may indicate a decline in the elderly. Some unusual behaviors span across any age group, not just the elderly, but should still be taken seriously, especially where it pertains to populations considered vulnerable or living on a fixed income. These problems range from financial to addictive behaviors, such as alcohol abuse. 

In further detail, the ten major problems to be aware of in the elderly include:

1. Financial problems
2. Health concerns
3. Abuse
4. Addiction
5. Legal matters
6. Mental health and hoarding
7. Cognitive decline
8. Loss of Independence
9. Shame
10. Social Isolation

Most senior citizens are retired and living on fixed incomes, which can be challenging, especially in recent times of rising costs and inflation. Furthermore, the seemingly simple solution of having a part time job may not be an option for those who are facing health issues, and despite health insurance (and Medicare), out of pocket medical costs can exacerbate financial problems. 

Physical health issues can hinder an elderly person from driving, walking, and even doing simple things like eating. Physical pain can manifest in mobility issues that affect cognitive decisions and needless to say, these types of problems require a large amount of patience and care. It is also embarrassing to rely on family or others to do things like drive or clean. Thus, it’s no surprise that these types of problems are kept concealed.

Be on the lookout for any elderly relatives who appear defensive or quiet about not being able to take care of themselves.

Whenever there’s a reliance on others for health and life, there’s a risk of being taken advantage of. This is why you may hear seniors referred to as a “vulnerable population”. Seniors are more likely to be taken advantage of financially, physically, and emotionally. Neglect is also a common issue – yes, even if there’s a paid caregiver involved. These are all situations that tend to go overlooked, especially when they’re already feeling ashamed and embarrassed about their quality of life. 

Across all age groups, senior citizens don’t make up the largest population of substance abusers. However, the 1 million adults aged 65 or older living with a substance abuse disorder is far too many, and the number has been increasing since 2020. After COVID-19, more seniors are quarantining, which means they’re staying home with prescription medications to treat health issues. Of the most serious concerns are the 4-9% of adults aged 65 or older prescribed opioids for chronic pain. Alarmingly, the number of seniors being prescribed opioids increased by 9x from 1995 to 2010!

While we don’t have hard facts on how prescription drug abuse affects the aging brain, we do know that addiction in any capacity results in a diminished quality of life. It’s important to reiterate that it’s never too late to break an addiction and doing so can improve quality of life and future health.

Legal matters can be a problem when someone gets sick prior to settling debts, drafting up a will, or deciding on what to do with their estate. Seniors may be hindered by their health issues or reluctant to ask for help. In this case, there’s only so much you can do aside from bringing up the issue periodically and trying to address it with urgency. It greatly helps to try to work with family members or caregivers prior to confronting the issue directly. Offering to pay for legal expenses can also be helpful.

It’s important to remind yourself (and your elderly family member) that depression and anxiety are to be expected. Getting older and managing the uncertainties of the future and managed care are anxiety-provoking and depressing, especially when coupled with the grief of a spouse. These issues can lead to other problems, such as hoarding and cognitive decline.

Cognitive decline also refers to the mental health of a senior citizen but specifically identifies the decline of their cognitive (or thinking) ability. Cognitive refers to their ability to think, reason, and make decisions. It can also refer to remembering details. Watch out if your loved one begins to change routine, fails to remember important dates, or has trouble making decisions, especially major ones. Especially be on the lookout if your loved one begins accumulating at-fault automobile accidents. This may indicate a future loss of independence.

Loss of independence refers to the inability of an individual to take care of one or all of their daily needs. While there’s no official spectrum concerning the loss of independence in the elderly, there can be either a partial loss of independence or a complete loss of independence. A partial loss occurs when there’s either a physical or cognitive decline that hinders the person from fulfilling at least one of their daily needs, whereas a complete loss of independence refers to a decline that hinders the person from all their daily needs. 

An example of this can be an elderly person that is completely paralyzed and bedridden, thus dependent on a dedicated caregiver to feed, bathe, dress, and assist them with using the bathroom. A partial loss on the other hand may refer to an individual who can use their limbs to stand, reach, and eat, though unable to walk, cook, or use the bathroom without assistance.

Partial or complete loss of independence can cause shame and embarrassment in an individual, which results in withdrawal and hoarding or squalid conditions in the home. If you believe a loved one is currently in these conditions, it is considered a biohazard that must be taken care of by trained professionals.

Shame refers to the feeling of humiliation or distress as a result of addressing ones wrong, foolish, or incorrect behavior. Any of the issues mentioned above can cause an individual to feel shame within themselves, even if it’s a result of circumstances beyond their control. Individuals that are very proud and protective of their independence can especially be at risk of developing shame, and such, be very reluctant or apt to isolate rather than ask for assistance.

Any evidence of a loved one showing a lack of interest in things they used to enjoy, or a sudden decrease in communication with friends or family, can be considered social isolation. If they appear to avoid family gatherings, and outings, or spend more time alone and appear defensive or avoidant about allowing company into their home, there is a strong likelihood of a deeper problem. Be aware of any irritability, agitation, or refusal of help any time you try to confront them. 

If you suspect a loved one is going through or exhibiting any of these behaviors, the first thing you will want to do is to try to put yourself in their shoes. Think of what they’re going through and how it can be affecting their life. Then, take action by planning an intervention. Ideally, this is where having the cooperation of other family members can be helpful. Make sure all of you are on the same page. Speak your concerns in a non-judgmental, caring, supportive manner. Offer to help them in a direct, firm, and respectful manner, and be sensitive to how they may be feeling during this difficult time.