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Home visits can reveal decline in older adult relatives

Paul R. Kennedy
More than 2 million elderly Americans are abused each year.

UC Irvine Health SeniorHealth Center sheds light on telltale symptoms

Visits to aging loved ones can be joyous reunions but they also are vital to ensuring the elder relative's health, especially in a today's highly mobile society with extended families spread over great distances.

Vacation and holiday visitors may discover mounds of unpaid bills, odd solicitations and unkempt surroundings — all possible evidence of a decline in their loved one's physical or mental function, says Dr. Laura A. Mosqueda, Chair of the Department of Family Medicine at UC Irvine School of Medicine.

“You’ll hear, ‘It shocked me when Mom drove on the wrong side of the road. I knew she was having problems, but I didn’t realize how bad it was,’” says Mosqueda, whose department includes UC Irvine Healthcare’s SeniorHealth Center in Orange. “Or they’ll find out that a caregiver is ingratiating themselves, or that another family member is abusing them.”


More than 2 million older adult Americans are abused each year and about two-thirds of the abusers are relatives, according to the National Aging Resource Center on Elder Abuse. For each case of abuse, another 14 are believed to go unreported.

To raise awareness, UC Irvine’s Center of Excellence on Elder Abuse & Neglect has assembled a fact sheet describing what to look for and what to do when you suspect neglect, abuse or a worsening of an older relative’s health. Written by the center’s co-director, Mary Twomey, the fact sheet serves as a checklist to assess whether your parents or relatives are having difficulty caring for themselves. If neglect or abuse is suspected, contact the center or the Orange County Adult Protective Services agency

It is inescapable, Mosqueda says, that with age, people become more vulnerable to victimization because of changes in the body’s physical, cognitive and emotional domains.

“I don’t mean older adults are wimps, they’re not,” she adds, but they may be reluctant to admit to a bad situation, fearing that they could “prematurely or inappropriately lose their autonomy.”

With nuclear families spread around the globe, having an older adult parent or relative live with or near you isn’t always possible or optimum. “Sometimes older adults really want to stay in their homes, with their friends and support systems,” Mosqueda says. “Not everybody has a warm, fuzzy relationship with their parents.”

When aging relatives do need help with such intimate activities as bathing and toileting, Mosqueda advises close monitoring of caregivers. People in the early stages of dementia-related illnesses often find their judgment so clouded that they may become easy marks for con artists.

Loneliness and depression also are common among seniors, especially as they lose spouses, partners and close friends, and often create an emotional vulnerability that Mosqueda says is “like having a big target on your back.”

Home visits, especially around such family-oriented holidays as Thanksgiving and Christmas, can mean a lot. “We know the holidays are difficult for many older adults, and a lonely time for those who’ve lost a spouse or partner,” says Dr. Lisa Gibbs, chief of the Division of Geriatric Medicine & Gerontology. “We’re always mindful of checking in with our patients to see how they’re doing, especially during the holidays.”

— Kristina Lindgren, Health Affairs Communications