Summary
In this episode of the CareLab Podcast, occupational therapists Emilia Bourland and Brandy Archie discuss the first three of five key signs that an older adult may need additional help at home. They explain why medication mistakes, poor nutrition, and declining personal hygiene are often early indicators that someone is struggling with daily activities. The conversation offers practical tips for recognizing these warning signs, starting supportive conversations with compassion, and finding solutions that preserve independence while reducing the risk of hospitalization and other preventable health complications.
Key Questions Answered
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How can medication mistakes signal that someone needs more help at home?
Medication errors—such as missed doses, taking the wrong medication, or confusion about prescriptions—can lead to serious health problems and are a common reason older adults end up hospitalized. Reviewing medications regularly and using tools like pill organizers or automatic dispensers can help reduce these risks.
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What are the warning signs that someone isn't getting proper nutrition?
Unexplained weight loss or gain, an empty refrigerator, spoiled food, or difficulty preparing meals can all indicate nutritional challenges. These issues may stem from reduced appetite, limited mobility, fatigue, or simply forgetting to eat.
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Why is a decline in personal hygiene an important red flag?
Changes in bathing, grooming, oral care, or managing toileting may indicate that everyday tasks have become physically or cognitively difficult. These changes often happen gradually and should prompt a closer look at what kind of support might help.
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How should family members bring up concerns without embarrassing a loved one?
Rather than pointing out problems directly, the hosts recommend asking thoughtful, open-ended questions and looking for opportunities to understand what's making a task difficult. Approaching the conversation with empathy helps preserve dignity and encourages honest discussion.
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Does needing more help always mean losing independence?
No. The hosts emphasize that support exists on a spectrum. Simple tools, home modifications, better organization, and assistance with specific tasks can often help people remain independent and safe without taking over everything they do.
Transcript
Brandy Archie
Hi everybody, welcome to CareLab. We have a great episode for you today because we are going talk about the top five reasons that you might need to think about your person needing more help at home, which is, I think, questions that people ask us all the time. I also should give you a caveat that you might hear a little bit of a little girl singing or talking in the background. Because I got
Emilia Bourland
Ha ha.
Brandy Archie
a four year old with an eye infection, and so you know, she's gotta be here and not a daycare. So yeah.
Emilia Bourland
Life happens. And it's better, it's better than me singing and talking in the background. So
Brandy Archie
It's definitely cuter, let's say that.
Emilia Bourland
it's it's it's both things. It's both things actually.
Brandy Archie
Ha ha
Emilia Bourland
okay. So so what are what are some of the reasons that you that someone might start to need more help at home? I'm gonna start it off by talking about absolutely one of the most dangerous number one reasons that people
often need more help at home. And that is medication errors.
Brandy Archie
yes.
Emilia Bourland
needing help managing meds.
so one of the most serious reasons that someone needs more help at home is because they're making medication mistakes. This is really, really common and it can happen right under your nose if you have someone who is managing their own medications, but maybe they're having trouble with that. And sometimes people can be having trouble managing meds and they can know it, but they might feel a little bit embarrassed about it. They may not want help, they might
might not want to lose their independence with that, so they won't say anything. A lot of times, however, people are having trouble managing their medications and they don't even realize it. but having medication errors is incredibly dangerous, as you can imagine. People can accidentally overdose, they can accidentally missdoses of important medications, things like hypertension medications, things to control their blood pressure, really, really important stuff. And so
Medication errors and mismanagement is actually one of the top reasons people end up in the hospital, which of course
Brandy Archie
Yeah.
Emilia Bourland
then can lead to all kinds of other problems that cause folks to need more help, right? So so how can you know about this? What I would recommend is every once in a while, kind of whether folks like it or not, sit down and go through medications with the the people that you are either caring for or the people that you love.
make sure that they actually A, understand their medications and what they're for, and B, that they can take them properly at the same time. And if not, there are tools that you can put in place. It doesn't necessarily always have to go from, you know, totally independent to someone else completely having to manage meds, right? Like Brandy,
Brandy Archie
Yeah.
Emilia Bourland
why don't you talk a little bit more about that? Cause I know there are some you have some really cool tools.
Brandy Archie
Yeah,
there's definitely some tools.
Emilia Bourland
particularly on on AS YAMI, yeah.
Brandy Archie
Yeah, there's some tools to to help with that. There's some mix in between. So I think like what I was thinking about when you were talking though was it's really hard to know if somebody is struggling with their meds and
Emilia Bourland
So hard.
Brandy Archie
you can make good excuses that give you an in to like look at the meds. Hey, I'm taking you to that doctor's appointment next week. Can you just help me understand what meds you're taking and just see how good a job they do of explaining them to you and
Emilia Bourland
that's a great idea. Yeah.
Brandy Archie
And
letting you know what they are and that could give you a lot of insight and especially if they don't have a pill planner. and then if you are noticing that there's like some disorganization there, or a lot of I've been some I've been to some people's houses where they have kept all of their old meds, they're all in the same space as their new meds,
Emilia Bourland
Yes.
Brandy Archie
they kept their deceased husband's meds and they're all in the same spot and like how are we ever gonna like keep this clear if you ever are a little
Emilia Bourland
Mm-hmm.
Brandy Archie
bit
you know, foggy on what you took and what you did not take. and so if you're noticing that then the next step up from that would be like adding a pill planner. And so the first one that you think of is like one that is simple and has one per day and you just open the things and you put the pills in. That can work fine. but you could- th if they're not taking that consistently if you use that and you notice today's Friday and Thursday and Wednesday's meds are still in there.
Then you might want an automatic pill dispenser, which is going you're gonna fill up once every two weeks-ish or so, and then set the timer and it will open and show only the pills that are supposed to be taken at that time that you have set, and it will not stop alarming until the pill dispenser is turned over. And hopefully those pills are in the person's hands. Now, if they don't actually put the pills in their mouth, that is not a thing that that product can solve for you. But if it's just
Emilia Bourland
Mm-hmm.
Brandy Archie
about remembering and staying organized.
It could work really well.
Emilia Bourland
Yeah, I think that that's a that's a great point to bring up is there are so many like gradients of assist that can be provided with medication management. part a lot of that also depends on whether or not people want to take their medications too, right? So
Brandy Archie
Sure.
Emilia Bourland
so it sometimes it's a memory issue. Sometimes though, sometimes meds are just really complicated. Like managing a bunch of medications can be very, very complex and sometimes.
Like anyone could need help double checking that. like when my I my mom had a surgery and she came home with a bunch of meds and I was setting up her pillbox for her, I had my brother d double check me on it because it was a lot and I wanted to make sure I didn't I didn't make a mistake, right? but you know, these if you're seeing these kinds of issues, it's always worth, you know, having that conversation with a doctor as well, make sure all of the medications are right.
make sure people again understand why they're taking their medications and making sure that folks are if if there is an issue with maybe someone who just doesn't agree with the medications, like that's a conversation that we need to have with a provider too, versus just, you know, thinking about how do we make sure that this is well organized on a daily basis.
Brandy Archie
Yeah, that's totally true. And also you might need to reconsider like how we've we've ha talked about this so many different times, right? About like Yeah,
Emilia Bourland
We could talk about this. Yeah. Yeah. Yeah.
Brandy Archie
poly med polypharmacy and so you should go back to some of our earlier episodes, especially with Doctor Reshma, who's a pharmacist who talks about some of that. And so just that process of going through those meds with them, you might realize that maybe we don't need multiple medications for blood pressure anymore.
and talk to the doctor about it. And then the other one other thing I wanna add is whether somebody's taking their medications for thirty years or not does not mean that today they're doing a good job managing those meds. And
Emilia Bourland
Mm-hmm.
Brandy Archie
in the case of your mom, for example, that's a really important case to like actually be on top of those meds because she wasn't taking all those meds before. So that's all new and there's tons of other symptoms happening. So you don't know if like
the medication is what's causing X symptom or it's because the surgery and so making sure we at least keep that constant and we're taking those correctly can help make sure that, you know, everything is on the up and up.
Emilia Bourland
Yeah, for sure. okay, so should we move on to number two for reasons that someone might need more help at home?
Brandy Archie
Yes. And number two is not getting the right amount of nutrition. So you might often
Emilia Bourland
Mm-hmm.
Brandy Archie
notice like at the doctor they might ask like have you gained or lost more than 10 pounds without trying? Right? Because that's a sim a sign that you're not getting the right nutrition. And that could be true for your person too, right? And so if they're losing weight or gaining a lot of weight, then we might need to reconsider how much help they're getting at home.
And so there's a ton of reasons why people most often it's like not eating enough or getting enough calories. Because our appetites change as we get older, our taste buds change as we get older. And then also if you're limited on your mobility or you're short of breath, you just might not have the energy and effort to get up and actually make a real meal and you're like snacking on crackers and stuff like that. And so that can be impacting your nutrition. So having some help there
could make a big difference in actually I shouldn't say like that at all. Having help with nutrition makes a huge difference in what
Emilia Bourland
Yeah.
Brandy Archie
your health outcomes are. And so don't leave that to chance, I guess is what I'm saying.
Emilia Bourland
There are also many so many things that go into nutrition. I and we're gonna talk a little bit more about some of those issues later in this episode. So I'll try to kind of stick, you know, more directly to nutrition now. But a sign another sign that someone might be having problems with new nutrition is kind of go over there, look at their cabinets. Look at their fridge. is there are is the fridge empty? Are the cabinets bare?
or on the other hand, is there a lot of food in there, but that it's it's spoiled, like you know, folks aren't eating. There can be lots of reasons that people aren't getting nutrition. Sometimes it's because they don't have access to the food or they have trouble going to get it. it can be because they are forgetting to eat. Sometimes people have loss of appetite for a variety of reasons, right? But kind of keeping an eye on these signs that someone might be having a problem with nutrition, again, to to Brandy's point is so important because.
Our bodies cannot run without appropriate nutrition, right? We need air, we need water, we need nutrition. These are the most basic things that we
Brandy Archie
These things. Yes.
Emilia Bourland
must have. And so if we don't have good nutrition, it's gonna have a huge impact on every other quality of life and healthcare outcome that you can think of. So looking for those signs can be a really good thing to watch out for.
Brandy Archie
Yes, super well said. Okay, should we do one more before we leave the cliffhanger for them to come back to the next episode for the last two?
Emilia Bourland
Yeah,
yeah, let's do let's do one more. okay, so I think the next one that we're gonna talk about is hygiene. All right, so why can hygiene be a sign that that someone might be needing more help at home? Well, it's because if people all of a sudden have a change in their hygiene, it probably indicates that they're having a change in their ability to complete their basic activities of daily living.
These are things like bathing, using the restroom, getting dressed, brushing their teeth, all of that base basic stuff. And so if suddenly someone has a change in hygiene, they just maybe they're having an odor that they didn't have before. Maybe their hair just looks really unkempt or or knotted. maybe their oral hygiene isn't that, isn't that good all of a sudden. These these are a sign that someone for
some reason we can't tell what the reason is just from seeing it, but for some reason this person is not able to keep up with their regular hygiene. And so something probably needs to be done to help that person out.
Brandy Archie
And the other thing I would just add is like it might not be suddenly. It might be small things over time. And that if you then
Emilia Bourland
True. Facts. Okay. Yep.
Brandy Archie
like, you know, flash back a month or two or whatever ago and think about how they were then and how you're seeing them now and like refresh yourself to be like, wait a minute. This is she would always have her lipstick on, or they would always be dressed at this time in the morning. Or I smell an odor. We're staying all nice and clinical, but like if they stink.
It might not be because they don't care
Emilia Bourland
Yeah.
Brandy Archie
about it, but just that they can't actually get it done. You know, getting in the shower
Emilia Bourland
Mm.
Brandy Archie
can be really challenging when your mobility has changed or if you're short of breath. and so people stretch it out. Wiping
Emilia Bourland
Wiping wipe wiping
after going to the bathroom becomes a really big issue for people, right?
Brandy Archie
Yes,
if we've gained weight or if we're having shoulder problems, we're having coordination problems, and so if we're not getting that done in a good way, or maybe we're having more incontinence or incontinence has started, right? And we're struggling with that. But all those outward signs, like you said, you can't tell what the real cause is, but just noticing the outward sign of a decline in their ability to take care of their bodies is a great reason to try to get involved and see if we can come up with more help.
And I'm also just like a really big fan of not like of of talking your way into more questions, if that makes sense. Like
Emilia Bourland
Mm, mm mm. And you're really good at that too.
Brandy Archie
s so you know, you don't have to be directed be like, ugh, you stink. What's wrong with you? That would be a bad approach. I'm saying don't do that. Please do not do that. That is not the example I want to use.
Emilia Bourland
Yeah, yeah, actually please don't do that. Please that that will not be well received.
Brandy Archie
But it could be like, hey.
I see you need a new shower curtain in there. When's the last time you got in the shower? I can make sure I have one for you before the next time. Right? Like that is a roundabout way of talking about the shower. And then they might likely say, it's been a while. why has it been a while? And now they can tell it's hard to step in. that's interesting. I wonder if we can get some help for that. I know an occupational therapist we call who can help us figure this out. so work your way into it because dignity
Emilia Bourland
Yeah.
Brandy Archie
is really important and nobody wants to
feel like they can't take care of themselves, even if they recognize that they're struggling.
Emilia Bourland
That's right. Yeah. No, that's such a great point. It's embarrassing, right?
Brandy Archie
Mm-hmm.
Emilia Bourland
So none of us likes to have things pointed out that we would feel embarrassed about. So whatever you can do to make it not about a personal issue with that person, but rather about understanding what the root cause of the problem is, or just understanding what their perceive what their perception of the situation is, right? Like
Because again,
Brandy Archie
A hundred percent.
Emilia Bourland
you you may not be able to determine the root cause of the problem. But if you ask some questions, you can probably get a much better idea of what's going on. So yeah, I I love that. I think that's great advice. And I also want to say thanks for correcting me earlier, because if you're notice noticing sudden changes in someone, that's usually an indication that there might be something medical going on. And in fact, could even be like a medical emergency and probably needs to be addressed pretty quickly. So so thanks for pointing that out. Sudden changes, we
really want to have addressed really quickly to see what's going on with someone. A lot of times you're absolutely right. These changes in hygiene occur much more gradually over time.
Brandy Archie
Okay, we're gonna pause it there and we're gonna let you come back so that you can hear the last two of our top five reasons people might need more help at home. in order to do that, you need to like and subscribe so you get alerted as soon as the next podcast episode drops, and that helps make sure that other people who need this content can find it. So we will see y'all on the next one. Bye.
Emilia Bourland
Bye.
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