Christmas is the time of year when many of us will be spending time with family, getting together with relatives we may not often see, and visiting family members that may live alone.
According to Age UK's latest figures, 3.5 million people in Great Britain aged 65+ live alone, this is more than a third (36%) of all people aged 65+ living in this country. More than a million older people also say they go for over a month without speaking to a friend, neighbour or family member.
Often it is small changes or minor problems that can be early warning signs of a potentially serious health issue, and with many of us only seeing elderly relatives a handful of times each year, it's vital to be aware of what to look for.
The clinical team of independent living monitor system Howz has compiled a simple checklist of 12 key signs to look out for in your elderly relatives this Christmas that may indicate a deterioration in health and wellbeing. The team includes a Nurse, Physiotherapist, GP and Occupational Therapist who all have experience with older people living independently as well as dealing with their own ageing relatives.
"The challenge many of us face is how to keep an eye on vulnerable members of our family when we can't always be there ourselves. When you do see your relative, look for the tell-tale signs that indicate whether they are looking after themselves, or struggling to cope, or if they are feeling under the weather but don't want to worry their family. The key to all this is predicting and preventing," Physiotherapist Louise Rogerson says, "so stopping a minor condition getting far worse."
12 signs at Christmas
Sign 1. How are their winter clothes fitting, has your relative had to refresh their wardrobe as their clothes are too big?
Unexpected weight loss is a key indicator that all's not well. Has your elderly relative lost weight recently without trying? Losing more than seven pounds (3.25kg) in a month can be a cause for concern.
Sign 2. Did they enjoy their Christmas lunch?
Are they eating and drinking as usual and enjoying their food? It is common to have a reduced appetite as we age, but it can also be affected by painful teeth or ill-fitting dentures, change in tastes, or being overwhelmed by large portions. Little and often is a good approach, and make sure your relative is drinking plenty - dehydration is a huge problem with older people.
Sign 3. Is your relative usually the heart and soul of the party?
Is your elderly relative taking less interest and enjoyment in their activities and hobbies than usual, or do they seem listless and unmotivated? Are they taking less care of their personal appearance? This may be due to growing mobility or eyesight problems, or perhaps low mood.
Sign 4. Is your relative usually the first to help out at the family dinner?
Does your relative need to hold on to manage steps or stairs, especially in low light, or experiencing increased difficulty getting into and out of their chair, or up and down stairs? Reducing strength and balance affects mobility, but if addressed early this loss can be slowed or reversed. Acting early to prevent a fall could be a life saver.
Sign 5. Have you had all the seasonal reminders you usually receive from your relative?
Have you noticed them being more forgetful, or struggling to stay with conversations? Are they having problems managing regular medications, remembering appointments, or regular family visits or phone calls? Problems with memory can be caused by a range of issues, some of which are reversible.
Sign 6. Does your relative talk about recent visits to friends or family?
Are they going out as often? Is your relative becoming increasingly unsteady and having falls or near misses? Are they using the furniture more to get around their home or have they increased their use of a walking aid? It may be they are finding this physically challenging, but it can also reflect increasing social isolation through bereavement or changes in mood.
Sign 7. Mince pie anyone? Are the cupboards stocked to the usual levels for this time of year?
Do they have enough wholesome food in the cupboards? Has your relative got their favourite drinks, both hot and cold? Shopping may be getting more difficult, consider getting heavier items delivered, but still leave the smaller items to buy locally. Going out to the shops is a great way to exercise and see other people.
Sign 8. More than the usual aches and pains?
Is your relative complaining of increasing or new pains? Do you notice any discomfort when they move around, or are they avoiding activity? Pain is hugely under-diagnosed in the elderly population, and there is a tendency to avoid pain relief medication. A review with a pharmacist or GP can often help with this to achieve effective pain control.
Sign 9. Taxi... all booked for 6pm? Is this usual?
Has their daily routine changed? Are they going to bed earlier or getting up later than usual? Have their mealtimes changed or have they changed what they eat? Our evidence shows that many of us stick to a routine, when this changes there is usually a reason. Understanding these small changes can help identify issues to be addressed or it may be choice.
Sign 10. Is the teenagers' music still too loud?
Are they more anxious, less settled in a social situation, or contributing less to conversation? Something may have happened to unsettle them or create anxiety, but the problem could also be hearing or sight difficulties making group occasions more challenging.
Sign 11. Is the house looking Christmas ready?
Look around their home to see if they are managing to keep it as clean and orderly as they used to. Is the house warm enough, are they using all the rooms they once did, or are some shut off? This can be an indicator of physical or psychological issues and so it is good to check what the cause of the change is. It may be that with a little help a reduced living space would work better for them without needing to move.
Sign 12. Looking like your relative may have been burning the candle at both ends?
Are they struggling to get to sleep, or are they getting up more during the night? Are they feeling more tired during the day? Whilst it is common to sleep less at night as we get older, it is good to know what normal is for an individual as changes may indicate health issues. Tiredness can increase the risk of falls and so it is a good idea to make the route to the bathroom as clear as possible with good lighting at night.
Louise continues: "Change and deterioration can take place very slowly, and it's easy to assume that because someone is getting older that, of course, they will start to struggle a little more. But if you catch that deterioration early enough, you can often slow or reverse it. Spotting medical conditions can lead to earlier treatment and a better chance of a positive outcome.
"Equally, you can also take steps to make the home safer, and so enable them to carry on living independently. Getting in extra support might help, and so too considering monitoring equipment to check that they have not had a fall or failed to get out of bed that morning," she adds.
For further support, Louise and a team of healthcare professionals will be hosting a live Facebook Q&A on Wednesday 28th December at 8pm to answer questions from members of the public and offer guidance and advice. To take part, simply submit your questions to www.facebook.com/howznewz and watch live during the event.
Make it your New Year's Resolution to take a little time each visit to notice the early, subtle signs that your elderly relative may be becoming more frail or ill and act on these quickly to prevent them losing their independence.