"I'm getting a bit worried about mum..."

Families of older Australians living alone must start to consider the future

[Image: Talking to mum at home]

This is the phone call between siblings that starts their mother’s journey away from an independent life towards, well, whatever comes next.  In retrospect we might see it as an inflexion point; as one of life’s most significant conversations.  It signals mum’s shift from being someone’s parent to someone’s responsibility. And mum herself isn’t even on the call.

Currently, 26.8% of Australians aged 65+ live alone and for the vast majority some version of this ‘concerned family’ discussion lies either in their future or their past. Isolating this moment in time raises three types of questions:

What’s Changed?

- What observations occurred in the lead-up to the discussion?  Was there an observed change in behaviour, or did mum self-report something?  Has this change been sudden or gradual? How worried should we be?

Who Knows?

- How many members of her network of family and close friends are aware of this change?  Who else needs to know?  Does everyone, including mum herself, agree that she’s perhaps approaching that moment of irreversible change?

What Now?

- What strategies can we now adopt to help mum maintain her independence?  What support can the family draw upon?  What professional help, medical and non-medical, should we now engage?  What can be done to avoid that acute event that will first hospitalise her in and then later stop her living independently?

The families of older Australians living alone must start to understand that the question, “How’s mum doing?” is really a conflation of twenty or more questions that range from mobility, falling, appetite and mood to sociability, dress, pain and medication.  We must get better at asking these questions in an organised, ongoing manner.  Just because mum hasn’t mentioned her insomnia for a while and has started worrying about her eyesight doesn’t mean that she’s now back to sleeping through the night.  Unless we ask her, which means remembering to ask, it’s unlikely that we’ll ever know.

Each family member must also accept and manage the fact that he or she will hear different parts of the story.  There are some issues, for example memory or toilet, that a parent may be willing to discuss with a daughter who lives nearby but understandably not with those who are not family or who live far away.  Unless such information is shared in a coherent yet sensitive manner, it exists in isolation.

Far too often the pieces of the puzzle are only assembled in a post hoc basis, when families and friends speak to try and make sense of some traumatic event.  Far better for those observations to be made available in an organised manner to the relevant health or social care professional.

Every member of the network, especially mum herself, must accept the idea of irrevocable change. To continue in a state of denial is to invite that acute event that will shorten, not lengthen, the opportunity for truly independent living.

Approaching the issue of ageing in an organised, compassionate manner is an integral part of allowing Australians to grow old with independence and dignity.

[Source: Stewart McCure, CEO of Patientze Ltd, developers of Familyze: a platform for private, online networks around an older person living independently to collect and collate symptom observations and ultimately improve healthcare outcomes. https://www.familyze.com/#home]