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Aging in Place: Loneliness often goes the way of cleanliness

Barbara Levison - MA, MSW, CMC

Herald Tribune  |  August 5, 2019  |  View article here

Fear of falling, loss of vision, fine motor skills, physical ability and memory are major causes of personal care neglect, according to senior health experts.

Hygiene issues often go hand-in-hand with loneliness for older adults.

They can materialize in the form of a scent, excessive food stains or the same old clothes being worn over and over again. But what happens if nobody’s there to notice that things are amiss? Personal hygiene doesn’t always seem like a big issue for older adults staying in their homes — until suddenly it is. It’s something that, according to senior health experts, can start with little habits, maybe a routine that snowballs into larger complications. But the signs can be missed entirely as seniors become more solitary.

“I don’t think the average person thinks of the enormous effects hygiene has on seniors,” said Jan Spates, director of nursing home care provider Right at Home. “It can change their whole world. It changes their socialization, changes where they eat and where they go, who they talk with. Some people get to the point where they won’t even grocery shop because of isolation. And when that happens and you start going without socialization, you often start deteriorating more quickly, your mental state changes, and it opens up a whole host of issues.”

Poor hygiene often leads to isolation — and isolation, in turn, can lead to declining personal care. It’s a vicious cycle, according to Spates, and one that often goes unnoticed if seniors don’t have family nearby.

“You notice people just shutting off from the world; they start canceling appointments or telling friends they don’t feel like going out. One of the main ways it presents itself is when people start giving up their normal routines and hobbies, they stop getting the newspaper or their coffee every day and they end up lonely in a chair and, suddenly, they haven’t bathed in weeks. But a lot of people have children and family members out of the area, and when you’re talking on the phone, you don’t notice anything. They mask it as well as they can from their family,” said Spates.

One of the keys for seniors looking to age in place is maintaining a strong support network while formulating a solid personal care plan. That often means having honest, open and sometimes uncomfortable discussions with family members and friends about what will happen as they get older. Do you want to bathe mom if it gets to that point? Does mom want that, or do we need to bring in home care or look at other options altogether?

Barbara Levison, president of the Florida Chapter of the Aging Life Care Association who also works with Sarasota aging life care company Proeger and Associates, said that identifying the causes for hygiene neglect is an important aspect of planning as well. There can be a variety of reasons someone 65 and older might stop showering, she said. It could be something as simple as they’re concerned for their safety when showering and need someone else in the house with them or need grab bars installed, or it could be something as serious as the onset of cognitive difficulties.

But being transparent and open to help is the key, she said, for both seniors and their family members.

“It all starts with having a conversation,” said Levison. “I always go back to communication and starting discussions early for people who want to stay in their homes. If you’re talking about these issues, especially if you have a family that’s able to be involved and supportive, you can work together to try and figure out what’s going to make everybody comfortable. It’s important to find support, whether that’s professionals or just the people who are available and in your life and that the senior can count on.”