A Roadmap to Supporting Aging Parents’ Health

As people live into their 80s and 90s and age in place, concerned families are sometimes forced to rely on a patchwork of caregiving to ensure their loved ones don’t fall through the cracks. Aging is the single largest risk factor for dozens of conditions, from dementia and cancer to arthritis and hearing loss.

“It’s hard to age. It’s really hard to age alone,” said Cedars-Sinai Geriatric Medicine Chief Sonja Rosen, MD. "People often don’t realize when they need more help, but you can be their advocate.”

America’s aging population—the group of people age 85 and older set to triple by 2050—poses challenging questions and transitions for families. Cedars-Sinai physicians share how to navigate the thorny terrain of aging, including monitoring safety concerns and communicating to keep the older adult’s wishes at the heart of every decision.

“Lead with love,” Rosen encouraged.

Recognize Risks to an Older Adult’s Wellbeing

Safety is paramount. If an older adult may be in danger of harming themselves or another person, experts urge families to intervene.

“We can be in a little bit of denial. We don’t want to think our parents need help, and we tend to ignore the signs—but if you see something, you need to speak up,” Rosen said.

While spending time together, whether as a caregiver or visitor, be mindful of your loved one’s appearance and surroundings. Have they washed or brushed their hair? Are leftover food or containers piling up on the kitchen counter? When was the last time they ate? Are they taking critical medicines as prescribed?

Noticing something is amiss—or may need a higher level of assistance—requires staying consistently curious about older relatives’ lives, without condescension.

It’s hard to age. It’s really hard to age alone. People often don’t realize when they need more help, but you can be their advocate.

Pay careful attention to repeated, concerning patterns and household threats, including:

• Missed bills or essential appointments.
• Wandering.
• Digital or financial scams.
• Potential home fire and fall hazards, including electrical cords and loose rugs.
• Spoiled foods, especially meat or produce. Check expiration dates.
• Unexpected weight loss.
• Withdrawing and speaking fewer words can be early signs of hearing loss or a memory disorder.

Subtle shifts may require stronger support to properly meet your loved one’s needs. Ask their doctor for resources, and weigh all your options. Consider professional in-home caregiving, recruiting a sibling or rotating help among adult family members.

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The ultimate litmus test for aging in place: Can the person perform activities critical to living on their own, such as showering or bathing (usually the first challenge, affecting three-quarters of those 85 and older), eating, getting dressed or going to the bathroom?

“If you need help with cooking, shopping, transportation or other instrumental tasks, you can live alone, but you need a caregiver or some type of part-time assistance to fill in those gaps,” Rosen explained. “You cannot live alone at home if you’re dependent in your basic activities of daily living. It boils down to, ‘Could you get out of the house in a fire?’”

Foster an Environment for Your Loved One to Age in Place With Ease

Physicians encourage families to take time to determine what your loved one needs to enjoy their golden years, including where and how they live, and proactively plan together.

Honor their wishes whenever you can safely do so, without imposing your own feelings.

“Your parent really might not want to change their life,” Rosen explained. “Consider whether they’re safe enough. Notice if their house is cluttered and messy or they could be eating better: Signs that it’s not perfect, but they’re getting by. That’s when you have to think about what matters most to them.”

Older people are often too embarrassed or afraid of losing their independence to raise concerns about their safety.

“We have to be as compassionate, kind and gentle as we can, so we retain everyone’s dignity,” she said.

Disregarding their desires can backfire, causing more rapid health deterioration. Instead, collaborate on equipping the house to safeguard older adults who choose to age in place. Muscle and bone damage increase vulnerability. By age 85, nearly three-quarters of older adults find movement challenging, and 40% are frail.

AARP, in its HomeFit Guide, recommends age-friendly accommodations, from grip bars in the shower to clearing excess furniture and electronics from the floor.

Simple gestures, such as arranging transport for faith services or finding accessible ways to exercise, can bring deep peace and fulfillment.

Keep an eye on their online world, too. Rosen recommends sharing phishing or scam alerts with family members of every age.

When a person is in immediate jeopardy, families can apply for legal conservatorship authority, although that is usually a last resort after gradual supportive measures.

Actively Participate in Your Aging Parent’s Care

Family members may fear they’re overstepping by getting involved in their parent’s healthcare. But Cedars-Sinai physicians welcome family support, if the patient is on board.

“That just gives us more information and a trusted partner to carry out our care plan,” Rosen said.

Join their appointments in person, virtually or through a dedicated, secure third-party call-in system. With their permission, monitor visit notes and medical test results, and message the patient’s care team, on their MyChart portal.

Saurabh Sharma, MD, a neurologist with Cedars-Sinai’s Memory Disorders program, encourages those with specific, sensitive concerns to write a letter directly to the patient’s physician in advance of the appointment.

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If an older adult is resistant to medical aids such as walkers, medications, exercise or other aspects of their treatment plan, ask the doctor to advise them directly, using concrete data. Health advice may be better received from a professional.

“As a family member, it can be very difficult to break through,” he said. “The patient needs a medical provider to assess them and give an accurate recommendation and the justification for it.”

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Safe Driving for Older Adults: When to Hand Over the Keys

Older age often necessitates a restriction or revocation of a person’s driver’s license. This loss of freedom can make older adults feel powerless or beholden to others.

We have to be as compassionate, kind and gentle as we can, so we retain everyone’s dignity.

Shifts in your loved one’s attention span, vision, balance and cognition can affect their driving, especially after age 70. As they age, people often exhibit diminished reflexes and the spatial and sensory skills necessary for safe driving.

Implement robust safeguards for those who still drive, such as communicating the importance of consistent seatbelt use and paying attention to the weather. Vulnerable older adults should avoid driving at night, which is especially hazardous as high beams distort perspective, and during weather that limits visibility. Getting lost should be taken seriously, along with any accidents.

“There’s a common misconception that just driving around the neighborhood is fine,” Rosen said. “But that’s a false sense of security—most accidents happen at or near home.”

Confidential driving tests available through both the AAA and AARP can gauge your loved one’s skills. You can also file an anonymous report with the Department of Motor Vehicles if there is potential for danger and tension about giving up driving.  

Be Present

Time is precious.

Sometimes, older adults’ forgetfulness or cognitive decline can mean your loved one’s conversation becomes repetitive or they lose track of times, dates, complex instructions or cues. Rather than correcting individual mistakes, meet them in their reality and try to redirect the conversation to their underlying feelings.

“Your parent isn’t being childish or unreasonable,” Sharma stressed.

Social isolation and loneliness are reaching epidemic proportions, and depression doubles over the age of 85. As your parent ages, empower them with the tools that keep them connected to the world around them—so you can focus on each other.

“Normalize these conversations about what can happen when we get older, before they become a crisis,” Rosen said.