General Household Chores

A little household assistance can often mean the difference between remaining at home and having to move to a place where more help is available. Your loved one may not tell you if these tasks become difficult. You may need to look for clues. Pay attention for any changes from the usual pattern.

The following questions will help you recognize if your loved one is having difficulty with general household chores. Answer the questions as best as you can, and then review the feedback.

Low risk (Score: 0)

As long as the following are true about your loved one, they’re probably safe to remain in their current living situation:

Not showing an increase in sickness or infections
No unexpected or sudden weight loss (10 pounds or more)
Can walk steadily alone or with a cane
Has not fallen down
Can still see well enough to distinguish basic shapes and physical hazards.

Changes in behavior around household chores are often a sign that an older adult is losing their vision, hearing, or sense of smell or taste. It can also be a sign of depression or memory problems. With any of these possibilities, your loved one is at a greater risk of falling or becoming physically ill. These signs could also mean that there is a more serious underlying condition, which is using up strength and stamina.

If your loved one begins to attend to daily chores in a different way than usual, begin by talking. Tell your loved one that you’ve noticed the changes and find out if they are also aware of them. Especially if they’re not aware, schedule a full physical examination. Make sure the doctor tests their eyes, ears, memory, and emotional state. This can help you catch problems before they become serious. It’s a good idea to do this even if your loved one knows about the changes to rule out something more serious and to prevent future accidents.

Medium Risk (Score: 1–5)

Address the items that you responded with a “Yes” if they have not already been taken care of.

If your loved one is living independently, it’s probably okay to continue to do so, but assistance may be needed on occasion. Pay attention to whether any of these becomes an issue:

Sudden or unexpected weight loss (10 pounds or more)
Bruises or cuts on the body, perhaps from a fall
Holes or dents in the walls at home, again indicating a possible fall
Withdrawal from contact with friends and family
Frequent bouts of sickness or infections

Another major concern when an older adult changes house cleaning habits is the danger of falling. A fall often leads to a broken hip, which could limit your loved one’s ability to live independently. Watch for signs of falling (bruises, cuts, dents in the wall). Learn what you can do to prevent falls by completing the Home Safety survey. Help with light housekeeping can make sure that piles of paper or small objects do not become hazards that could cause your loved one to trip and fall.

Here are the questions you answered “Yes” to, and some suggestions for taking care of those specific issues.

High Risk (Score: 6–10)

It appears your loved one is showing signs of needing more help. If living alone, consider a move to a more social situation. Home-based services are another option that may allow your loved one to continue to live independently. However, it may also be time to consider a more structured environment, such as moving in with family, or into an assisted living community or adult foster care. Consider a change from the current situation if your loved one is showing signs of the following:

Evidence of falling (bruises or cuts, or dents in the walls of the house, usually near the floor.)
Unexpected lost weight of 10 pounds or more
Declining energy and stamina
Getting sick more often

The changes may be a sign that your loved one is slowing down. However, many serious problems begin with symptoms like these. From the number of issues you indicated, it’s a good idea to ask your loved one to have a complete medical physical exam to rule out something more serious. It could turn out to be as simple as needing new glasses, or getting help with shopping and cooking.

After addressing any health concerns, consider having a social worker or a geriatric care manager visit your loved one’s home. If your loved one was formerly aware of the condition of their home but that awareness seems to be diminishing, determine why—it could be lost interest from loneliness, depression, grief, or dementia.

These professionals are trained to notice behaviors that indicate a need for greater help. They know about available services in the area, and are skilled in working with people to ease the transition for accepting services.

Here are the questions you answered “Yes” to, and some suggestions for taking care of those specific issues.

1. Preparing two nutritious meals per day? Yes No	Fortunately, most communities have a “Meals on Wheels” program that can bring a daily nutritious meal to homebound older adults. Check with your local Area Agency on Aging or go to the Meals on Wheels website http://www.mowaa.org/ for services.
2. Doing light housekeeping tasks (tidying up, washing dishes, doing laundry)? Yes No	Arrange for housekeeping services from friends, neighbors, or reputable local services.
3. Doing heavy housekeeping tasks or yard work (mopping, raking, washing windows)? Yes No	There are outdoor maintenance services that can be scheduled one time, annually, or on a regular basis. Most services will schedule year-round and call a day or two before to let you know they’re coming. Snow plow services will come automatically when it snows, and gardening services will schedule visits to do planting, mowing, and removing leaves. Window washing or cleaning gutters can also be scheduled in advance.
4. A bare refrigerator or pantry? Yes No	A lack of foods at home may indicate that shopping and/or cooking are an issue. Arrange for family, friends, or neighbors to help out with shopping and/or deliver prepared foods. You can also order groceries to be delivered by many grocery markets. Most communities have a ‘Meals on Wheels’ program that can bring a daily nutritious meal to homebound older adults. Check with your local Area Agency on Aging or go to the Meals on Wheels website for services.
5. Moldy or expired foods in the refrigerator? Yes No	Old or moldy food in the refrigerator could mean that the foods are causing illness. Ask friends and neighbors who bring food to put dates on them. Ask visitors to check the refrigerator and throw away outdated foods.
6. Unexpected weight loss (10 pounds or more)? Yes No	An unexpected weight loss is a concern even if the person is overweight. If your loved one suddenly drops 10 pounds without intentionally doing so, the problem could be as simple as tooth pain, or it could be something more serious. For many, it is a sign of depression or loneliness. For some, it could mean that they are having trouble shopping and cooking. We suggest you make an appointment for a physical to rule out something more serious.
7. Changes in housekeeping habits (unwashed dishes, piles of laundry)? Yes No	Whenever there’s a change from usual habits, it’s a good idea to make an appointment for your loved one to be evaluated by a doctor to identify the cause, and to rule out something more serious. Arrange for housekeeping services from friends, neighbors, or reputable local services.
8. Unpleasant odors in the home? Yes No	Find out if your loved one is aware of the odors. It’s possible that their sense of smell has diminished. Find out the source of the odor in order to eliminate it. Let friends, family and neighbors who visit know about it so that they can help detect and let you know when there’s an issue. Arrange for housekeeping assistance from family, friends, or a reputable local service. Call your Area Agency on Aging for referrals.
9. Signs of spills that have not been cleaned up? Yes No	Find out if your loved is aware of the spills. Determine the best way to prevent future ones or to help your loved one know about them. Arrange for assistance from visitors by asking them to look around and let you know if they notice anything unusual.
10. Doors closed to rooms that used to always be open? Yes No	Find out if your loved one is aware of the change. If so, find out why they decided to close the door(s). There may be a simple reason that is not serious. It’s important to talk with your loved one and to have them evaluated if they are not aware of habitual changes to rule out something more serious.

General Household Chores

1. Preparing two nutritious meals per day?

2. Doing light housekeeping tasks (tidying up, washing dishes, doing laundry)?

3. Doing heavy housekeeping tasks or yard work (mopping, raking, washing windows)?

4. A bare refrigerator or pantry?

5. Moldy or expired foods in the refrigerator?

6. Unexpected weight loss (10 pounds or more)?

7. Changes in housekeeping habits (unwashed dishes, piles of laundry)?

8. Unpleasant odors in the home?

9. Signs of spills that have not been cleaned up?

10. Doors closed to rooms that used to always be open?

Low risk (Score: 0)

Medium Risk (Score: 1–5)

High Risk (Score: 6–10)