Low Risk (Score: 0)

If the person you care for lives alone, it’s probably safe to continue for
them to do so if the following characteristics are true:

• Alert, oriented, and retains good memory
• Socially and physically active
• Demonstrates good judgment
• Able to manage self care without assistance
• Healthy coping skills during times of distress

If, however, you notice your loved one becoming confused, socially isolated, or
unable to manage self-care, more help may be needed. If you’re concerned,
consider hiring non-medical in-home care. It will also help to have people check in
on your loved one frequently. Arrange for visits from friends and family,
neighbors, faith-based groups, or volunteer organizations. If it’s difficult
to arrange for regular visitors, phone calls are another way to give your loved one
support and to let you know if anything seems unusual. Moving to an assisted living
community may be appropriate if mental health worsens.

Medium Risk (Score: 1–5)

If your loved one is living independently, it may be fine to continue.
Occasional help may be needed. Arrange for people (family, friends, neighbors,
faith-based groups, volunteer organizations) to check in regularly either by
visiting or calling your loved one, and have them let you know if anything seems
unusual.

Things to look for include:

• Increased confusion, disorientation, memory loss, or forgetfulness
• Difficulty expressing thoughts and communicating with others
• Difficulty performing familiar and simple tasks
• Signs of forgetting things on the stove (burnt pans, smoky smell or smoke
  marks in the kitchen)
• Withdrawal from family and friends
• Poor judgment
• Personality changes
• Wandering and getting lost
• Increased sleeping or insomnia
• Persistent physical symptoms such as: headaches, pain, digestive problems,
  dizziness
• Loss of energy or listlessness
• Changes in eating habits (unexpected weight loss or weight gain)
• Loss of interest or pleasure in activities which used to be enjoyable
• Increased stress
• Thoughts of death or suicide

These can be symptoms of the onset of dementia, depression, a reaction to
stress, a prescription drug side effect, signs of neglect, or alcohol abuse. Safety
risks in the home may increase, such as leaving cooking appliances on due to
forgetfulness, or wandering and getting lost outside the home. Medication(s) may be
taken incorrectly, which could cause a bad reaction.

If your loved one is depressed (20% of older adults show at least some signs of
depression), you may need to be on the alert. You should know that older adults
have the highest rate of suicide among all age groups in the U.S.

Increasing social contact with other older adults, family, and friends may help.
Strongly consider hiring non-medical in-home help. A visiting nurse can assist with
medication management. A medical pager might provide additional safety and
reassurance. It can be worn around the neck or wrist. If your loved one falls or
gets in trouble, they can push the button for help. An assisted living community or
residential care center could be appropriate if you think help is needed more
regularly. Other housing options include moving in with a family member or moving
into an adult foster home. If you suspect the problem may be getting worse, a
medical checkup for your loved one is recommended.

High Risk (Score: 6–12)

Your loved one needs frequent assistance and supervision. It’s probably
not safe for them to be living alone if any of the following are true:

• Frequently wanders away from home and becomes lost
• Is unable to perform basic self-care activities such as bathing, dressing,
  and toileting
• Forgets they are cooking, leaves burners on and scorches food cooking on the
  stove
• Expresses thoughts of death or suicide
• Refuses to eat
• Incorrectly takes prescription medication or stockpiles medications
• Consumes too much alcohol
• Appears to rely upon mood-altering medicines such as tranquilizers and
  sleeping pills.

It’s probably necessary to consider a living situation with more help and
social contact for your loved one to assure safety from things such as: forgetting
something, accidentally starting a fire, or causing an accident that also injures
others. Until a move is made to a safe environment with other people, arrange for
people (family, friends, neighbors, faith-based groups, volunteer organizations) to
regularly check in with your loved one by visiting and calling, and to let you know
about anything that’s usual. Older adults have the highest rate of suicide in
the U.S., especially older adult men.

Living with a family member, or hiring non-medical in-home help is very likely a
good idea. You may also consider an adult foster home or a residential care center.
A consultation with your loved one’s physician and perhaps a specialist in
psychiatry, neurology, or geriatric psychology is strongly recommended.