When to move into a nursing home

When is the right time to suggest parents or loved ones can no longer live safely on their own?

Sometimes, the decision is forced by illness, an accident or other circumstances related to aging. For other elders, changes are subtle. In a special report on assisted living, the July issue of Mayo Clinic Women's HealthSource lists warning signs to help gauge when seniors need assistance in the home or alternative living arrangements. These signs may also indicate that a call or visit to a primary care doctor is in order.

Weight loss. Losing weight without trying is a signal that something is wrong. It can indicate a significant health problem, such as cancer, dementia, depression or heart failure. Weight loss can also be related to difficulty finding the energy to cook or problems with grasping cooking tools. Changes in the ability to taste and smell can make food less appealing.

Poor home maintenance. Piled up dirty dishes or clutter, overgrown grass or any big negative changes in home upkeep are clues that seniors may be having health problems or age-related changes that hinder them from keeping up with household chores.

Lack of personal hygiene. Failure to keep up with daily routines — teeth brushing, bathing and basic grooming — can be signs of trouble.

Mood changes. Everyone has good and bad days, but a different mood or outlook on life could be a sign of depression or another health concern. Losing interest in hobbies or daily activities is not a natural sign of aging.

Memory loss. Forgetfulness tends to increase with age, but there's a big difference between normal absentmindedness and the type of memory loss associated with conditions such as Alzheimer's disease or other forms of dementia. Early warning signs can include repeatedly asking the same questions; having difficulty finding words; using inappropriate words; and being unable to complete familiar tasks.

Mobility problems. Muscle weakness, joint problems and other age-related changes can make it difficult to move around and perform basic tasks or chores. Unsteadiness increases the risk of falling. And falls can cause major injuries and even death in older adults.

It can be difficult for all involved to determine that independent living is no longer safe or practical. Sometimes, a family member's expression of concern can be the impetus needed for the elder to realize it's time to see a care provider or consider other living arrangements.