What to Do
Recognize Change
Your ability to observe the person you care for and to recognize obvious as well as not so obvious changes is important. When you see a change that is sudden (e.g. symptoms of a stroke), unexpected (e.g. sudden mood swing) or a change that happens over several days or even weeks (e.g. the drainage from a cut that becomes thick with an odor or a change in the color or shape of a mole) – call the person’s doctor.
Listen to the person you care for. If he or she is reliable, listen when they tell you something is wrong. Take time and have them explain in more detail what is wrong.
Here are some conditions that require you to call for medical help immediately.
Heart Attack – a medical emergency. Blood flow to a part of the heart has stopped. Some heart attacks are sudden and intense and there is no doubt what is happening, however most heart attacks start slowly, with mild pain or discomfort.
Symptoms of a Heart Attack (American Heart Association, 2012) are:
- Chest discomfort – Usually in the center of the chest, lasting more than a few minutes or that goes away and comes back. It can feel like pressure, squeezing, fullness or pain.
- Discomfort or pain in other areas of the upper body: the back, neck, jaw, both arms, or the stomach.
- Shortness of breath with or without chest discomfort
- Other signs: cold sweat, nausea or lightheadedness.
The most common symptom for both men and women is chest pain or discomfort. However, women are more likely to have some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.
Don't wait more than five minutes to call 9-1-1 or your emergency response number. Emergency medical services (EMS) can start treatment faster than if you try to drive someone to a hospital. Also, the person could pass out or their heart could stop before you get to the hospital.
Stroke – a medical emergency. Blood flow to a part of the person’s brain has been blocked or stopped, either from a clot or from bleeding. Symptoms of a stroke (National Institute of Neurological Disorders and Stroke, 2012) are:
- Sudden numbness or weakness of the face, arm or leg (most often on one side of the body)
- Sudden confusion, trouble speaking or understanding someone else’s speech
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden severe headache with no known cause
Call 911 – tell the person on the phone you think your family or friend is having a stroke.
Tell the EMS responders you want to go to the local hospital (if available) that has a stroke center with 24 hour-emergency stroke care. Do not let the person you care for talk you out of calling. Time is critical. If given within 3 hours of the start of symptoms, clot busting drugs given by a doctor can reduce the injury of a stroke.
Other Conditions – Here are some conditions that occur or develop over weeks or even months. Stay observant and inform the person’s doctor.
- Dementia – If you care for an older adult, always watch for the warning signs of dementia, a progressive decline in a person’s ability to think. Alzheimer’s disease is one type of dementia. Warning signs of Alzheimer’s disease (Alzheimer’s Association, 2012) include:
- Memory loss that disrupts daily life, such as forgetting important dates, asking for the same information over and over, relying on memory aides (e.g. reminder notes).
- Challenges with problem solving. Persons will have trouble developing and following a plan or working with numbers. Trouble in keeping track of monthly bills is common. It might take them much longer time to do a routine task than before.
- Difficulty completing familiar tasks at home, work, or leisure. The tasks a person usually performs each day become difficult, such as washing clothes, driving to the local store, managing a budget at work, remembering the rules of a favorite card game.
- Confusion with time or place. The person will lose track of dates, seasons, and the passage of time. Sometimes they forget where they are and how they got there.
- Trouble understanding visual images and objects in space. It is common for persons with dementia to have difficulty reading, judging distances, and seeing different color contrasts. They might not recognize their own reflection in a mirror.
- New problems with words in speaking or writing. The person you care for might have trouble following or joining a conversation. It is common for a person to have trouble finding the right word or calling things by the wrong name. The person might stop in the middle of talking with you and have no idea how to go on.
- Misplacing things and losing the ability to retrace steps. Watch closely, the person you care for might put things in unusual places, a carton of milk in the garage, a toothbrush in the kitchen drawer. A person may lose things and be unable to go back over their steps to find them.
- Decreased or Poor judgment. A person with Alzheimer’s will change the way they make decisions, such as in the way they deal with money. Telemarketers might easily get them to donate or buy an item sight unseen. A person may no longer pay attention to grooming or keeping clean.
- Withdraws from work or social events. A person begins to avoid hobbies, social events, work projects or sports. It is common for example to cancel regular social events (e.g. bridge game, night at movies) or to have trouble completing a hobby project.
- Changes in mood and personality. A person can become confused, suspicious, depressed, fearful or anxious often without warning. It is common for the person to get upset easily at work or with friends.
Disease Changes – If the person you care for has a known disease, such as diabetes, arthritis, or glaucoma, know the changes that tell you the disease is worsening or progressing. This means you need to know what are the common symptoms. For example, if your family member or friend has diabetes, know the behavior changes that occur with low blood sugar. If a person has glaucoma, know the signs of vision problems.
New Medicines - When a person starts new medicines, watch for changes. Changes may be shown in appearance, behavior, mental status, and weight.