Care Management • Eldercare Advocacy • Dementia Care

What to do When Behavior Changes Are No Longer Normal

Judie Rappaport
elderly woman in bed while adult woman sits at her bedside

Dear Judie,


Years ago, Mom (85) and I had a wonderful discussion about her moving in with my family when she was no longer safe at home. Now she’s refusing to leave her home for my house or to move to assisted living. She says, “I’m staying right here in my own home until something happens that proves I need to move”. I’m thinking something has already happened: she keeps losing weight, isn’t always clean, and doesn’t seem interested in activities with her friends anymore. How do I know if she’s tired and eats less because she’s 85 or needs help? 


- Jerome, PSL


Dear Jerome,


Deciding whether to intervene in a parent’s life is difficult. Certain changes are expected and acceptable as we age; intervention is necessary when the changes are unexpected and unacceptable. These beginning guidelines can help judge if Mom’s at risk or safe and enjoying her quality of life, even if her way of doing things differs from what you’d like/expect her to do.


  • We would expect an 85-year-old to have less energy than a 75-year-old. However, losing interest in the family she loves would be unexpected.
  • If Mom’s been ill or is frail, we would expect her social life to diminish. If she’s been active and is suddenly too weak/tired to go out, that’s unexpected and she’s at risk for depression caused by isolation.
  • If Mom’s weight has been steady for years, we would expect her to maintain a similar weight and appetite. A loss of 10+ pounds is unexpected and may be caused by depression, confusion (forgetting to eat), dental problems that cause pain when she eats, or other serious issues.
  • If Mom’s personal hygiene patterns have remained the same for years, we would expect her to continue her grooming. An unexpected change signifies potential problems like cognitive impairment or fear of bathing with no one around to know if she falls.

These possibilities all point toward Mom needing help. Begin with a complete medical exam ASAP to determine the cause of these “unexpected & unacceptable” changes.

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