The Four Most Unexpected Behavioral Changes in the Elderly – Is this Normal? Part IV (Final)


In parts I, II, and III of this series, we’ve explored changes in hygiene, anger, and paranoia as three of the most unanticipated changes in behavior that you may have noticed beginning to occur in your own aging parent. More than that, I offered my own opinion on when the line between “normal aging” and “time to see a physician” might be crossed in each scenario. (To read any or all of my prior posts, please follow this link.)


Today we’ll close this series with what I consider to be the fourth most unexpected behavioral change that any adult child anticipates seeing in his or her aging parent: depression. I’m including it here because it is so vitally important that it should never be ignored. (So there’s the answer to when it’s time to see a professional right there: always seek help for your aging parent who is showing signs of depression. I will provide a comprehensive list of symptoms further down in this post.)


  1. IV. Depression

I’d like to differentiate here between that which is “normal” and that which is simply under-recognized and/or under-treated. Depression is not necessarily a typical function of aging, nor should we ever settle for this way of life for someone we love. However, there is a strong likelihood of depression’s co-occurrence along with the presence of certain debilitating, long-term diseases and certain unpleasant life events, such as the death of a loved one or the social and economic status changes that may correlate with aging.

Again, I cannot stress strongly enough the importance of seeking help for an elderly person who is suffering from depression. Like other illnesses mentioned in the earlier posts, this is yet another malady which impacts older people far differently than it does younger ones. In the elderly, depression increases the risk of death from other illness, is associated with an increased likelihood of cardiac disease and stroke, as well as inhibits the ability to recuperate from most any medical setback.

The good news is, unlike other medical conditions, depression is highly treatable with a combination of medicine and/or psychotherapy. Unfortunately, the older generation in which our parents came up is known for being both more stoic as well as more conscious of keeping certain types of personal information under wraps. Many seniors don’t necessarily think of depression as a health problem per se, but more of something to be “handled on one’s own.” It’s unwise to leave this particular change in behavior to the detection of others. This one is really up to us, the adult children, to detect, and to point out to health care professionals.

Some sobering statistics

Without help, depression in the elderly can take a deadly turn. Statistics on suicide and the elderly are downright staggering. Suicide among older with males is disproportionately higher than all other age demographics. Additionally, World Health Organization Studies show that approximately 70 percent of those elderly people who have committed suicide had seen their primary care doctors within just one month of their deaths.


As the primary family member and/or caretakers in your parent’s life, the burden falls on us, the adult children, to stave off any difficulties or uncertainties our parents may face, including illness. In fact, a National Institute of Mental Health study shows that intervention by close family members is key to decreasing suicidal thoughts and successfully improving depression in the elderly. That’s pretty much the magic formula: inclusion; along with professional treatment and appropriate follow up.

Signs of depression in seniors

The symptoms of depression in the elderly include:

  • Apathy/slow movement and/or speech
  • Loss of interest in hobbies and other interests
  • Lack of motivation and energy
  • Withdrawal and isolation
  • Unexplained physical aches and pains
  • Irritability/anxiety/worry
  • Feelings of worthlessness (worrying about being a burden, self-loathing statements)
  • Neglecting personal care and hygiene
  • Sleep disturbances (too much or too little)
  • Lack of concentration
  • Increased use of alcohol and other substances
  • Changes in eating habits/weight loss
  • Sadness

If you suspect that your aging parent is suffering from depression, please don’t ignore the signs. Take your loved one for proper care. Above all, a senior who is suffering from depression needs someone who can be there to follow through with visits, phone calls, and help with medication planning and follow-through. Make sure your Mom or Dad gets out of the house for walks, visits to the library, outings to the mall, etc.

If I can help brainstorm in any way, please reach out to me.

All the best,

Rabbi Scott Saulson, Ph.D.

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Unexpected Behavioral Changes in The Elderly – (Is This Normal?) Part III

Part III

In Parts I and II of my series on unexpected behavioral changes in your aging parent, we’ve discussed the ins and outs of both changes in personal hygiene and increasing agitation. Today we’re going to be looking into paranoia, our third unexpected change in behavior that you may be seeing in your own aging parent.

  1. Paranoia

Does your aging mother call to complain that her nurse/housekeeper/neighbor is stealing from her? Worse, does your mom even accuse family members—or YOU—of taking the craziest minutia from her home? Nothing you say can convince her otherwise. Maybe she watches her cleaning person like a hawk, following the woman from room to room, certain that this poor lady is the reason behind your parents’ diminishing window cleaner supply.

“You owe me a pill. I counted and one’s missing.” This is another common complaint from those who are slipping into the grips of such paranoia. I have a client, a working mom of two whose mother-in-law lives with the family and requires full-time assistance (such as being driven to and from all medical appointments in addition to her own errands), who’s almost always accused of either stealing, dropping, or somehow otherwise misplacing a pill between her harried drive from the pharmacy and back to the house where they all live.

Why is the mother-in-law even counting what’s in her pill bottles, anyway? What’s that about?

The truth is, the mother-in-law may or may not have even counted her pills. She may just be angry (at any and everything); she may be trying to exert some form of control, reminding the daughter-in-law that she’s always watching out for the family’s safety. Who knows? Maybe counting the pills is somehow soothing.

I’m always going to suggest a medical appointment for an older person whose demeanor has changed to this level. What needs to be deciphered, for example, is whether or not Mom believes she saw her neighbor sneaking into her home in the middle of the night to steal her houseplants (a hallucination), or whether Mom is so overly anxious about her own health, finances, abilities, etc. that she’s started to become paranoid about the world around her and is therefore lashing out with anxiety-induced accusations.

Often, some elderly folks may be helped by taking medication to help alleviate the very real anxiety that can come along with growing older. Here’s one more tip: Have Mom tested for a UTI (urinary tract infection). Simply stated, routine medical hiccups do not always manifest in the elderly in the same manner as they do in the general population at large. A physician who is knowledgeable in caring for seniors will recognize sudden onset of paranoia as a reason to take a urinalysis, which is a great deal less costly (and frightening) than a brain scan.

In the meantime, if I can be of help to you and your family during this time of change, please reach out to me so that we may start a dialogue.

All the best.


Rabbi Scott Saulson, Ph.D.

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Is This Normal? Part II

Unexpected Changes in the Elderly: (Is this Normal?)

Part II

In my last post we discussed the neglectful changes in hygienic practice that one all-too-often may notice in his or her aging parent(s), the possible reasons behind these changes, and ways to go about remedying the situation to the most satisfactory degree for all involved.

Today I’ll continue with my series, “Top Four Most Unexpected Behavioral Changes in the Elderly,” identifying and discussing our second change: anger.

  1. Anger/agitation

Getting older isn’t easy. We slow down, we often get ill, and all too often, we become dependent on others. For many, this is upsetting, and so they take it out on those around them. Additionally, there are changes in testosterone levels in men, which leads to that infamous “grouchy old man” syndrome. And let’s not forget that medications—newly prescribed and/or poorly interacting—may be playing a role in how Mom or Dad is now reacting to the daily grind. While certain prescribed medications can have tremendous implications on anyone’s attitude, the elderly tend to be on many long-term prescriptions, and may be forgetful about keeping an accurate list for each specialist. Have there been any recent changes in prescriptions? Older folks really do have a tendency to become grumpy as they age, and the reasons are as varied as the days are long. If you’re the main caretaker for your aging parent, keeping a daily journal (even making notes in your regular planner works fine) is crucial in figuring out patterns of behavior and whether or not we need to worry. (If you’re not the main caretaker, I’d still recommend keeping a journal of your interactions with your parent(s). You can call often and ask where Mom is going, how her doctor appointment was, how she’s been feeling, etc.)

Does Dad become grumpier at family and social gatherings, for example? Perhaps he’s feeling nostalgic about his life. Maybe something far simpler is at play: has he had a recent hearing check? Large social gatherings tend to be frustrating when Mom and Dad can’t make out the conversation streams around them. Or, perhaps Dad is feeling lonely or isolated after having seen a few of his close friends die. Encouraging him to join a new social group could help. See if there’s a local seniors center nearby, or look online for a meetup of people who share his same interests and who would be welcoming. Spending time alone with your father, talking one on one, could help you determine what those interests are. Maybe he is wishing he had spent more time at church or synagogue, maybe he wishes he’d seen more of the country, or spent more time fishing, etc. It’s not too late for these things! Of course, if this type of agitation becomes anything more than that, you need to take your parent to a doctor as soon as possible. Hitting, biting, excessive cursing, etc.—these are beyond the norm.

Spending this time hearing what your aging parent has to say, even if you must put up with the grumpiness, might help your family unlock the door to a simple solution for making everyone’s life a lot more upbeat. I am here to help you ask the right questions if you don’t know where to begin. Please reach out to me.

All the best,

Rabbi Scott Saulson Ph.D.





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The Four Most Unexpected Behavioral Changes in the Elderly – (“Is this normal?”)

Part I

September 24, 2015

We hear it all the time: “What is ‘normal?’”—a reminder that there’s a broad range of what’s considered to be acceptable and unacceptable behaviorally and that we shouldn’t compare ourselves to others.

As a professional who counsels families dealing with issues on aging, I am here to tell you that here, at least, there are classic behaviors people tend to display as they grow older, making these behaviors on the one hand “normal,” yet in no way any less worrisome to you, the care taker, or close family member.

So today I thought I’d review three or four of the more pronounced changes you may have noticed in your aging mom or dad lately, and tell you whether or not these changes are simply typical, or ones which might indicate further investigating by a physician is necessary. However, I’ve decided instead to discuss just one change at a time during the course of the next couple of weeks as some of the more prominent changes manifested by aging can be rather heady.

And that, friends, leads us to the first unexpected change you may have noted in your own aging parent:

  1. Changes in hygiene

I hear this one all too often. “So-and-so absolutely refuses to bathe or shower. It’s become a real problem. She was always so fastidious about her hygiene, too!” It’s confusing, slightly embarrassing to discuss, and let’s be frank: it’s gross. Worse than all of those things, a lack of hygiene in the elderly is unhealthy, and that’s why this typical change in behavior is the one I mention at the top of my list as one not be ignored.

First, you may want to check with a medical professional about the norms of bathing at advanced age.  As people get older and perspiring activities are less common, a reduction in the frequency of bathing is understandable.  But body odor, oiliness, flakiness, and the aftermath of reflux and of visits to the toilet do need attending to. Equally problematic: sense of smell wanes as people age. Talk calmly to your parent and try to ascertain what’s going on here. Is this about forgetfulness on his or her part, or do you think that is Dad trying to exude some control over his own life through this apparent self-neglect? Is it possible that Mom is merely happily reliving a time in her life when dirt between the toes was a badge of honor for “flower” children?

What do you think is really going on with your mom or dad? Get out of your own head and look at things from his or her perspective. What changes, if any, have recently occurred—perhaps health- or mobility-related or even changes in residence or daily routine may have a sparked anxiety.

Make things as easy and as safe as possible for your parent. Make sure the bath or shower has been outfitted with a safe and comfortable shower chair, and that Mom or Dad can reach everything needed in order to get clean. In the end, relaxing your standards somewhat is probably the best idea. If you need to hire a nurse to come in and help make sure that your dad or mom has been bathed and put in clean clothes once a week, that’s great. Life will probably become a lot more tolerable for all involved, too.

Next time: we’ll discuss anger/agitation in the elderly. Until then, please know that I am here to help any family that is in crisis. Please reach out to me.

All the best,

Rabbi Scott Saulson, Ph.D.

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Getting Through the First (fill in the blank) Without Mom or Dad

I caught up with a long-time client last week. After losing her mom this year she’s having a difficult time coming to grips with how to handle the fast-approaching holiday season. She has suffered an immense amount of loss in the past five or so years, having lost her husband, her father, her brother, and now her mother, leaving “J.,” as we’ll call her, with no close family except for an adult son.

“Hey, what are we doing for Christmas dinner this year?” the son asked casually one day, not long ago. Continue reading “Getting Through the First (fill in the blank) Without Mom or Dad” »

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Working Late

In my town there lives a gentleman named Gus, who lives a life of partial retirement. While his age entitles him to Social Security and Medicare benefits, he also rises at 5:00 a.m. daily in order to be ready for his morning drive to a nearby hotel, where he reports to work from 7:00 a.m.-noon, five days a week, minimum. His business card credits him with sales and marketing; and while yes, he does book large groups in need of a hotel in which to stay for an upcoming engagement or celebration, this gentleman also runs errands for hotel management, assists with payroll, manages the front desk, fills in for errant employees, acts as the go-between for guests in crisis and high-up management, and drives the occasional guest to the airport using the hotel van. He also comes running in the middle of the night when there is an emergency at the hotel, as his is the number overnight employees are directed to call in a pinch. When the owners of the hotel are on vacation, he is put in charge of the staff and the hotel, as his decades in the industry (60) and his unusual aptitude with language (at one time in his life he was fluent in seven of them) make him invaluable for the staff as well as the management, and he is as much appreciated for his skills as for his true love of the work. Continue reading “Working Late” »

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The Secret

I was speaking with a friend who’d attended the most fascinating service the other day, certainly one which got us both to thinking, in which a young man was formally given his Hebrew name in front of an entire congregation of worshippers. Continue reading “The Secret” »

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Get Ahead of the Game When Selecting a Longterm Senior Care Residence for Moms and Dads. Part II

(This is the second half of my most recent blog post. Read Part I)

  1. Get yourself a spiral notebook
    (A memo pad or journal will work, too–whatever suits your style–just so long as you keep it handy.) Use it to jot down questions you’d like to ask the head of marketing during your tour. (It’s important to remember that this person is trying to close a contract.) Whenever something comes to mind, write it in your notebook. Ask for an appointment time which coincides with a meal, so that you can not only taste the grub but also see how the residents take to it. Do they get to plan their own menus? What if your parent has dietary restrictions (medical or religious)? What if Mom is under the weather and can’t get out of her apartment for a meal? Will someone be available to bring it to her? Is there 24-hour access to a physician? Who dispenses medication, and what’s the process to ensure it’s done in a timely and safe manner? Speaking of assistance, the staff—from janitorial services to front desk to kitchen to counselors—are the frontline, day to day faces your mom or dad will see. A smile, a nod, a greeting, etc., these small acts of kindness make all the difference in another person’s life. Greet all the staff members you see with a smile. What reaction do you get? If you’re able, break away for a moment and ask about their job satisfaction. “Would you bring your mother here?” is the perfect question to ask any residential employee.

Continue reading “Get Ahead of the Game When Selecting a Longterm Senior Care Residence for Moms and Dads. Part II” »

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Get Ahead of the Game When Selecting a Longterm Senior Care Residence for Moms and Dads (Part I of II)

Entrusting your aging parents to the care of someone else is one of the toughest decisions an adult child will ever face. It seems we cannot escape the media accounts of innocent senior citizens falling victim to the “caretakers” tasked with providing them the safety they deserve. What if something like this were to happen to your own parents? The thought alone is panic-inducing.

How can you ensure that Mom or Dad will be wholesomely cared for in the facility you select? Continue reading “Get Ahead of the Game When Selecting a Longterm Senior Care Residence for Moms and Dads (Part I of II)” »

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“If you don’t Have Anything Nice to Say…”

Time-honored techniques for coping when your aging parents are stressing you out

The parent-child relationship… To say it’s complicated is as understated as saying the world is a big place.

Let’s face it, even in their younger days, your mom and dad had a special way of grating on your nerves—something which has nothing to do with how much you love them. Continue reading ““If you don’t Have Anything Nice to Say…”” »

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