Nursing Home Signs You May Not Be Noticing

Published: Last Updated: Category: Retirement

As the population ages, more family members find themselves taking care of elderly parents, grandparents or other loved ones. It can be difficult to care for loved ones while working, caring for your children, and keeping up with social commitments. You will likely arrive at a crossroads where you’re forced to ask “when is it time for assisted living?”

While many family members do not want to consider committing their loved ones to an institution like an assisted living facility or a nursing home, it isn’t always possible to move them into your house. As loved ones’ medical conditions worsen, they may need around the clock care, which you may not be able to provide.


Approximately 19 million people in the United States have mild to severe mobility issues, with the median age being between 59 to 67 years old. Disease and trauma can cause changes in gait and balance. The primary concern for people with mobility problems is the increasing likelihood of falls.

Having poor balance or changes in the ability to walk is a common cause of falls for older adults. Falling can lead to serious injuries which can further limit mobility, result in a loss of independence and reduce their quality of life. Some senior citizens do not recover well after falling. Broken bones and hip injuries can become fatal.

If a loved one shows increasing signs of not being able to get around without assistance, then they will need continuous care. You may need to consider asking, “when is it time for assisted living?”

Even if they use a walker, cane or wheelchair, there can be obstacles in a house which can increase their risk of falls. Toys left out on the floor, attempting to go up or down stairs or even a pet can accidentally trip them and further limit their mobility.


If you notice a loved who used to be fastidious often wears the same clothes or their clothes appear dirty, they are unshaven, or their hair hasn’t been washed, this can indicate they are no longer able to care for themselves. While forgetfulness can lead to poor hygiene, so can depression, dementia and physical problems which limit their ability to take care of themselves.

Poor hygiene habits make people look dirty and cause body odor. They may eat without washing their hands, garbage may not be disposed of properly, and they may have poor bathroom habits. These problems may result in illness. Pests, which can carry diseases, may also enter a messy home where they can find food.

Poor hygiene can result in parasitic infections of the hair and skin, the skin can become infected due to bacteria or fungi and food poisoning, or gastrointestinal problems can result from poor toileting habits or not washing hands before eating. Further complications can arise from these issues, such as dehydration, which in some elderly patients can be fatal.

If your loved one shows signs of poor hygiene habits, putting them in an assisted care facility will ensure they get the assistance in staying clean. There will be people to help them bathe, use the toilet, do their laundry and keep their room neat. Some of these problems can help answer the question, when is it time for assisted living? The following video sheds more light on the issue:


While the memory sometimes isn’t as sharp when you’re older, severe cognitive declines are usually due to health issues. Caregivers may start noticing both short- and long-term memory problems, confusion, coordination problems and impaired judgment. Cognitive problems are the result of damage to the brain, either by trauma, genetics, or by abusing drugs and alcohol. Certain medical conditions, such as dementia, can also result in cognitive disorders.


Since all forms of dementia affect the brain, it usually results in some form of cognitive problems. Mild Cognitive Impairment, MCI, is common in many older people and is often the first stage of dementia. Its symptoms may include:

  • Forgetfulness
  • Frequently misplacing or losing objects.
  • Trouble remembering words.
  • Become more impulsive.
  • Getting lost in familiar places.

Although some people who have MCI can get better, others will usually experience steady declines if they are diagnosed with some form of dementia.

As cognitive abilities diminish, many seniors may become more irritable, apathetic and depressed. This degradation of cognition may result in family members questioning when is it time for assisted living care for their loved ones?

However, it’s unclear whether depression develops because of declines in mobility and cognitive functioning or if it contributes to the development and progression of reduced cognitive abilities.


Further evidence of someone’s inability to care for themselves is poor nutrition and eating habits. Many older people will lose weight, their clothes will start looking baggy, and poor nutrition can cause tiredness.

Sometimes people with dementia will forget to eat. Poor dental hygiene may affect their ability to chew food; decreased mobility functions will make it difficult for them to feed themselves or, if they’ve developed depression, they may not feel like eating.

Poor nutrition can further complicate many of the conditions a senior may have, and it can weaken the immune system. A weakened immune system can lead to developing infections, their wounds may not heal well, and the risk of falling can increase because of weaker muscles. A person who has a poor diet may not get enough liquids. Especially a lack of water, which can result in dehydration.

Dehydration presents problems because in some cases, it causes an older adult to become very ill. Severe dehydration can be fatal. During the summer, someone who is dehydrated may not be able to perspire to cool their bodies. As a result, they can become overheated and may succumb to the heat. There are several factors for older people that lead to dehydration, such as:

  • Inability to retain water.
  • Stress
  • Chronic conditions like diabetes.
  • Medications
  • Not eating enough fruits and vegetables.
  • Eating too few carbohydrates.

When is it time for nursing home care? Poor nutrition may be a major hint. Professional caretakers can help seniors to remain in better health through a balanced diet. When a loved one isn’t getting the proper nutrition, an assigned living facility might be necessary.


As their physical or mental health declines, some older people may develop changes in their personalities. Where they were once outgoing and friendly, they may become withdrawn and quiet. Especially if they are grieving or undergoing changes in their health that they don’t understand.

They can also become abusive or aggressive seemingly without cause, but certain forms of dementia, infections, strokes, depression, and traumatic brain injuries are the common causes for such personality changes.

Personality changes with Alzheimer’s patients are common as the disease progresses. Another type of dementia, called frontotemporal dementia, affects the parts of the brain responsible for behavior and emotions. These parts are the frontal and temporal lobe.

As you can see from the image, the frontal and temporal lobes are located behind the forehead and around the ears. Behavioral, personality, and changes in relationships are some of the prominent, early signs of this form of dementia. It most often develops among 50 and 60-year-olds, but people in their 20’s or as late as their 80’s can develop it as well.

As the disease progresses, a patient’s ability to form words and understand them may be affected, their muscles may weaken, and some patients develop ALS, or their muscles in their body, including the eye muscles, may stiffen. Someone with this type of dementia may need more help than a sole caretaker.


Depression also links to the other problems listed above. While depression can be situational and result from losing cognitive abilities, reduced mobility and changes in personality, it can cause some of these conditions. Depression can lead to:

  • Lack of appetite
  • Sleep disturbances
  • Lack of interest in taking care of oneself
  • Irritability
  • Sadness
  • Isolation
  • Thoughts of suicide

Although depression affects nearly 6 million people 65 and older, only about 10% get help for it. If you notice signs of depression in an elderly loved one, notify their doctor.

With the population getting older, families often take on the responsibility of caring for loved ones at home. Certain conditions can make things complicated. If you find that you continually wonder “when is it time for assisted living care?”, the time may be now.

Have you had any experience with needing to place loved ones in assisted living? If so, tell us your story below.


Content Sources

  • NCBI, “Mobility Difficulties Are Not Only a Problem of Old Age”,
  • AAFP, “Gait and Balance Disorders in Older Adults”,
  • MedicineNet, “Poor Hygiene: Symptoms & Signs”,
  • Seniorhealth365, “Poor Personal Hygiene in the Elderly”,
  • PsychGuides, “Cognitive Problem Symptoms, Causes and Effects”,
  • Healthline, “The Stages of Dementia”,
  • Journal Watch, “Depression and Cognitive Impairment in Older Adults”,
  • Livestrong, “Ten Factors That Affect an Older Adult’s Nutrition”,
  • Thorek, “14 Surprising Causes Of Dehydration”,
  • Mayoclinic, “Senior health: How to prevent and detect malnutrition”,
  • Healthgrades, “Personality Change”,
  • Alzheimer’s Association, “Frontotemporal Dementia”,
  • WebMD, “Symptoms of Depression”,

Image Sources

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