When families live far away from one another, the holidays bring scattered families together. This gives adult children the perfect opportunity to closely inspect how aging parents are managing. Family members who haven’t seen their aging loved one since last year may be shocked at what they see: a parent who looks startlingly frail, or one whose home was once well-kept, but is now in disarray.

The number of caregivers considered long distance is significant. According to a study conducted by the National Alliance of Caregiving, in collaboration with AARP, 15% of the estimated 34 million Americans who provide care to older family members live an hour or more away from their relative.

It’s no coincidence that calls to assisted living facilities and other housing alternatives spike just after the holidays. That’s when relatives pick up worrisome clues of trouble.

So while you’re visiting that loved one and spreading holiday cheer, be a bit of a “spy” and check to see if your loved one shows any of the eight potential signs of trouble. You’re not being nosy; you’re being proactive and smart.

1. Give a Big Hug

  • Look for obvious weight loss; anything from depression to cancer, to difficulty shopping and cooking can be behind a noticeable loss of weight.
  • If you can notice something “different” about a person’s strength or stature in just a hug, it’s noteworthy. Pay attention to how your loved one walks (shuffles more?) and moves (rises easily from a chair? (has trouble with balance?), comparing these benchmarks to the last time you were together.
  • Look for obvious weight gain; injury, diabetes and dementia might be the cause. This is because the person doesn’t remember eating and has meals over and over.
  • Changes in personal grooming habits might cause strange body odor. Memory trouble or physical ailments might be noticeable on close inspection. Also look for changes in makeup, hair or the ability to wear clean clothes.

2. Search Through the Mail

  • Is there a lot of unopened personal mail? Not everyone reads their junk mail, but few of us can ignore an old-fashioned, hand-addressed letter.
  • Unopened bills can be a sign that your loved one is having difficulty managing finances — one of the most common signs of dementia.
  • Letters from banks, creditors or insurers may be routine business. But it’s alarming if they’re referring to overdue payments, overdrawn balances or other worrisome events.
  • Older adults are often vulnerable to scams and even those who have been fiscally prudent are vulnerable if they’re having trouble with thinking skills (a common sign of Alzheimer’s disease.) Some charities hit up givers over and over and your loved one might not remember donating the first time.

3. Take a drive – with Mom or Dad behind the wheel

  • Look for dents in the car – this could be signs of careless driving.
  • Make note of whether or not mom or dad fastens his or her seat belt. Someone with mild dementia might not remember to buckle up.
  • Does your loved one exhibit signs of tension, preoccupation, or are easily distracted? Are they no longer willing to drive at night or on the highways?
  • Impaired driving such as tailgating, slow reaction time, consistently driving lower than the speed limit, confusing gas and brake pedals are all signs to watch for.
  • Does the auto dashboard warning lights come on? Does the car have sufficient oil, gas, antifreeze and windshield-wiper fluid?

4. Inspect the kitchen

  • Check the perishables for their expiration dates. Your loved one might be buying more than he or she needs, but you want to be sure that there’s a reasonable ability to get rid of the old stuff.
  • Ten bottles of ketchup or a dozen different bags of sugar might indicate that he or she can’t remember from one shopping trip to the next.
  • Check the microwave, toaster, coffeemaker, washer and dryer – any device you know your loved one uses routinely.
  • Look for signs of a past fire – stove knobs or pot bottoms, potholders with burnt edges or smoke detectors that have been disassembled. Accidental fires are a common home danger for older adults.

5. Look around the living areas

  • Piles of clutter might be an indication that your loved one is unable to throw anything away. This might be a sign of a neurological or physical issue. Papers that spill onto the floor are a tripping hazard.
  • Check for cobwebs, signs of spills that haven’t been picked up or other signs of housekeeping that have become lax. Spills are a common sign of dementia – the person lacks the follow-through to clean up after a mess. Your loved one may have some physical limitations and may need more housekeeping help.
  • Grime and clutter in the bathroom could be a truer picture of how the person is keeping up with things. Often those who make an extra effort to tidy up for guests neglect the bathroom.
  • Has your loved one cut back on their activities, hobbies or interests? There are many reasons people cut back, but showing interest in almost nothing is a red flag for depression.

6. Notice how other living things are faring

  • Are there plants that are dying or dead? How well other life is looked after may reflect how well your loved one can look after their own life.
  • Animals that don’t seem well tended to is also a reflection on how your loved one is taking care of him or herself. Are their dead fish in the fish tank, does the dog have long nails or seem underfed?

7. Walk around the grounds

  • Look for gutters choked with leaves, broken windows or fences. This is an indication of a home maintenance problem.
  • Check to make sure that mail has not piled up in the mailbox and that it’s being retrieved regularly.
  • Check to see if any newspapers are being delivered but are ignored and are piling up around the home.

8.  Talk to your loved one’s inner circle

  • Does his or her neighbor tell you that they don’t see the person much lately, or they don’t call anymore.
  • Hints of concern in their voices about his or her health might open your eyes to potential problems.

Should this year’s holiday visit open your eyes to a decline in your parent, then it’s time to put a plan of action in place.

Steps to Take

Initial conversation – Have a heart-to-heart with your elderly loved one about their present circumstances, their concerns and the measures they’d like to be taken to make things better. Introduce the idea of a health assessment appointment with their primary care physician. Would they feel more at ease if a home health aide visited a couple of times a week? Or they might need help with housecleaning or bill paying.

Identify Resources – You might want to keep things light during the holidays, but do take this opportunity to collect all necessary information now to avoid frustration and confusion in the event of a crisis later on.

Prepare a To-Do List –This “to-do” list can be implemented over a period of future visits. Keep records of your elderly loved-one’s medical information. This should include health conditions, prescriptions and their doctor’s names and contact numbers. A financial list should contain property ownership and debts, income and expenses, bank account and credit card information. You should also have access to your loved one’s vital documents that could include their social security number, the deed to their home, their will, powers of attorney for finances and healthcare, and any insurance policies.

Remember to give your loved one’s the power to be in control of their own lives – as much as is reasonable. the more systems you have in place, the more your loved one will be kept independent and safe in their own home, giving you peace of mind as you return home from your holiday and future visits.

The experienced attorneys at Martha C. Brown & Associates are committed to keeping current on the ever-changing rules and regulations concerning nursing home care, home health care and other laws concerning the elderly. Our attorneys focus their continuing legal education on the laws, rules and regulations regarding Elder and Disability Law. We help our clients and their families work through elder law and estate planning issues to give you peace of mind. Please call 314/962-0186 to set up an appointment.