If you’re a long-distance caregiver, you may be planning a holiday visit to check in on your aging loved ones. This visit is, perhaps, the first opportunity in several months that you’ll have to personally observe them and their home environment.

In the meantime, you’ve probably relied on regular telephone conversations and information passed along by closer-living relatives to gauge their wellbeing. Absence, even for a short period, often allows us to observe a situation with fresh eyes upon our return. For this reason, visits during the holidays can reveal a great deal about our aging loved ones.

I know; I’ve been there myself. I lived 200 miles from my parents when my father passed away, leaving my mother alone in their family home. Shortly after Dad’s death, Mom started showing signs of decline. I wanted to honor her wish to continue living in her own home, but that meant I needed to know when it was time to bring in outside help. So, I kept a close eye on several things during each visit with my mom. You can use the following pointers to help gauge how well an aging loved one is faring in your absence.

Physical Changes

Have they lost or gained weight? Are they sleeping too much or too little? How is their balance? Are they walking with any discomfort or changes in coordination? (Note: certain medications can cause joint pain, muscle issues, dizziness and drowsiness.)

When I noticed changes in my mom’s physical appearance and mobility, I made sure these concerns were addressed by her primary care doctor before my visit ended. If I noticed any sudden odd behavior or confusion, I quickly made an appointment with her doctor for a urine test to see if she had a urinary tract infection (UTI). UTIs are very prevalent in elders and, while they are easily resolved with antibiotics, they cause serious symptoms that can mimic or exacerbate dementia-related behaviors.

Read: Urinary Tract Infections in the Elderly

Emotional Wellbeing

Are they still going to church on Saturday or seeing the hairdresser on Friday? Do they still take a nightly stroll around the block or enjoy sitting down with a good book in the afternoon? When I visited, I took notice of whether my mom was still engaged in her normal routines, such as grocery shopping, preparing meals, basic housekeeping, reading the newspaper and maintaining her personal hygiene.

To gauge whether a loved one is staying active and getting valuable social interaction, it helps to have a general idea of what their usual schedule is like and the kinds of pastimes they enjoy. When my mom stopped partaking in her usual daily activities, I knew it was time to hire in-home care. Luckily, I was able to get an excellent referral from a relative.

Read: How to Select a Home Care Company

Medications

Like many elders, my mother did not like taking her pills. This was very obvious as she had unused and expired prescription bottles strewn throughout the house. This was one of the first areas that I stepped in to help with. During visits, I’d work with her to organize and purge her medications, and eventually I asked a neighbor to stop by regularly to ensure the system I had put in place was working.

As Mom declined further, it became clear that she needed someone present to help her manage her meds, so I hired a professional caregiver. I also scheduled a doctor’s appointment each time I was in town to have Mom’s regimen evaluated and obtain an updated medications list. I posted a large copy on her fridge and stuck a smaller copy in her wallet (very handy tools in emergency situations).

Read: The Emergency Medical File Every Caregiver Should Create


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Home Environment

A thorough look around your loved one’s house can speak volumes about their physical abilities and mental state. For example, I always looked to see if/when Mom’s bills were getting paid when I was there. Once I started finding bills unopened on her desk and lost between sofa cushions, I knew it was time to step in. Since I was already on her checking account and she had given me financial power of attorney (POA), I changed her billing address so that her bills would come directly to me for payment.

Read: Financial POA: How to Manage a Senior’s Expenses

Pay close attention to the state of the kitchen as well. My mom began forgetting to turn the stove off, which was easy to pick up on when I was there. At that point, I knew it was time to disconnect the stove and oven and let the caregiver take over meal preparation. Additional signs of unsafe cooking include scorched pots and damaged cookware.

Other household indicators to look for include piles of laundry, bathroom(s) that have descended into unsanitary conditions, and expired food in the fridge and freezer. Keep in mind that many seniors tend to put extra effort into their personal care and their home just before visitors arrive to keep up appearances. However, just because there are no obvious warning signs doesn’t necessarily mean that nothing is amiss. You know your loved one best, so be on the lookout for even subtle indications that they may be having trouble.

Read: Signs a Senior Needs Help at Home

How to Handle a Senior’s Decline

If you see a pattern of decline in your loved one, but you’re not sure how to help or where to start, I suggest beginning an honest conversation with them. Mention your concerns and the steps you can take to improve their health and safety while helping them retain their independence.

  1. Discuss the idea of a having a health assessment done by your loved one’s primary care physician.
  2. Your loved one may need help with housecleaning, laundry and/or bathing. Ask them how they would feel about having a home health aide visit a couple times a week. I was able to convince my mother to accept this help by reminding her that additional support would keep her healthy and safe, thereby allowing her to continue living in her own home longer.
  3. Propose making an appointment with an elder law attorney to ensure that all your loved one’s legal questions are answered and their documents are in order. My mother’s attorney was very helpful in areas outside of the law as well, so don’t be afraid to ask questions and pose possible scenarios. It’s likely that he or she knows of additional resources that may be of assistance.
  4. Identify sources of support that can be your eyes and ears when you go back home. This list may include neighbors, family, friends and professionals. Make sure everyone on the list has your contact information in case of an emergency.
  5. Pay a visit to the local Area Agency on Aging (AAA) or Senior Center to learn more about federal, state and local resources and services that are available to your loved one. Use AgingCare’s Area Agency on Aging Directory to find your local AAA.

The more support systems you have in place and information you have gathered, the more likely your loved one will be able to remain independent and safe in their own home. Being proactive during your visit will give you peace of mind, even as you return home from your holiday.