4 Red Flags to Look for During Holiday Visits With Parents


When families live far away from one another, the holidays may be the only opportunity that long-distance caregivers and family members have to personally observe older relatives. Age-related decline can happen quickly. Family members who haven't seen their aging loved one since last year may be shocked at what they see: a formerly healthy father looking startingly frail, or a mom whose home was once well-kept now in disarray.

And 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.

Changes That Indicate the Need to Take Action

For those who have relied on regular telephone conversations and assessment by other closer-living relatives to gauge aging parents' well-being, the upcoming holiday visit may be revealing. Absence – even for a short period – often allows us to observe a situation through new eyes.

Weight Loss

One of the most obvious signs of ill health, either physical or mental, is weight loss. The cause could be as serious as cancer, dementia, heart failure or depression. Or it could be related to a lack of energy to cook for a loved one or just themselves, the waning ability to read the fine print on food labels or difficulty cleaning utensils and cookware. Certain medications and aging in general can change the way food tastes. If weight loss is evident, talk to your loved one about your concern and schedule a doctor's visit to address the issue.


Pay close attention to the way your parent moves, and in particular how they walk. A reluctance to walk or obvious pain during movement can be a sign of joint or muscle problems or more serious afflictions. And if unsteady on their feet, they may be at risk of falling, a serious problem that can cause severe injury or worse.

Emotional Well-Being

Beware, too, of obvious and subtle changes in your loved ones' emotional well-being. You can't always gauge someone's spirits over the telephone, even if you speak daily. Take note for signs of depression, including withdrawal from activities with others, sleep patterns, lost of interest in hobbies, lack of basic home maintenance or personal hygiene. The latter can be an indicator not only of depression, but also of dementia or other physical ailments including dehydration, a serious condition sometimes overlooked in elders in the winter months. If you notice sudden odd behavior with your loved one, be sure to seek medical attention as it could be a urinary tract infection which is prevalent in elders and easily resolved with antibiotics.

Home Environment

Attention must also be paid to surroundings. For instance, your parent may have always been a stickler for neatness or for paying bills promptly. If you discover excess or unsafe clutter and mail that has piled up, a problem may exist. Also, keep an eye out for less obvious indications for concern. Scorched cookware, for example, could be a sign that your parent forgets if the stove is on. An overflowing hamper could mean he or she doesn't have the strength and/or desire to do laundry. And by all means, check prescriptions and medication bottles for expiration dates; and make note of all prescriptions your family member takes and place that information in your personal files as well as the elder's wallet in case of an emergency.

How to Handle Signs of Decline in Your Parent

There may be other areas of concern, specific to your family member. Should this year's holiday visit open your eyes to current and potential problems or negative changes in your parent's physical or emotional state, then it's time to put a plan of action in place. Check out 20 warning signs that might indicate your parent needs at home for a detailed list.

Initial Conversation

First, have a heart-to-heart conversation with your elderly loved one about their present circumstances, concerns and the measures they'd like 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 times a week? Maybe they have legal questions and would greatly benefit from an appointment with an attorney. Or they may need help with housecleaning or bill paying.

Identify Resources

While you may want to keep things light during the holiday season, do take this opportunity to collect all necessary information now to avoid frustration and confusion in the event of a crisis down the road.

Pay a visit to the local Council on Aging or Town Hall for resources and services available in your parent's community. And get a copy of the local telephone book to take home with you – it will come in handy as you and your loved one create a "go to" list of services over time.

This list should include friends, neighbors, clergy, local professionals and all others who your family member has regular contact with. In fact, if you haven't already, take the time to visit with those friends and neighbors and make sure you have their addresses, telephone numbers and e-mail information and make a point to provide them with your contact information as well.

Prepare a To-Do List

Now is the time to begin compiling a to-do list to be implemented over a period of future visits. Keep records of your elderly parent's medical information. Medical information should include your loved one's health conditions, prescriptions and their doctor's names and contact numbers. A financial list should contain property ownership and debts, income and expenses, and bank account and credit card information. You should also have access to all of your parent(s) vital documents that could include their will, power of attorney, birth certificate, social security number, insurance policies, deed to their home, and driver's license.

And remember to give your loved ones the power and permission 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.

Gail M. Samaha is the founder of GMS Associates. She is a successful management consultant who from her own personal experience along with her background as a hospice volunteer and 30 years of business management, created an elder care planning division for elders and caregivers and trusted advisors.

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dearest gmbyacht, I totally understand your frustration. We dealt with a similar situation. We are the children who live 150 miles away. We tried to get the parent to move closer, get a housekeeper, have things fixed in the house, use meals on wheels daily, etc etc. He refused and refused and lied and lied to us about how things were, even after we would go and see for ourselves. It was a real struggle to know he was in declining health and his home was a disaster. We were ever so grateful that a neighbor was watching and kept us informed. It is so hard to be the child of a parent that refuses help and refuses to move and fights with all their strength to stay in their home. We did not have the resources to pay for what was needed, the parent did however but refused to pay anything, even got to the point of not flushing toilets to save money on water bills. Please don't be too quick to judge the children of the elderly, your crown for helping will be laid up in heaven and bless your heart for caring. You just do what you can when you can, but don't make it your total responsibility, I'm sure the children know that you can only do so much. They are more than likely burdened with knowing and feeling their hands are tied too if the parent is stubborn. Bless you
One might consider talking with someone from adult protective services. Could be that will be the best choice for someone like that down the road. Better to call and have some idea before it is needed. This way you will know at the time if it is the best thing to do.
Amen to Char123, and God Bless to gymbyacht for being a good person. There is no "wrong" here, only compassion. I dealt with a very similar situation 10 years ago with my mother. She absolutely refused to move from her apartment, fired the caregivers we hired for her, etc. etc. It was only a catastrophic event (she was trapped in her bath tub and couldn't get out or call for help), that allowed us to intervene...and only then because she was very frightened.

Recently my wife's father, age 87, was in a major auto accident and his world came crashing down. We live 300 miles away and she is the only family member to deal with it. When she arrived at the family home she discovered major signs of Elder Abuse By Neglect at the hands of my wife's 41 year old adopted sister with undeniable mental problems. Should we have seen the signs? Maybe. However we have no time to asign "blame". All we can do is be ready for the next crisis. Our Cell Phones are now "on" 24/7 and we jump if it rings at night or early in the morning. "Reverse Parenting" is a tough job, particularly when the parents keep things from you. I saw this with my mother, and I see this with my father-in-law. To make matters worse, in the past year, the adopted daugther who'd been living with my father-in-law, brought in 7 cats, all in-doors with NO LITTER BOXES...and refused to clean up after them! The Horror that my wife walked into at the family home was unimaginable. To make matters worse, my father-in-law is running out of money. His only asset is his home and we have to repair it and sell it to fund his living/medical needs. To accoomplish this, we had to force the adopted daughter out... and now she is living in a homless shelter! I don't believe in "lose-lose" scenario's, but this one may just qualify.

We all have burdens to carry. Don't be qjuick to judge.