4 Red Flags to Look for During Holiday Visits With Seniors

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According to a study conducted by the National Alliance of Caregiving in collaboration with AARP, 15 percent of the estimated 34 million Americans who provide care to older family members live an hour or more away from their care recipient. This means that a significant number of caregivers rely on regular telephone conversations and check-ins by other closer-living relatives to gauge an aging loved one’s well-being.

Unfortunately, age-related decline can happen quickly, and in many cases, seniors are skilled at concealing new and worsening problems. For many of these families, holiday visits are the only opportunity for them to observe a senior in person, so it’s important to pay close attention to their physical and mental health and their living situation.

During this year’s holiday gatherings, be sure to look for the following warning signs that a loved one may need some extra help at home.

  1. Weight Loss
    One of the most obvious signs of ill health, either physical or mental, is weight loss. Possible causes could be cancer, dementia or depression. Seniors may also experience reduced energy, which can make it challenging to shop for and prepare a nutritious meal and clean up afterwards. Furthermore, all this effort can seem especially unnecessary if they live and eat alone. Certain medications and aging in general can also change the way food tastes. If weight loss is evident, talk to your loved one about your concerns and schedule a doctor’s appointment to address the issue.
  2. Changes in Balance and Mobility
    Pay close attention to the way your loved one moves and how they walk. A reluctance to walk, changes in gait or obvious pain during movement can be a sign of joint, muscle or neurological problems. If your loved one is unsteady on their feet, they may be at risk of falling, which can cause severe injury or worse. If you notice changes in their mobility and coordination, make an appointment with their doctor to discuss options to keep them safe and mobile, such as pain management, physical therapy and mobility aids.
  3. Emotional Well-Being
    Keep an eye out for changes in your loved one’s moods and behavior. You can’t always gauge someone’s emotional state over the telephone, even if you speak daily. Look for signs of depression and anxiety, including withdrawal from social activities, changes in sleep patterns, loss of interest in hobbies, and changes in basic home maintenance and personal hygiene. The latter can be an indicator of dementia or other physical ailments like dehydration, which often happens to elders in the winter months and can be serious. If you notice sudden odd behavior in your loved one, such as confusion or agitation, be sure to seek medical attention. These are common symptoms of a urinary tract infection (UTI), which is prevalent in seniors and easily resolved with antibiotics.
  4. Home Environment
    Attention must also be paid to a senior’s surroundings. For instance, if your loved one has always been a stickler for neatness and paying bills promptly, but you discover excess clutter and piles of unopened mail while visiting, it indicates a problem. Take a walk-through of their home while you’re visiting to see if they are keeping their house to the usual standards. Be aware that sometimes the signs of trouble are a bit subtler. Scorched cookware could indicate that your loved one forgets food on the stove or in the oven, and an overflowing hamper could mean they don’t have the strength and/or desire to do laundry. Check the expiration dates on their prescriptions and over-the-counter medications and try to determine if they’re taking their medications as prescribed. You know your loved one and their habits best, so go with your gut if something seems off.

How to Handle Signs of Decline

The issues explained above are the four most common signs of age-related decline that long-distance caregivers experience during visits with their loved ones, but there are others to look out for. You can view a comprehensive list here: Signs a Senior Needs Help at Home.

While you may want to keep things light during the holiday season, do take this opportunity to address any red flags that you observe. Collect any necessary information while you are in town to avoid added frustration and confusion in the event of a crisis down the road.

The Initial Conversation

First, have a heart-to-heart conversation with your loved one about their present circumstances and both of your concerns. Suggest making an appointment with their primary care physician for a complete health assessment. The results of this evaluation will help you both determine what next steps are necessary to keep your loved one safe, happy and healthy.

Identify Supportive Resources

If possible, pay a visit to the local Area Agency on Aging or department of human services for information on resources and services available in your loved one’s community. It may be difficult to get in touch with these offices around the holidays, but it is still worth reaching out, leaving a message and researching the services they offer.

Sit down with your loved one to create a current list of people they interact with on a regular basis. This list should include friends, neighbors and clergy whom you trust to keep an eye on your loved one and can contact in the event of an emergency. Double check their addresses, telephone numbers and email addresses, and be sure to share your own contact information with them.

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. There are three categories to this list: medical, legal and financial.

You’ll want to develop a complete medical record for your loved one, including their health conditions, prescriptions and their doctors’ names and contact information. This is extremely helpful for you to have on file, and your loved one can keep a condensed copy on hand for both routine appointments and medical emergencies.

Read: The Emergency Medical File Every Caregiver Should Create

A financial list should contain all of a loved one’s property ownership, debts, income, expenses, and bank account and credit card information. Should you need to assume control of their finances over the short or long term, this list will help minimize confusion and ensure all their bills are paid on time.

Read: 10 Things You Should Know About Your Parent’s Finances

The legal aspect of this to-do list is possibly the most important. There are vital documents that must be obtained to ensure you can access your loved one’s medical information, make health and financial decisions in case they become incapacitated and administer their estate. If they have not already done so, it is crucial for your loved one to meet with an attorney to draw up medical and financial power of attorney documents and a will. You should have access to these documents and other important information, such as their social security number, Medicare information, insurance policies, the deed to their home, and their driver’s license.

Read: How to Select (and Afford) an Elder Law Attorney

These preparations may seem excessive, but it is better to be over-prepared than caught off guard when a loved one’s care needs suddenly increase. Throughout this process, remember to empower them to control their own life as much as possible. You may receive some resistance, but remind your loved one that sharing this information and pursuing supportive resources will enable them to remain independent and safe in their own home and give you added peace of mind as you return home from your holiday visit.

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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16 Comments

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.