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.
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.
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.
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.
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.
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.