During the holiday season, many people will visit their aging parents, sometimes seeing them for the first time in several months or longer. They may begin to notice that their parents are experiencing the changes that often come with aging.

Holiday visits with aging parents provide a good opportunity for adult children to evaluate and observe how their parents are doing. It's an ideal time to talk to them about their health and to find out their wishes for when they need assistance or can’t care for themselves. Don’t wait for a crisis, such as a stroke or a fall, to begin these conversations or to begin providing assistance.

Warning Signs That Help May Be Needed

According to CareGuide.com (www.careguide.com), the following "warning" signs may help you know if and when a parent may need assistance:

1. Is your parent unsteady while standing or bruised from a fall? Falls are common among older adults. It is estimated that one-third of older adults living at home experience a fall each year. Those who fear falling often restrict their activities, which can lead to weakness and make them even more likely to fall.
2. Does your parent look thinner. Do you notice poor eating habits? Does he have trouble complying with a special diet? Many older adults experience poor nutrition and weight loss. Significant weight loss can be dangerous to overall health and is often caused by health conditions, depression, dementia, medications, alcohol use, or limited finances.
3. Does your parent feel depressed? Changes in physical health and level of independence may lead to less social activity, anger, and depression. Although as many as 25 percent of older adults may suffer from depression, many physicians fail to diagnose it because the symptoms are often similar to other medial conditions.
4. Does your parent have trouble getting out of the house? Is he no longer driving? For many older adults, no longer driving can mean a loss of independence, making them feel isolated and less connected to the outside world.
5. Does your parent have difficulty remembering a major event? Difficulty with memory can be attributed to a number of things. Cognitive impairment, such as dementia, can result in confusion, wandering, and aggression. It is important to have a physician evaluate the person’s cognitive capabilities.
6. Does your parent have difficulty keeping track of medications? Older adults face serious health risks if they do not take medications appropriately. They may forget doses, take the same dose twice, or take duplicate medications without realizing they are the same.
7. Is your parent’s house disorganized. Are chores undone or bills unpaid? Everyday household maintenance can be overwhelming for some older adults with decreased strength and stamina. They may need help to manage everyday activities.
8. Are there potential hazards in your parent’s home, such as extension cords or basement stairs? Hazards in the home include thick carpets, dim lighting, impaired vision, and overmedication.
9. Is your parent having difficulty making it to appointments and running errands, such as picking up prescriptions and groceries. This puts them at risk of not getting their everyday needs met.
10. Has someone close to your parent recently become ill or passed away? It’s common for older adults to depend on someone else, such as a spouse or neighbor. When that person becomes unable to continue providing assistance, the older person’s needs become more apparent to everyone involved.

If any of these warning signs apply to your parent, you should begin to gather certain information for planning for their care. Find out what medical conditions your parent has. Learn what income and assets he has to pay for care and elder services? Find out what plans have been made to address long-term care needs, and find out his personal preferences. And think about your own capability for caregiving. If you are the primary caregiver, how much time, energy, and money do you have to contribute to your parent’s needs?

Talking About Getting Help

The most important first step is talking to your parent about getting help. Issues related to aging are not easy to discuss. Many older adults are reluctant to talk about their declining health, limited physical functioning, and increased dependence on others. Adult children may be uncomfortable facing their parents’ mortality and taking on new responsibilities.

Suggestions for beginning the discussion:

• It’s never too soon to begin planning while your parent can participate in making decisions.
• Ask open-ended questions. Phrase your concerns as questions to allow your parent to express his concerns and preferences. Learn about the plans he has already made.
• Set an agenda for the discussion. Establish several issues that need to be talked about, such as finances, housing, health care, household chores, etc.
• Don’t avoid negative issues. It won’t benefit anyone to gloss over the issues of financial resources or a worsening medical condition.
• Be supportive. Remind your parent that your goal is for him to get the best care possible, and that you want to honor his preferences.
• Accept your parent's feelings and preferences and make a sincere attempt to address them.
• Be patient. Don’t be disappointed if decisions aren’t made in the first discussion.
• Seek guidance or an outside opinion. Consult with a doctor, accountant, lawyer, clergy, or other adviser before taking any medical, financial, or legal steps.

For More Information

• www.careguide.com
• Find information about family caregiving at www.uwex.edu/ces/flp/caregiving
• AARP: www.aarp.org
  • Includes resources in English and Spanish, and a free online seminar on Planning for the Care of Aging Parents.