Home for the Holidays, Home for the Unexpected

Going home for the holidays can bring great joy but for those who haven’t seen their aging parents or grandparents in a while, it can also bring new -- and sometimes -- troubling insights.

With the hustle and bustle of the season, it's important to remember that these holiday visits present a valuable opportunity to observe your aging loved ones’ health and environment to determine how well they are thriving and whether they require additional help from family or a home health aide.

Here’s what to look for when your family gathers this winter to celebrate traditions, enjoy a meal, and reconnect with those who are near and far.

Everyone Dancing Merrily, in a New Old-fashioned Way

Are there any noticeable physical changes? Without being too obvious, take a close look at your loved one and make note of:

• Weight loss or gain
• Skin discolorations or easy bruising or bleeding
• Difficulty seeing or hearing
• Changes to hair and nails
• Unsteady gait

Mobility is an especially important issue so pay attention to whether their gait is steady, how they maneuver a step up a curb, or whether they can manage going up and down a flight of stairs. Observe if help is needed getting in and out of a chair and if they’re using their cane or walker regularly.

More subtle signs may appear with grooming habits and whether their clothing, shoes, and outerwear are clean and well-fitting or smelly and in disrepair.

You’ll want to ask some gentle questions to determine whether what you’re observing is an indicator of an underlying health issue that has not been identified, the need for some extra help from family and friends, or the need to hire a home health aide to provide in-home care on a part-time, full-time, or 24/7 live-in schedule.

If your senior is reluctant to ask for or receive help, or to hire a caregiver, find a way to broach that topic right and check out ”Starting the Conversation About Elder Care with Aging Parents.”

There’ll be Parties for Hosting, Marshmallows for Toasting

Are your loved ones participating in regular activities within their social circle? How are they sleeping, communicating, and getting along with others? Any changes could indicate that a senior may be lonely, sad, or grieving.

It’s also possible they have a condition that requires medical attention.

Keep an eye out for such out-of-character behaviors as:

• Mood swings
• Risky decision-making
• Impulsiveness
• Inappropriate gestures or comments

Any of these could be signs of a brewing urinary tract infection, constipation, a drug interaction, an undiagnosed stroke, or the onset of dementia, all of which require a call or visit to the doctor

Deck the Halls

Has there been a change in the upkeep of your loved one's home? An unmaintained home can be a dangerous environment that threatens your loved one’s ability to age in place.

If you notice repairs need to be made or simple maintenance is needed -- changing light bulbs or replacing smoke detector batteries -- this is not necessarily a reason for concern and can often be remedied by a handyman.

Issues of greater concern would be:

• Overflowing garbage
• Expired or moldy food in the refrigerator
• Unnecessary clutter on countertops and floors
• Unkempt lawns and shrubs
• Broken siding or shingles
• Unshoveled walkways

These are telltale signs that your loved one may be struggling with maintenance of their home and could benefit from help.

In a study by the National Institutes of Health, elderly respondents said the most difficult indoor tasks included vacuuming, changing bed linens, doing laundry, HVAC upkeep, and cleaning the toilet. Outdoor tasks they found difficult included mowing the lawn, painting the outside of the home, and cleaning the gutters.

Making a List and Checking it Twice

Finally, have there been any changes in your loved one's routine? Check to see if they are keeping up with everyday tasks such as:

• Taking medications on time and in the proper doses
• Scheduling and going to medical and dental appointments
• Paying bills on time
• Caring for pets
• Opening mail and packages
• Managing spending, bank accounts, and investments

A Happy New Year, Let’s Hope it’s a Good One, Without any Fear

If you are nervous about initiating this conversation with your loved one, you are not alone.

Compose your thoughts in advance and have a basic idea of what you are going to say. Decide who should be involved in the conversation, but limiting it to one or two people will feel less overwhelming.

You might find it best to tread lightly and:

Calmly tell them this is a conversation and not an intervention.

Acknowledge that some of your observations may have resulted from the busyness of the season that led them to postpone some chores, appointments, or repairs.

Give them many chances to speak without interruption.

Emphasize that it's never too soon to start a discussion about the future and while this conversation may be uncomfortable for all, it can also bring peace of mind for everyone involved.

And finally, be prepared with resources should your senior be open to the idea of help.

While you are observing, don’t forget to make the most of this holiday season with all of your loved ones -- and don’t hesitate to get the services your loved ones need.