This year the holidays and holiday gatherings will look a bit different for most of us because of the pandemic. Experts advise us to stay home and limit our in-person celebrations to those living in our immediate household.

Observing the holidays with loved ones outside our household will likely take place virtually or physically distanced. You may observe, during this time of distanced or virtual gathering with your older loved ones, uncharacteristic behavior, or lifestyle changes and routines that may prompt concern.

The following are some common signs that could signal a cause for concern and action. Use this list for clues or changes that warrant attention:

1. Concerned friends and neighbors. They are noticing worrisome changes and step in to provide help, but when the changes are such that they are concerned for your loved one’s safety, it’s time to step in.
2. Their home. It does not seem as clean or sanitary as before. Routine home care and maintenance, inside and outside, is being neglected. You may start to notice hoarding tendencies, or perhaps see trash isn’t being taken out – maybe you notice food that seems old.
3. Finances. Bills are unpaid or paid more than once; you notice an unusual number of payments to telemarketers, charities, and television advertisements; utilities are at risk of being shut off; money is hidden; and/or the mail or newspapers are piling up.
4. Eating habits. Has your loved one lost weight? Does he/she have no appetite or missing meals? Your parent tells you that they just ate lunch but there is no sign of plates, pans or cups to support this statement. Or perhaps a friend or neighbor has commented the refrigerator has a strong odor or there’s molding, rotten food in the kitchen, or a burnt pan on the stove that your loved one can’t explain.
5. Medications. Medications are being taken incorrectly. Your parent doesn’t know why they are taking certain medications and they can’t tell you what they are taking them for. They are confused about their doctor’s advice, not filling their prescriptions, or missing medical appointments.
6. Safety. Your parent is having difficulty getting up and down their stairs, or they have had repeated falls in their home. Your parent seems less cautious about strangers and you are worried that they may be vulnerable to individuals with bad intentions. They do not seem to have the same safety awareness that they once had, and you wonder what they would do in an emergent situation.
7. Hygiene. Your parent’s clothing may be soiled, worn for several days (or video calls), not appropriate for the weather, or may not coordinate like usual. They may be bathing infrequently and not attending to oral hygiene. You may notice neglected nails and teeth, sores on the skin, or your neighbor of friend may report of body odor or bad breath.
8. Driving. The car has new scratches or dents that can’t be explained, and regular car maintenance is being ignored. Your parent may have mentioned that they got lost while out driving or ran out of gas. Or, they may seem too nervous to drive, have trouble purchasing groceries, or don’t have insight that it’s time to give up the keys.
9. “Dad is fine,” your mother says. Dad agrees, though your gut tells you otherwise. They have learned to compensate for one another or may be afraid or embarrassed to share that they are struggling.
10. Uncharacteristic behaviors. You notice your parent is being unusually loud or quiet, paranoid, agitated, making phone calls at all hours. Your parent no longer seems to initiate activities, is more withdrawn and isolated, and you wonder if sleeping all day is now the norm.

What next? Be proactive!

Whether you live close by or at a distance, there are steps you can take to support your loved one’s health and well-being:

• Start with a conversation. Talk about your concerns. Consider including other people they trust and who care about your loved ones in the conversation, such as family, close friends, or clergy who may be able to come alongside your loved one as they make these changes.
• Regular checkups. If you’re worried about weight loss, depressed mood, memory loss, or other signs and symptoms, such as those described above, encourage your loved one to schedule a doctor’s visit. This can help identify and address any possible causes of changes. Ask about follow-up visits as well. Offer to go with them and take notes. Remind them how nice it is to have an advocate.
• Take care of safety issues. We can’t cover our loved ones in bubble wrap to protect them, but we can review any potential safety concerns with them. Start by prioritizing what needs to be addressed first. Then suggest small, manageable changes so they don’t become overwhelmed. Include your loved one in the discussion and decisions. Go at a pace they can accept.
• Engage an Aging Life Care™ expert. Also known as a geriatric care manager, an Aging Life Care expert is a health and human services specialist who acts as a guide and advocate for families who are caring for older relatives or disabled adults. Aging Life Care experts know the ins and outs of the various resources in your area and can connect you to appropriate resources, provide education and advocate for your loved ones needs. By engaging an Aging Life Care Professional®, you are working with someone who takes a holistic, client-centered approach to caring for older adults. Visit the Aging Life Care Association website to locate an expert near you.

It’s not always easy or comfortable talking with parents or other older loved ones about concerns. Sometimes they won’t admit they need help, and other times they don’t realize they need support. Assure your loved ones that their health and well-being are a priority for you and that you are in this together. Fortunately, there are many options and resources for supporting them and you.

About the Author: Wendy Nathan, BSc, CMC is a Certified Care Manager with Aging Wisdom, an Aging Life Care practice based in Seattle, WA. Wendy also facilitates a family caregiver support group for the Alzheimer’s Association.