This holiday season, many of us will be heading "home." Back to the place where we grew up, where we learned to ride a bike, where our buried treasures are still in the backyard, where we walk through the front door and the memories of being a kid are still in the air.

But, you are not a "kid" any longer. Your parents are getting older and this year might be a different "homecoming." According to the National Alliance for Caregiving, of the 44 million family caregivers nationwide caring for someone over age 50, a little over seven million are long-distance caregivers who live one hour or more from their loved one.

On this holiday visit, you may feel that Mom is complaining more about her arthritis and can't reach the top shelf for the gravy boat anymore. She's also lost a lot of weight and looks more fragile.

Or perhaps Dad, once gregarious and cheery, is forgetting where he keeps putting his car keys or has become withdrawn, quiet and can't complete his thoughts during conversation.

You realize somehow that things have changed. While you will soon be returning to your life and routine after the holidays, you're worried about what these changes might mean for the future care and safety of your parents.

So, how do you know when changes are serious and may signal the need to have the conversation about caregiving so that you can understand what your parents' long-term care wishes are and how they want to live out the rest of their days?

The Signposts on the Road to Caregiving

Before you head home this year, you may want to review some of the signs that indicate your parent or parents need more care – whether they want to continue “aging in place” in their own home or even have to consider alternative living options to ensure their health and safety.

Many organizations have developed signs to look for - the National Association of Area Agencies on Aging, AARP and Caring From a Distance to name a few. Here is a compilation of some of these signs to watch for (or click on the links to get their complete lists):

  • Changes in eating habits, weight gain or loss, drinking more alcohol than usual
  • Neglecting personal hygiene (body odor, bad breath, soiled clothes, neglected nails or teeth, unattended skin sores or rashes)
  • Not taking medications or taking too much, wrong doses or frequency
  • Cluttered or unsanitary home (mail or newspapers piling up and unopened, a lot of expired food in the refrigerator, dirty dishes piling up in the sink, bugs or pests not addressed, lots of dust or dirt)
  • Behavioral changes (more loud or quiet, paranoid, agitated, withdrawn and uncommunicative)
  • Social rituals have changed (no longer going to religious services, book club, bridge game or social gatherings, avoiding friends or neighbors)
  • Physical injuries or problems such as a recent bad fall, burns, bruises, trouble walking or navigating stairs, trouble hearing or seeing
  • Mishandled finances (past due notices, overpaying bills or paying twice, hiding money, documentation that points to big financial changes for no reason - refinancing home, pension fund depleted, etc.)
  • Unusual purchases (especially any signs of entering unusual amount of contests, online or home shopping network purchases, telemarkter schemes, etc.)
  • Forgetting important things – leaving the stove on, leaving front door wide open, getting in the car and forgetting where they are going

So, if you feel your loved one is experiencing any of these signs – it's time to take action.

The Caregiving Solution

The first thing you need to do is talk with your older loved one. If your mom, dad or other loved one is incapable of having this conversation, you'll want to talk with your other parent who may be doing the primary caregiving.

Many parents don't want to worry their adult children and take on this caregiving burden all alone. That is where the caregiver can become as ill as the loved one they're caring for if they don’t get help and support. Ensure your caregiving parent that you are here to help – it's because you are concerned about both of them that you want to have this conversation.

If your loved one is living alone, engage your sibling(s) in helping to have this conversation. See my article on having the "C-A-R-E" conversation.

For additional help, you can turn to:

The Elder Care Locator - a service of the U.S. Administration on Aging, you can find a range of elder care services in your loved one's community - everything from Adult Day Care Centers to respite care to transportation services and more.

Geriatric care managers - if you have access to this professional through your employer, you may want to see if they can do an assessment of your older loved one's care needs. If you don’t have access through your employer, you can find a care manager through the National Association of Professional Care Managers.

Enlist local friends or neighbors - they may have already come to you this holiday with concerns about your parent(s). If not, reach out to those you trust and tell them of your concerns. Make sure they know how to get ahold of you in an emergency or if they sense the situation may be worsening.

Talk to your loved one's doctor. Express your concerns and again, make sure they know how to get in touch with you should the next visit uncover serious concerns. (be aware that health care professionals are bound by rules and regulations on providing any personal or detailed health information without the patient's consent - this is known as the Health Insurance Portability and Accountability Act of 1996. So, you will need to ensure that your loved one has you listed as a responsible party or person to contact in an emergency.)

And always remember – you are not alone. There are many resources and loving, kind friends, family and professionals out there to help you.

Happy Holidays!

Featured Partners & Friends

Given the many crucial issues surrounding the physical, mental, emotional, and lifestyle demands associated with caregiving, it’s important for families to be aware of where to go for answers, support, and encouragement.


Alzheimer's Disease Research Center

Caring for a Loved One with Alzheimer's Disease: A Guide for the Home Caregiver
by Peter Rabins, M.D., MPH, and Ann Morrison, RN, Ph.D.

firstSTREET Online

Health Style Press

Lotsa Helping Hands

Meals on Wheels

National Alliance For Caregiving

National Area Agencies on Aging

United Health Care