Author Maura Rhodes is a health journalist based in Montclair, New Jersey, who has written about caregiving throughout all ages and stages of life.
One visit can reveal a lot if you know what to look for.
A visit to an aging parent can be a lovely opportunity to celebrate a holiday or birthday, show off the grandkids or simply share a meal. It also can tell you a lot about how mom or dad is really doing, especially if all the feedback you get on the phone is “I’m fine.”
And it may well be that your parent is perfectly okay. But there also is a chance they’re not being honest with you — or themselves — for fear that if they admit they’re struggling with basic self-care or housekeeping tasks they’ll be pushed to give up their independence or even their home.
Sometimes, too, an aging parent may not realize anything is amiss, particularly if they are in the beginning stages of dementia. Either way, this is where your powers of observation can come in handy. Next time you visit, before you even step into the house, you can begin to assess how your parent is faring physically and mentally.
Pay particular attention to the “instrumental activities of daily living,” says clinical psychologist Cynthia Green, Ph.D., president of Total Brain Health, a provider of wellness-based brain training programs and services. “These are the skills we do to manage independent functions such as transportation, cooking, personal hygiene, home-keeping and so forth.”
If your parent seems to be struggling in any of these areas, they may need — and even welcome, after initial pushback — some form of in-home assistance. Keep your eyes peeled for these problems in particular:
- The yard is a mess. If your dad’s once meticulously trimmed lawn is overgrown or your mom’s prized flower garden has gone to seed, it could be an indication that either parent no longer has the physical ability to push the mower or pull weeds.
- The car has new dents or dings. If your parent’s vehicle seems to be gathering new scratches and scrapes or it’s often parked askew, it’s possible that safe driving has become an issue.
- Your parent dresses inappropriately. This is one of the earliest tipoffs that an older person is in decline, says Mildred Jarman, BSN, an in-home nurse in San Francisco who has specialized in geriatric care for 33 years. “They can’t properly assess what the weather is,” she explains, “so they may put on a heavy jacket for a walk on a hot summer day, for example.” The daughter of one of Jarman’s clients remembers visiting her mother with a friend. “When we arrived, my mom disappeared into the bedroom for the longest time. When she came out, she was dressed to the nines — much too dolled up for an afternoon chat at home.”
- Personal hygiene has hit a personal low. You may notice that your parent greets you at the door wearing clothing that’s stained or missing buttons, for example. Or, if you’re visiting for a few days, they may wear the same clothes every day. Glance at her nails; are they untrimmed or dirty? When you hug him, do you pick up a whiff of body odor or even urine, a sign he could be dealing with incontinence?
- Your parent is sporting unusual bruises, cuts or scrapes. These can be signs of falls or kitchen mishaps or other indications that physical ability and agility are on the decline. Pay attention to how your loved one moves about. Does he struggle to get out of a chair? Does she hang on to furniture or touch walls or doorframes to stay balanced?
- There’s no food in the house. Or what’s there is moldy, stale or spoiled. An empty fridge or bare cupboard can be a sign your parent is struggling to grocery shop or cook, or even that they have lost interest in eating, which can be a sign of depression or something else. It may also mean that they aren’t eating well. Does your mom seem thinner than last time you saw her? Are dad’s clothes hanging off him?
- Prescriptions are piling up. Take a peek at your parent’s pill bottles. Compare the date when they were filled with the amount of medication in the bottle. You should be able to tell if the drugs are being taken — or forgotten.
- Valuables have gone missing. Jarman says this is common among older people as they experience cognitive decline. “They simply give things like expensive jewelry or even money away,” she explains. “They no longer care. It’s not a priority.” Keep an eye out for missing objects around the house. If it’s clear your parent is handing out heirlooms or other important items, it may be time to assess their mental health.
- Pets aren’t being cared for. The adorable mutt your parents adopted when all the kids were out of the house and doted on like a late-in-life baby isn’t so adorable anymore. He’s looking unkempt, perhaps even underfed. A litterbox that clearly hasn’t been scooped in days (or weeks) is another sign a parent is no longer able to care for a furry family member.
- Money is being mishandled. Stacks of unpaid or unopened bills, late payment notices, unbalanced checkbooks and wads of cash stashed in odd places all can be red flags. Other bill-paying pain points may not be noticeable unless you do some sleuthing. One woman recalls her father, who was always sharp as a tack and able to do math in his head, nearly hitting “send” on a payment of hundreds of thousands of dollars. He had accidentally added several extra zeroes.
It’s when a parent’s behavior veers from what was normal for them that you most likely need to be concerned, says Green. Changes in behavior are much more telling than the behaviors themselves. When your fastidious mom’s furniture is covered in dust or your Emeril-obsessed dad is suddenly living on corned beef from a can, it’s probably time to sit down for a talk.