The garage: Fender benders, and nicks and scrapes on the sides of the car could indicate there's a problem with driving. This could indicate that visual and spatial skills have diminished, Kaufman said. If driving is a concern, AARP's free online seminar "We Need to Talk" can help prepare you for that conversation, says Hillary W. Thomas, senior program specialist with AARP Georgia.
The kitchen: Check out the refrigerator. Are there lots of takeout containers, or expired or moldy foods? Food poisoning is a dangerous risk for the elderly, Kaufman said.
What are they eating? Dramatic weight gain could signal a diet of unhealthy snacks instead of nutritious foods, and dramatic weight loss could indicate that they are not eating much at all, or that they don’t like to eat alone. “When older adults are isolated they tend not to eat as much,” Thomas said.
Observe how the Thanksgiving meal is prepared. Are they able to get the meal together, to coordinate the prepping and cooking times? Red flags should go up if they don’t appear to make a traditional dish the way they’ve always made it in the past, or if they’re using the wrong ingredients, such as salt when the recipe calls for sugar.
The bedroom: Is it as well-kept as in the past? And are its occupants as well-kept as in the past? It could be a cause for concern if they don't smell clean, or it appears they aren't changing clothes regularly.
The family room: Are they telling the same stories over and over again, but do not remember? Is the place messy when it would normally be clean and orderly?
The medicine cabinet: Ask them how they keep track of which prescription drugs to take, and when.
Family members should note anything that makes them think, “Hmmm. Something’s not right,” Kaufman said.
If the family hasn’t already had an initial caregiving conversation, the holidays are the perfect time to initiate one. Just make sure the care recipients are included, Thomas said.
She advises adult children to ask their parents what they want to do about aging, and really listen to what they say.
“People like to automatically put it in this parent-child relationship, but the person receiving the care is an adult too,” Thomas said. When the children come in telling the parent what they’re going to do, it often leads to a combative, adversarial relationship, she said.
Even if there are concerns about the care and health of aging loved ones, families don’t always know what to do. Bringing in a care manager to assess the situation and develop a care plan can help get everyone going in the same direction. When a professional comes in, the loved one is usually more forthcoming and it takes the family out of having to be the bad guy, Kaufman said.
Families can search for care managers through the nonprofit Aging Life Care Association at aginglifecare.org.
One Christmas gift that adult kids can ask of their parents is a family meeting to take care of all decisions about their aging. They can plan ahead, get all the “what if” wishes of the parents, sort out all of the finances, and gather documents such as wills, advance directives, and the power of attorney. Kaufman calls this gift “Peace of Mind.”
“Many times, parents will say they don’t want to involve their kids because they don’t want to be a burden to them. But when you don’t do things and it becomes a crisis, that’s a burden,” Kaufman said.
Thomas recommends families gather a caregiving team and develop a plan long before it's needed. AARP lays out the specifics in "Prepare to Care: A Caregiving Planning Guide for Families," a free source available at AARP.org.
WHAT TO LOOK FOR
Professional assessments can take a few hours to several days and should include a thorough review of your loved one’s physical and mental health, medication use, daily routine, home and community safety, support system, appearance and hygiene, finances and personal interests.
If you are doing it on your own, here's a partial list to use as a guide. A more comprehensive list can be found at AARP.org/relationships/caregiving-resource-center.
» Physical health: chronic diseases; weight changes, incontinence, balance problems, fatigue or sleeplessness; swollen feet or legs; vision; hearing;dental.
» Mental health: mood swings; forgetfulness; sadness or loneliness; difficulty maintaining friends; decreased interest in life.
» Medication use: list of all medicines, vitamins and supplements taken.
» Daily living: ability to dress, bathe, and other activities of daily living.
» Appearance and hygiene: appropriately dressed for weather and occasion; personal hygiene; overall appearance.