I live a three hour plane ride from my parents, though we talk by phone nearly every day. Whenever I ask them how they're feeling, they always respond with a one syllable word - usually "fine" or "great." But when I recently visited, I saw firsthand how much they had aged in only six months. I'm worried, but they insist they don't need help. How do I know if my parents really need assistance or I'm just being over protective making myself feel better?

Amy S., Englewood, NJ

It's understandable to want assurance that your parents are living safely and there are a pair of eyes watching over them when you can't be there. On your last visit, did they appear confused, poorly dressed, or noticeably thinner? Those would be sure signs that they need some support. From my own experience I know that this is precisely the time that a parent will resist interference, so that they can maintain their privacy and independence for as long as possible. If this is the case, consider hiring a geriatric care manager.

Rather than making daily visits, your parent could schedule weekly or bi-weekly visits with a Geriatric Care Manager (GCM) who would check their vitals, compliance with medications and work with your parents and you to arrange for services if and when they're needed. A simple email to you would keep you informed of their condition and needs.

Depending on your parents' needs and/or the specific arrangement you make, a GCM also can accompany a client on medical appointments and make sure that prescriptions for medications are filled and lab work is done. I have recommended GCMs to many clients and they have found them to be a perfect solution in situations similar to yours. You can find more information about GCMs on their website www.aginglifecare.org.

Nancy Stein, Ph.D., is the founder of Seniority Matters (www.senioritymatters.com), a caregiver advisory and referral service in South Florida for seniors and their families. You can contact her at nancy@senioritymatters.com.

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