During your Sunday evening phone calls with Mom, you’ve wondered: Is her memory getting a little shaky?

You’ve shrugged it off. Everyone’s tired later in the day, particularly someone who will celebrate her 84th birthday in January. And now that you think about it, your memory isn’t perfect. When you live far from elderly parents, it’s easy to rationalize and ignore — and hope.

Your upcoming trip home for the holidays will provide the opportunity to make an honest assessment of how your parents are faring. It’s common for adult children to be surprised during these visits, according to Sarah Randolph, who is executive director at Bridge Haven, an assisted living center in Lawrence that specializes in dementia care.

Sarah Randolph, executive director at Bridge Haven

After all, no one — especially not a parent — wants to admit they need help.

“A lot of this is motivated out of love, because they want to protect their children from worrying about them,” Randolph said.

Understandably, parents who are having trouble with daily tasks also worry they may have to leave their home or stop driving. When faced with the fear of losing independence, parents can become highly skilled actors who put on a good show for their unsuspecting children.

Randolph has had adult children tell her, “They sounded great on the phone. I had no idea. Wow, I did not expect this. The house is dirty. Mom clearly hasn’t been eating. And, oh my gosh, she’s been driving.”

That’s not unusual.

“It can be a real wake-up call, and it can be super overwhelming,” Randolph said.

She suggests that adult children not overreact, and that they talk with their parents and their siblings about solutions. And a conversation with Mom’s physician also would be a good idea.

Dr. Eric Huerter, who is an internist with Reed Medical Group MDVIP, said physicians can help adult children understand changes in their elderly parents’ behavior and health.

“If their problems are mild, sometimes they just need help getting back on track with eating and drinking regularly,” he said.

Sometimes, problems are significant, and mom has had a stroke or is in the early stages of dementia.

Medications can affect older adults. He noted that it’s even possible that Mom’s glass of wine before dinner has become too much for her. As we age, our bodies don’t metabolize alcohol efficiently.

“Sometimes, there is other evidence. We can tell they’ve lost weight by looking at them. They’re a lot sleepier than usual, and they nod off more easily,” he said. “Look for clues of falls, such as furniture that’s out of place. Or they’re walking from furniture item to furniture item so they don’t fall.”

Dr. Eric Huerter

Hygiene is another indicator, including the smell of urine.

And Huerter has learned: “If they’ve done their makeup, they’re better.”

As difficult as conversations about the end of life can be, Huerter said, it’s important to know what your parents’ wishes are. He encourages completing advance directives.

As you and your parents determine what’s best, Randolph said it’s important to remember you’re not alone. Your friends and your friends’ parents likely are working through many of the same concerns.

“You have to make the best decision you can at that time,” she said. “That will be based on the amount of information you have then. This is a journey. It’s a process. If something else is needed, you’ll make that decision.”

Perhaps Mom simply needs a bit of help — someone who can shop for groceries, handle the cleaning, check that she’s taking her medications and prepare a meal or two. An alert bracelet or necklace always is a good idea in case she falls. Maybe her needs are greater and include in-home medical care. And perhaps it is time that she moves to a place that’s safer than her home.

These decisions can be hard on parents.

“By the time our residents are here,” Randolph said, “they’ve been juggling a lot of balls, just to stay at home.”

For an adult child who is stepping into a new role, the transition can be difficult.

“One of the adult daughters to one of our residents said she has been through a divorce, child rearing and job changes,” Randolph said. “And the most stressful thing she’s done was becoming a parent to her parent.”

— Caroline Trowbridge is marketing communications manager for Lawrence Memorial Hospital. She can be reached at caroline.trowbridge@lmh.org.