For many, the holidays mean going home. And for those with aging parents, it's as good as time as any to make sure mom and dad are still able to stay at home.
Starting with Thanksgiving and going into the New Year, senior-focused agencies see a bump in calls as adult children check in with parents.
"It happens every year; kids come home for the holidays and suddenly notice things aren't right - right at the holidays," said Janet Ikenberry of Douglas County Senior Services.
Sandra Kelly-Allen, with Lawrence-Douglas County Health Department's Project LIVELY, said December can be a peak month for the program, which connects seniors with needed services and evaluates their homes for safety.
Just some quick observations - of a parent's weight loss or difficulty getting out of chairs, clutter in a once well-kept house, expired food in the refrigerator - can clue children in to problems at home.
"It's just an opportunity to look for any changes that might be a sign that maybe someone isn't feeling well or maybe an illness has crept in and needs to be diagnosed and mom and dad need some physical attention," said Seth Movsovitz, owner of Kansas Elder Care.
A visit reveals what phone calls cannot.
When Gail Zukav-Ross' mother lived on her own, her daughter kept in touch through daily phone calls. But those conversations were no substitute for being there.
"I can tell you she talks a great game. I would talk to her on the phone and she is just fine, doing great, voice sounds strong, sounds like she is on top of everything. And, she is not," Zukav-Ross said. "You can't trust a phone call, especially if they don't want you to know they are struggling. It's too easy to hide it on the phone."
Recognizing a problem
Patty Hoover returned to her hometown of Eudora a few years ago. Soon afterward, her father died and she moved in to help take care of her mother.
Over time, Hoover and her siblings realized that their father had been covering for his wife's increasing forgetfulness. But that wasn't something they figured out until after Hoover started living with her 82-year-old mother.
"If you live out of state and don't come back very often, you are so excited about seeing them that you may not see those signs. You need to spend enough time - four or five days or come back for the weekend," Hoover said.
Zukav-Ross said she kept in touch with her mother's friends and neighbors, who would be frank about her health conditions. Still, there were troubling signs the daughter didn't learn of until she went home.
One night while visiting, she noticed that her mother's breathing stopped while she slept. A doctor's visit and tests revealed her mother was suffering from sleep apnea and needed oxygen while she slept.
Another sign that things weren't going well was her mother not changing out of her housecoat during the day.
After trips in and out of the hospital and a doctor's refusal to allow her to live alone, her mother moved to an assisted living facility in Lawrence two years ago.
Now, with her 88-year-old mother living on her own at an apartment in Drury Place at Alvamar and twice-a-day visits from helpers, Zukav-Ross still does daily check-ins. She looks in the refrigerator to make sure there isn't expired food and checks the trash can for evidence that her mother has prepared food and eaten it.
Zukav-Ross, who is also a psychologist and life coach, said other things out-of-town children of aging parents should look for are complaints of not seeing friends, difficulty in getting to doctor appointments or social functions, unpaid bills or overdraft bank notices, confusion on when to take medicine and reorder them, and temperatures in their homes being too high or too low.
Children might want to check the bottom of pans to see whether they are burned, a clue that their parents might be forgetting to turn the stove off, Movsovitz said.
Another indicator of seniors' health is if they stop doing their favorite hobbies or activities. For example, if a once regular churchgoer now never attends services, that is a sign something isn't right.
"Even the most impaired, if (church) is a central, core part of their life, still get out, even in a wheelchair," Kelly-Allen said.
What to say and do
When signs are clear that there have been changes, Kelly-Allen said children should resist the urge to take over.
They could still help clean the bathroom or cook dinner, but she advised letting the parents take the lead. Children should step back and watch to see how much the parent really can do.
Red flags should go up, Kelly-Allen said, if children find all they do when they go home is help mom or dad cook and clean.
"Something needs to change," Kelly-Allen said. "It is helpful for a day or over short time periods, but not the rest of the time."
And children shouldn't overreact, especially if their siblings have been the ones giving care. Kelly-Allen likes to call it the Alice from Dallas syndrome.
"The decline is much more stark than for those that have been here and helping all along," Kelly-Allen said.
Siblings should still be concerned, but listen to the caregivers and ask questions in a supportive - not accusatory - manner.
"Because that can really blow the lid off the holidays," Kelly-Allen said.
Being overly emotional could alarm the parents.
Movsovitz said it's "absolutely OK" for children to call a parent's physician with concerns. Even better, if a doctor's appointment can be squeezed in while the child is still home, he or she should go with the parent.
Another option is to hire someone to help with the bathing, cooking, housekeeping and running errands.
Julie Mettenburg said her business, Home Helpers, had a jump in calls after Thanksgiving from families looking for day-to-day assistance for their parents.
If a parent reluctantly agrees to seek help, Kelly-Allen said, don't leave it up to them to make the first phone call. Instead, she suggested having the children contact agencies.
Project LIVELY can also ask the hard questions that children might not want to put to their parents.
When the topic does come up, Kelly-Allen said, be willing to negotiate. Let the parents still manage the tasks that are important to them, she said. That might mean the senior can continue to cook, but could bring in a housekeeper to clean. Or they could start out with Meals on Wheels twice a week and work their way to five days a week.
Most of all, Kelly-Allen said, when children broach the issue they should keep in mind to whom they are talking.
"You can't parent your parent. You are still the kid," she said. "So be compassionate and caring and address the concerns form a place of dignity and with respect."