After the hustle and bustle of the holidays and all of the traveling, now you’re back home sitting at your dining room table thinking, “I don’t think mom is doing as well as she was the last time I saw her.” It’s not an uncommon realization to have after being home for the holidays. When you call and check in it’s usually a short conversation about how things are going and what’s new and then you hang up until next time. Things may seem fine. But when you actually visit mom, you see that the story is a little different.

Maybe you notice things such as: unpaid bills, stacks of mail, shut off notices, missed medications, missed doctor appointments, donation letters from charities, piles of clutter around the living room leaving only paths to walk through, dirty or soiled clothing, bruises, dishes piled up in the sink, burned out light bulbs, expired food in the refrigerator, an unpleasant smell, cabinets with boxes of the same food (think Saltine cracker boxes- many of them), weight loss or weight gain, dehydration and/or confusion, the same stories or questions being repeated over and over, ants, mice, scratches or dents on the car, phones that are dead or off of the charger.

If you noticed any of these things, it’s time to have a serious discussion with your family about what is next for mom and/or dad. These are all signs of something much larger going on.

There are a number of possible causes of the kinds of circumstances that I described above, and you don’t need to see every one of my examples in order to start questioning what the real situation is. If you see one or two, it’s time to find out the cause. You could be seeing signs of an infection, depression or dementia. It is important to make sure that your parents are safe, healthy, happy and living in an appropriate environment for their needs and functioning level.

I suggest scheduling an appointment with your mom or dad’s family doctor for a routine physical and appropriate blood work. If the doctor recommends seeing a specialist or doing a follow up, don’t hesitate to get the appointment scheduled.

I’d also suggest calling an elder law attorney to get some good, up-to-date documents in place to help your parents designate someone to act on their behalf, should the need arise.

And finally, for another layer of support, I’d talk with a geriatric care manager to find out what resources are available and reliable in the community to help provide good care for your parents whether they are at home, in a high rise, in a personal care home or need skilled nursing care. It’s important to have an advocate on your team, especially when there are so many options to choose from and we are already overwhelmed with the everyday tasks of our own lives.