Heading home for the holidays? Here are 5 signs your aging parents may need more help.

1. Mail: Are your parents losing their handle on their bills? Is their mail piling up unopened? Do they seem susceptible to offers in junk mail? A simple fix is to offer to help with bill paying and, if they are willing,to redirect their mail to your address. But is there a deeper issue with their cognitive ability? It may be time for a cognitive assessment.

2. Falls: According to the Center for Disease Control, at least 250,000 older people are hospitalized for hip fractures every year. And many people who fall, even if they’re not injured, become afraid of falling causing them to cut down on their everyday activities. If your parents experience a fall it may be time for a cane or walker. If your parents are going to remain at home, evaluate their residence for trip hazards like area rugs and retrofit the bathroom with anti-slip materials and grip bars in the shower. Get a medical evaluation to check for any trauma resulting from the fall and to see if any underlying medical issues caused it.

3. Food: Have your parents stopped cooking? Is the fridge full of expired food? The kitchen can be an excellent indicator that mom and dad may need more support. Meals on Wheels may be an option or maybe your parents would benefit from a home health aide to prepare a few meals a week. Maybe they’d love the idea of assisted living where they can get three meals prepared for them each day. You won’t know unless you ask.

4. Forgetting: Is your parent forgetting family member’s names or getting lost while traveling familiar routes? Have they left a burner on after cooking? While we often want to dismiss forgetfulness as just “old age,” it’s wise to have your forgetful parent assessed for cognitive issues.  Have you noticed your parent’s home or personal appearance has become messier? This may just be a sign that your parent is more easily tired by household chores and could benefit from a housekeeper or a home health aide. But this could also be a sign of something more serious such as depression or dementia. Mention these signs to your parent’s doctor. If you don’t have a relationship with your parent’s doctor and HIPPA prevents the doctor from sharing information with you, ask the doctor if they will at least listen to your input even if they can’t respond to you.

5. Driving. If you run errands or go out to dinner while you are visiting your parents, resist the urge to get behind the wheel and let your parent drive. Notice their reaction times, signaling or turning issues, and any hesitation they may show. Are they no longer able or willing to drive at night? It may be time to make some alternative transportation plans for them like a Lyft account, or The Ride.

If you do notice any of these warning signs, ask your parents how they are managing and if they have any concerns. Use open-ended questions like, “How are things going?” and “How are you managing these days?” You want to start a conversation. Don’t start by telling them what they need. Always ask first. Listen intently and acknowledge their feelings and observations. Then you can add your observations or concerns – but be careful not to come across as judgmental or controlling.

It can be difficult to acknowledge that our parents are aging and may need more assistance than they want or than we are prepared to give. But if you notice one or more of the following signs, it’s time to assess your parents’ needs and determine if they need some lifestyle adjustments, additional support, or perhaps, a change in their living situation. Finally, know that you probably can’t find solutions to all of their challenges while you are home for the holidays. Fix what you can while you are there – like moving things to lower shelves or fall-proofing the house. And know that helping your parents as they age is a process.