For some, holiday gatherings deliver an unwanted gift: the realization that an aging relative is losing the ability to live independently. When far-flung families come together to celebrate, adult children can be alarmed to discover that mom is forgetting more than she used to, dad is leaving the house in disarray, or auntie is now trembling and shuffling when she walks. No wonder inquiries about elder care services, including nursing homes and assisted living, peak annually just after the winter holidays.
The time has come to begin looking into options for long-term care.
"It's definitely something that we see every year," said Amy Goyer, AARP's family expert. "People start doing their homework right after the holidays."
Goyer encourages families to avoid jumping to the conclusion that a residential institution like an assisted-living facility is necessary. "Some people have a knee-jerk reaction," she said.
But a stack of unopened mail could be just a sign of holiday stress, she said, rather than a symptom of inability to care for oneself with proper support. If a loved one is having trouble paying his bills on time, he might just need someone to handle his finances. If he has trouble getting in and out of the bathtub, families should consider having a walk-in shower built; if he isn't eating right, they should consider Meals on Wheels; if the house is messy, they could have a housekeeper visit every week.
For some aging relatives, though, it may be time to consider an assisted-living facility or even a nursing home in the most serious circumstances, such as when a relative has a fall and suddenly needs around-the-clock care.
Inquiries made for senior care providers through one website, SeniorHomes.com, were on average 58 percent higher in the weeks after Christmas than in the weeks leading up to the holiday. That's according to recent data released by the site, which features and advertizes long-term care providers and connects them with potential residents.
The data, collected from 2009 to 2011, show a spike in inquiries following Christmas day and continuing through January. Family members often asked managers for tours of facilities. But they didn't necessarily conclude assisted living or another care option was needed immediately. In fact, says SeniorHomes.com CEO Chris Rodde, the rate of people moving into assisted-living facilities did not increase following the inquiries.
Even if mom or dad isn't ready for such a drastic change, families shouldn't wait to make these types of inquiries until after a loved one's mental or physical capacity has diminished. "For adult children it's important to start asking the questions and to start the conversation with parents and siblings," Rodde said. "A lot of people avoid the conversation in the first place until things get really bad."
Goyer emphasizes that early on it's important to become familiar with local services that can help loved ones live independently in their own homes, and to help keep track of how an aging relative is doing even from far away. "Over the phone, ask: 'What did you do today? How did you get there? Are you feeling comfortable driving?'" she said. "You want to ask about their home, their transportation, health, finances and support system. Ask, 'Do you feel safe in the house? Are you going to activities?'"
Dealing with a loved one's change in behavior, though, could require just a simple medication adjustment. Sharon Allison-Ottey, an internal medicine specialist with training in geriatrics, said people between the ages of 65 and 70 should get full physical exams every year.
If this hasn't been done, families should schedule an evaluation with a doctor who specializes in geriatric care. The family should try to accompany their elderly relative to one of the appointments, writing down their concerns ahead of time. The doctor should cross-check medications to make sure they are not liable to interfere with each other. "You may think your mom has dementia," Allison-Ottey said, "but maybe medications are crossing each other and she just isn't sleeping well."
Families may want to consider a geriatric assessment, which is a head-to-toe, two-hour exam performed by a geriatrician. Doctors will evaluate the heart, lungs, ears, eyes, memory, and ability to walk, among other things.