by Emily Carton, M.A., LSW

It is not uncommon for the phones of a social service agency to ring after a major holiday. Family members who have not seen each other for a long time get together and may be shocked by what they see. Other families will see an older relative outside his or her normal routine and be dismayed by what they haven't noticed before. When an older person has been able to compensate for his or her decline by verbal and social skills, a family gathering is often the place where the decline is "seen," for the first time. What you will see might "hit" you like a slap in the face. You don't want to believe it's true but it's there in black and white: the unopened mail, the unpaid bills, the refrigerator full of spoiled food or refrigerator with no food at all. It may be the dirty clothes piled up in the bedroom of someone who used to be meticulous about his or her dress. Or it may be that suddenly relatives who have been out of sight are not remember. And sometimes, it is simply a gut reaction that something is not quite right.

What to do when you recognize that your older relative needs help?

Begin by staying calm. Your inclination may be to jump in and try to resolve the situation all at once. This can be overwhelming as well as unrealistic. You panic. You think of what you have to do, when you can do it. You ask yourself how you have suddenly become the responsible person for your relative. Maybe you adore this person; maybe you never got along. You need to step back and view this from another angle.

This problem did not start yesterday. It was building over time. It doesn't necessarily need to be solved overnight and most likely, it can't.

You want to approach the situation without alarming the person you care about. Regardless of what you find, the older person needs to be a part of the process. No one wants to be told what to do. Think of this as a collaborative process unless circumstances make that impossible. Saying too much or offering too much too soon, may make your loved one more defensive. Step back and slow down, unless the situation is life threatening.

  • Start with small problems. Gently offer to help tidy up the house or clean out the refrigerator while you are there. This may be the only way to gather information and get a better picture of what is happening. Think of yourself as a detective.
  • Gather information. Know what services are available. One phone call to the local Area Office on Aging should provide you phone numbers and places to call in your area. Consider contacting the National Geriatric Care Managers Association for the names of private care managers in the area. When you need help you will know where to go.
  • Talk to neighbors. Let them know what is going on. Give them your phone number and ask that they be your second eyes.
  • Arrange with your relative's physician for a full geriatric assessment to determine the cause of the problem.
  • If your loved one is still in charge of his or her finances, check the mail to see if bills are delinquent or any large checks for cash have been written. Abnormally large checks for cash are often an indication that the older person is a likely candidate for exploitation. You can also talk with the manager of your relative's bank to alert you if any large amounts of cash are being taken. Find out if there is a power of attorney who can step in and take financial responsibility.
  • Ask yourself before suggesting or arranging any service: Am I am doing this for my own peace of mind or for the well-being of my relative? Am I making decisions based on my values or am I seeing a potentially dangerous situation?

Hopefully, this scenario may never apply to you. However, because of the nature of our lives, many of us do not live in the same city as our older relatives. What we may find after not seeing someone for a long period can be alarming, but your relative may not experiencing it in the same way. He or she may be focusing on the pleasure of your visit.

They may be in denial. They may not realize that anything is the matter. They may be trying to compensate for their losses. Try not to inadvertently take away your relatives pleasure at seeing you, or his sense of pride by focusing too strongly on the things that aren't right. Instead, try to weave what needs to be done into the holiday. Don't let it dominate.

The point of your visit was to celebrate the holidays. You can still do this. Regardless of what faces you ahead this is still a time for being together, reminiscing, and creating experiences and memories worth holding onto. It's important for your older relative. It's important for you.


Area Offices on Aging: (800) 667-1116
National Association of Geriatric Care Managers (602) 881-8008

Emily Carton MA, LISW, is a licensed social worker who works with Elder Options, a private care social service firm in the DC Metropolitan Area. She is also an is an intern in Bibliotherapy at St. Elizabeth's Hospital in Washington D.C.


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