As the holidays approach, I want to share a story with you. It's the story of a friend of mine, Noreen* -- a typical sandwich-generation mom and daughter who had many people and priorities to juggle. But it was at Thanksgiving last year when she realized something needed to change.
Noreen left home for college 30 years ago. After graduation, she got married, had two sons and settled into a life in a small town north of Boston. But her roots, along with her aging parents, were still in Western Massachusetts. Among her three siblings, Noreen lived the closest to her folks and was the most worried. Her brother, Tom lived on the west coast and typically chalked up Mom's forgetfulness and Dad's driving mishaps as part of getting older. Pam, the youngest, had her hands full with a rebellious teenager and a recent divorce. She had no room on her plate to worry about Mom and Dad.
So, as Noreen drove -- or crawled -- along the highway last Thanksgiving, she wistfully remembered Thanksgivings past. Mom's famous pecan chocolate chip pie, Dad's careful carving of the turkey and the children's delight at watching the Macy's Thanksgiving Day parade in their pajamas seemed like scenes out of a Norman Rockwell painting. Noreen also recalled the fractious squabbles that sometimes erupted amidst the merriment. Those tensions seemed far less weighty than the anxiety she now felt about her parent's safety and welfare and her siblings' apparent dismissal of her fears.
Arriving at her parents' home, Noreen couldn't help but stare at the peeling paint and the unkempt lawn. Years ago, she suggested her folks sell the house and find a place to live that was more senior-friendly. Dispelling her concerns, Noreen's parents quickly dismissed the idea. Noreen, unsupported by her siblings, let the issue drop. Now, she regretted that decision. She opened the front door and got a whiff of something burnt. Turns out it was the turkey. Noreen's mother was apologetic. She had gotten distracted by the excitement of the holiday. Tom and Pam were busy ordering take out Chinese food and seemed un-phased by the Thanksgiving turkey that had already been tossed. Mom had always been a consummate cook. Now, no one seemed to care that she ruined the holiday meal centerpiece. Noreen also worried about her Dad, who seemed unsteady and frail. She asked how he was feeling and he replied "under the weather," but hadn't seen the doctor in months. As the day progressed, Noreen grew increasingly more concerned. She saw a stack of bills on the kitchen counter, some of them dating back months. She observed Mom forgetting simple things and getting frazzled easily. While Noreen did not want to worry excessively or make a scene, things seemed out of sorts and she could no longer pretend otherwise.
Holidays are a time when emotions get stirred up. Like Thanksgiving cranberry sauce and stuffing, our emotions are a mixture of ingredients: excitement, joy, sadness and stress can all be part of the family recipe. Many adult children, like Noreen, must face a changing reality and confront their own anxiety and grief as their parents lose their strength and independence. These changes are often more prominent around holiday time, particularly for adult children who live at a distance. It is easy to overreact when we see, as Noreen did, bills piling up or a home not properly cared for. At the same time, it is important to differentiate changes in behavior. A new-found tendency to let the house go a bit can be part of normal aging, or it can represent illness and decline. When I later met Noreen for coffee, she told me she worried that the burnt turkey was an ominous sign. I assured her that one burnt turkey does not foreshadow disaster, but a pattern of uncharacteristic behaviors, is more of a concern.
Holidays can be incredibly stressful. In the midst of all the activity and eating, they can also provide an opportunity to observe our parents as they age. So this season, here is what to look for to determine if your worries are justified and whether there are real concerns about your parent's well-being and safety that need to be addressed:
• Change in eating habits/weight loss
• Forgetfulness -- out of the ordinary
• Neglected personal hygiene and cleanliness
• Decrease in socialization and activity level
• Significant mood changes
• Unexplained dents in the car
• Misuse of prescribed medications
• Mishandling finances
Like Noreen, so many adult children feel they shoulder the burden of worry on their own. Getting siblings on the same page whenever possible is a good place to start. Sharing perspectives on Mom's increasing forgetfulness or Dad's unsteady gait can shed new light on your understanding of the problem. Has it been an ongoing progressive decline or an intermittent reaction to stress or illness? Gathering information, as objectively as possible is the first step toward being an effective caregiver. Unlike Noreen, you don't have to go it alone. Getting the support and information you need early on can help you navigate the unexpected twists and turns along the caregiving journey.
*Noreen is a composite of friends and family caregivers