This past year, a good friend of mine began sharing with me her concerns about some odd behavior she was seeing in her parents. “They aren’t exactly forthcoming over the phone. They cancelled their annual cruise that they live for because ‘Mom needed some down time.’ And, when I questioned them about this, they told me to mind my own business and hung up on me!” she said. This and other odd episodes created a nagging feeling in her that things were not quite right. She decided to extend her Thanksgiving visit with her mom and dad to have a chance to secretly observe and check up on them.

What a strange and saddening role reversal. Instead of mom and dad making sure she eats right and her car is in good shape, now she feels the need to peek into their refrigerator and quietly examine their car for scratches and dents.

We all want our parents to forever remain capable of living independent lives but, that’s not reality for everyone. And, whether we see our parents regularly or only a few times a year, any noticeable change should be monitored carefully. The real question is how do we, as well-meaning children, get a better idea of what is really going on with our parents?

First, observe their physical health. Are they staying active? As we get older, our five senses start to diminish, which can cause problems in day-to-day activities like mismatching shoes to misplacing the remote control. However, having a hard time climbing the stairs because of balance issues, not being able to read the instructions on the medicine bottle, or sudden weight loss are some changes that can indicate bigger concerns.

Second, observe their physical living conditions and appearance. The condition of someone’s living environment will clue you in on whether someone is struggling.

Look for scrapes and dents in car. This can be an indication of vision issues, impaired judgment, or slowed reaction and thinking.

What are they eating?  Is the pantry and refrigerator full of unhealthy snacks or expired/moldy food? Is there evidence that a lot of meals are takeout? Observing them prepare a meal can be eye-opening. Find out if they’re able to plan, coordinate and execute a meal like they used to.

How clean is the house? Seeing a few dust bunnies is one thing, but if you notice junk or trash piling up or the presence of strange smells, you may have cause for concern.

Observe routine household management. Do you notice if bills are unopened or piling up? If you can, look at their bank statement to see if there are any overdraft fees or unusual payments.

Are your parents as well-kept as in the past? A decline in personal hygiene and pride in appearance can indicate depression, memory issues, or even financial problems.

Third, observe their mood and state of mind. As is the case with my friend, her parents telling her to mind her own business and hanging up on her was a marked change in their mood and state of mind. A more subtle change could be someone getting easily confused or overly agitated about schedule changes, like a doctor changing an appointment time. Perhaps they become more withdrawn and timid in crowds or around a group of their friends. This can be a sign of depression or they are having a hard time hearing.

A sign of good emotional health is that they still participate in and enjoy favorite hobbies and stay in contact with friends. Ask neighbors or friends who see them regularly about this. Sometimes you can gain great insight and avoid a possible confrontation.

Facing these kind of life changes is never easy, but facing them with patience and a spirit of cooperation can make a positive outcome. My friend came back from her visit with her parents with both sadness and relief. They admitted to cancelling their cruise because of financial problems and that they would probably have to sell the house they have lived in for 50 years. Not wanting to be a burden to their daughter, they kept this to themselves. And while she is sad to see them go through these difficulties, because she got involved and opened the lines of communication, she is now able to help them make better choices moving forward.