We are now in the middle of the Holiday Trifecta — Thanksgiving is past, and the year-end holidays are around the corner.  Holidays can be especially stressful for those of us whose parents may be declining. This covers a wide range — in some cases, it can be as simple as realizing that you will need to begin to devote regular efforts to help a loved manage through daily life; in others, we might face the grief of knowing, or fearing, that this is probably the last holiday season together.

Because remote family members visit so often during the holidays, we often receive requests at this time of year to help assess whether someone is still safe, and to identify the kinds of help available and what might be needed.  We also notice enormous stress in uncertain adult children hoping to do the right thing with their parents while navigating uncharted waters.  In this column, we will provide holiday visit guidelines, from how to manage a short trip to considering whether a member can continue to live alone, safely and unaided.

1.  Treasure and be present with the person before you

First, as we often say, it is always good to stop and remember those things that cannot be changed: aging, the effects of some illnesses, the progress of dementia, and other factors.  “Old age,” as Betty Davis said, “is not for sissies.” Sometimes we see families whose holidays would improve if they paused briefly to realize that a parent will never again have the health and energy of past times. However, treasured holiday memories can still be created with person before you. Honor that person; try to make him or her comfortable; ask to hear a story, or tell one yourself.  Even in advanced stages of illness, holiday experiences can be joyous if accepted for what they are. It is good advice for life in general, and especially with aging loved ones.

2.  Assign someone the task to be sure your elder is not over-stimulated

Especially for elders who are used to being active, and have their own hopes for a holiday experience “like old times”, the temptation to try to keep too fast a pace during a holiday can lead to exhaustion.  Be sure that every day, someone is prepared to stay at home, or leave an event early, if your elder would be happier by not trying to keep up with the most energetic members of the family. This can be an adult child, a younger family member, family friend, or regular caregiver.  This is simple, but easy to forget.

3.  If the elder is traveling, plan extra time

Whether it is security scans at airports or long car rides, the pace and distractions that many of us take in stride as part of travel can be exhausting, confusing, or frightening for elders.  If you are in a rush, the problem is exacerbated. Plan ahead, allow for a slow pace and leisurely pace, and explain what is going on.  This can relieve pressure on everyone.

4.  If you visit home, be on the lookout for signs that help may be needed

People who visit home after an absence of several months sometimes can see the signs of decline in the condition of the home or the elder.  It is important to be on the lookout for these, especially if family is not regularly present.  Signs include a poorly-stocked kitchen, plumbing or appliances that do not function and have not been repaired, clutter that may be the initial stages of hoarding, or poor hygiene.  Rarely to our elders call and say, “I cannot manage alone and I need help to continue living here.”  Far more often, the signs appear without a request for help.  If you have concerns about whether someone is safe at home, an assessment by a geriatric care manager or local senior citizens’ service center is called for.  One good list of criteria to use to determine whether an assessment is called for was created by Professors Hall, Bossen, and Specht at the University of Iowa College of Nursing. It is available here for those interested: http://bit.ly/u0E1hq .

The holidays with aging parents can be bittersweet. But with proper planning and the right attitude, the emphasis can be on the sweet.  Do not try to do too much; find ways to enjoy the person as he or she is today, and to help him or her enjoy the day as much as possible.  Grieve if it is called for, laugh when you can, ask for help when you need it. It is all part of life’s pageant.

Jim Reynolds is CEO of Caring Companion Home Care in Concord, MA. He can be reached at jim.reynolds@caringcompanion.net.