Joanne returned home after not seeing her parents for about 6 months. She found her dad is not doing nearly as well as he has been leading her to believe. Their weekly conversations were centered on talking about Joanne's mom who had been ailing. Her dad had kept up the faade that he was taking great care of her and all was well.

She found out differently. The house was a mess and had not been cleaned well in some time and needed quite a bit of maintenance as things were starting to fall apart. Bottles of pills were outdated indicating they hadn't been taking them as prescribed. The refrigerator was almost empty of nourishing food. She felt guilty, why hadn't she seen it before, seen it coming, read between the lines?

But the truth is that an elders situation can deteriorate quite quickly: a year, 6 months even 3 months can make a big difference in one's abilities. Each person and situation and condition is different.

Here's what to look for if you're going home to aging parents. This list is based upon the three areas that first indicate a need for more oversight and assistance.

Personal care

• dirty clothing

• dirty hair or body

• appear unkempt

• dust in the bathtub

• home in disrepair or disheveled

Nutrition

• more snacks than real food in the house

• very old or outdated food items in pantry

Medications

• too many/too few pills in bottles

• old med bottles, no new refills

• still display symptoms that meds should alleviate

Other general areas

• unexplained dents in the car

• not leaving the house for a week or more

• falls

• angry or passive, offensive or defensive

• bills or mail piled up

• utilities or appliances not working

• scorched pans

Most people move to assisted living or nursing homes due to these situations, and not because they are chronically ill and need nursing care. If you see 2 or more of any of these, it is time to discuss the need for a medical check up and possible non-medical assistance to avoid further deterioration. If addressed early enough people may be able to stay in their homes longer and that is what everyone wants.