Chances are you’re familiar with this holiday song first recorded in 1954 by Perry Como. Coming home to the people we love is a time-honored holiday tradition. What may be new this year is an awareness that things are not quite right with your elder.

For many families, the holidays are an extended period together that can show holes in the fabric of your loved one’s life. Holes like unpaid bills or an unkept appearance.

Don’t be fooled. Small changes may not seem like a big deal, but chances are your elder has learned some coping mechanisms and there is more going on than you see. This is especially true if mom and dad are still together. They may be embarrassed to tell you they are struggling and have learned to compensate and cover for one another.

More importantly, small changes like not being able to open a can or jar has a major impact on nutritional eating. Combine that with arthritis and suddenly they are taking short cuts in hygiene or cleaning the house. Poor vision may make it harder for an elder to drive to the bank or to the grocery, store increasing isolation and putting them behind on key tasks.

Here are some warning signs to watch out for when you are home for the holidays.

• Home: Are they neglecting routine maintenance inside and outside the home? Is the house not being cleaned? Is there spoiled food in the fridge?
• Safety: Are they having difficulty using the stairs? Are they unsteady walking or getting up from a sitting position? Does the car have new dents or scratches?
• Finances: Are there unpaid bills lying around or notices that utilities will be shut off? Are they ordering things they don’t need from TV, phone solicitations or junk mail? Are they hiding money?
• Hygiene: Are they wearing mismatched clothing, clothes that are soiled or unsuited for the weather? If you notice body odor, bad breath, nails that are too long or sores, they may not be bathing or brushing their teeth regularly.
• Nutrition: Have they lost weight? Have they lost their appetite or are they skipping meals? Is food they used to love uninteresting to them?
• Healthcare: Are pills being left in the pill box and not taken? Are they confused about what medication to take and when? Can they tell you the last time they went to their primary care doctor or specialist? What about the eye doctor or audiologist?
• Unusual behavior: Is your loved one more quiet than usual or louder? Do they seem agitated? Are they no longer taking part in activities they love? Are they sleeping more or less than usual? If friends or neighbors notice changes and tell you about them, it is time to intervene.

Some of the changes you notice can be handled with a simple fix like new glasses, hearing aids or a medication switch.

But this is not the time to bury your head in the sand. Start with a conversation where you can express your concerns without being directive – “You should” “You Need to”. They may not realize they need help, know what resources are available or are afraid of being a burden. Don’t expect this to be one big conversation. It will take several discussions over time.

If they won’t listen or they shut the conversation down, then you may benefit from the guidance of an Aging Life Care Specialist. This health and human services professional will guide you and your loved one to the right resources, help you navigate tricky family situations, be the family’s eyes and ears on the ground and an advocate for your elder.

Don’t wait until the next holiday to act. A lot can happen between now and then.