Deb Hallisey’s mother, Doris, is in her late 80s and lives alone. She’s legally blind and has mobility issues. Doris knows she needs help—but has no plans to move into an assisted living home.

Hallisey, who lives an hour away from her mother in Princeton, N.J., has spent plenty of restless nights worrying about her mom. But she knows it would be hard to find a facility that would agree to take Doris’ dog, Bella, who barks frequently. “Bella is one of her reasons for getting up in the morning,” says Hallisey. “At the same time, I need to know that my mom is safe.”

It’s a common situation. A 2018 AARP survey found that 76% of Americans ages 50 and older prefer to stay in their current homes as they age. And many elderly Americans do just that, often under the watchful eye of their children or other younger relatives.

But you may struggle with the question of whether your parents are actually capable of living independently, and if so, for how long. “It is quite common for an elderly person to deny the need for help or represent to others that they are doing well and managing,” says Susan Hurst, a social worker and assistant clinical director at Stowell Associates, in Milwaukee, Wisc., which provides home care and care management services. Older people are often hesitant to disclose problems because they’re afraid they’ll be told to move,
Hurst says.

Especially if you don’t live close by, you need to be on alert for the signs your elderly love one isn’t coping well—and/or enlist others to help you make that determination.

Know what to watch for

The next time you visit your parents, check for the following:

Disorganization. Does the house seem more cluttered than normal? Are there stacks of unopened mail? Often, early dementia or depression brings an inability to manage daily tasks, like banking, medication or meal preparation; your parent may miss doctor appointments and social engagements, says Hurst.

“It is quite common for an elderly person to deny the need for help or represent to others that they are doing well.”
Susan Hurst, social worker and assistant clinical director at Stowell Associates

Isolation. Ask your parent about his calendar and who he’s seen lately. If you sense that he’s isolated and has lost interest in engaging in life outside the home, that’s a cause for concern, says Lenard Kaye, a social work professor and director of The University of Maine Center on Aging.

Weight loss. This could be related to a host of issues, such as depression, dementia, or an underlying medical issue.

Falling. According to a 2018 study by the Centers for Disease Control and Prevention, one out of four individuals aged 65 and older report falling each year. Three million wind up in the emergency room. Many of those falls occur right in the home. Those who fall regularly—two to three times within the past few months—may have mobility or balance problems, says Hurst.

Don’t live in easy visiting distance? Reach out to people in your parents’ community. Friends, neighbors, and those in their place of worship, can be your eyes and ears. “Your parents’ next door neighbor may tell you that they notice the mail or newspapers piling up, lawn work hasn’t been done, or the garage door isn’t being shut,” says Hurst.

Also, many local law enforcement offices have programs to regularly check in on the well-being of older adults in the communities they serve.

Have the conversation

If you think your parent may be at risk, sit down with them in person. Explain that you care about their well being and want to ensure they remain safe in their home.

“Their next door neighbor may tell you that the mail is piling up, lawn work hasn’t been done, or the garage door isn’t being shut.”
Lenard Kaye, director of The University of Maine Center on Aging

Then offer solutions to help. If the issue is falling, easy fixes like removing rugs and tightening up loose banisters on stairwells can help, Kaye says. You may also need to consider more significant design modifications.

If you expect to encounter resistance, you may want to enlist a third party to be there for the conversation.

You can also hire a geriatric care manage (GCM) to help assess your parents’ situation and, if necessary, execute a caregiving plan. You can find a certified GCM through the Aging Care Life Association.

Get help from technology

If your parent is struggling, but can manage without day-to-day help, there are dozens of gadgets that can increase their safety.

For medication: Pre-sorted pills can help your parents keep track of their meds. Amazon’s PillPack, for example, provides a monthly strip of pill packets the user remove daily, and will notify you if your parents miss a dose.

For falls: There are various sensors on the market that allow your loved one to be monitored passively. These types of technologies tend to be more reliable than something they would have to wear or press, since they require no action on the part of the person being monitored.

There are also new systems on the market that blend cutting-edge “smart” technologies with access to help in the event of an emergency. The MobileHelp Smart, for example, works with the Samsung Gear S3 Smartwatch, allowing your parent to track key health metrics while also having access to emergency response if they need it. The watch costs $350, plus $25 per month for 24×7 monitoring.

For connectivity: Many companies are using voice commands as a more seamless way for older adults to interact with technology.

Hallisey, for example, programmed her mother’s phone so she can place calls through Amazon Alexa. She also bought smart plugs for the lamps in her living room, so they can be turned on and off through the device.

The smart devices have helped her stay in touch, and have given her mother a sense of security and independence. “I know I can introduce other things and she’ll be more comfortable with it,” Hallisey says.