You want to make sure your aging parents are safe and that they are taking care of themselves, but sometimes they are reluctant to ask for help, or they don’t realize they need assistance, and you have to assess the situation.

We talked about signs that your aging parent may need assistance; here are a few more ways to determine if additional help is needed to ensure their health and safety.

Environmental damage – Burned pans in the kitchen or dents in the car may indicate possible confusion or mobility problems.

Bruising or other physical trauma – Mom or dad may have fallen, or have other difficulties getting around the house.

Lifestyle changes – A change in social behaviors, staying home, declining invitations may indicate depression or trouble getting around.

Inappropriate behavior – Neighbors may have noticed confusion in conversations or actions, which could be a sign of dementia or other illness that needs medical attention.

Symptoms of depression – Depression in older adults is often overlooked. Feelings of despair or hopelessness, as well as loss of interest in activities once enjoyed can be warnings of depression.

Of course, any signs of mental or physical changes should be checked by a doctor, but sometimes assistance, whether it is a new living arrangement or help at home may help your parents enjoy an improved quality of life.

However, I know from first hand experience that watching your parents become less independent, both physically and emotionally, can be very stressful. I remember wondering, “Hey, where’d all the grown-ups go?” the first time I had to make decisions about my mother’s care when she was ill.

There are lots of resources out there to help you as well as your parents when it’s time to consider home care assistance or a change in living arrangements. But, don’t wait until a crisis forces you to take action, discuss their wishes, even when it’s tough to bring it up with them, and plan early.

Dear Senators: Want the attention of American voters? Here’s a tip: 89 percent of adults aged 18 and over want Congress to make improving programs to protect low-income seniors against rising Medicare costs a top priority. Put this issue front and center of your campaigns, and you’ll get our attention.

Our parents, especially those with limited incomes (read “most”), struggle with food and gasoline prices. Let’s not add rising Medicare premiums on to that pile of worries too.

A telephone poll conducted by Harris Interactive for the National Council on Aging found that 89 percent of adults aged 18 and over believe that improving programs to protect low-income seniors against rising Medicare costs should be a top priority for Congress this year.

“Regardless of age, income, or party identification, the vast majority of Americans believe that Congress should improve Medicare this year to better protect seniors in greatest need against these rising costs,” said Howard Bedlin, NCOA vice president of policy and advocacy.

Senate leaders are currently crafting Medicare legislation that is expected to be voted on in this month. The bill is primarily designed to increase payments to physicians, which will likely cause additional increases in Part B premiums that have already more than doubled since 2000.

“Protections designed to help beneficiaries with income below about $15,000 with rising out-of-pocket costs, such as Medicare Savings Programs (MSPs), are badly broken and must be fixed,” Bedlin added. “There are serious barriers to participation, resulting in enrollment rates estimated to be as low as only 13 percent. In addition, asset eligibility thresholds have not been adjusted to reflect inflation in almost 20 years.”

The NCOA/Harris survey, conducted in May, found that 91 percent of those polled support simplifying eligibility rules for these Medicare programs to make it easier for low-income beneficiaries to get the help they need. The survey also found that the American public strongly supports proposals that would fix some of the other problems associated with historically low enrollment. Specifically, 86 percent of respondents support raising asset eligibility levels for Medicare low-income assistance programs, and 87 percent support increased funding to find and enroll low-income beneficiaries in these programs.

In an effort to address these problems, NCOA and a group of national organizations representing seniors and persons with disabilities have come together in support of provisions to improve the legislation. In a letter to the Senate, more than 40 organizations urged Senators to simplify and align low-income assistance programs (including MSPs and the Medicare Part D Low Income Subsidy); improve outreach and participation for those currently eligible; and stop penalizing seniors who did the right thing in putting aside a modest nest egg of savings for retirement by bringing outdated asset limits in line with today’s cost of living. Organizations signing the letter agreed that: “Helping vulnerable beneficiaries with income below $15,000 is as or more important than helping doctors with income over $150,000.”

I couldn’t agree more.

About me: I’m Lori and I live in our nation’s capital, where I watch what the federal government and elected representatives are doing to protect our country’s elders. Like Elizabeth, I’m part of the Sandwich Generation, a boomer with elementary-school age children and older parents. Lucky for me, my parents (one 80-years-old and the other close to it) are still in good health (knock on wood) and do not require special care options. But I know that’s not the case for many of my peers, so I’ve jumped into the conversation now, so I’m ready for whatever life may bring.

Recognizing that an elder parent needs assistance in his or her home marks a big change in an adult’s life. This discovery often comes during a holiday or during a visit if the parent lives far away.

Here are some warning signs that a parent may need home care or other senior housing arrangements:

Unopened mail and bills pile up – Something as simple as decreased vision may make reading mail difficult. Or all of a sudden, managing a checking account becomes difficult. Sometimes, even the simple act of opening the mail seems overwhelming for an aging senior.

An unkempt home, or laundry and dishes piling up – This is especially troubling if a parent has always been neat and orderly.

Unexplained weight loss and food in the refrigerator is uneaten or spoiled – A parent might be unable to get to the store, or they get overwhelmed or confused when preparing a meal.

They might eat just enough, but sometimes their meals aren’t nutritious. A decreased sense of taste is a physical sign of aging, and it might mean that nothing tastes as good as it used to.

Weight loss can also be a sign of illness, dementia, depression or heart failure.

A decline in personal hygiene – Bathing or doing laundry may have become physically challenging, or they may fear falling in the shower or tub.

Missed doctor’s appointments - Though many older people wish to remain in their own homes as long as possible, the physical signs of aging often mandate the need for assistance, and oftentimes a change in living arrangements.

Watch out for these signs, and don’t dismiss them — the help they need is available, so research your options.

Hello, and welcome to the Seniors for Living blog.

Seniors for Living is a a free service that helps you and your family research, evaluate, contact, and compare senior housing options such as assisted living, Alzheimer’s Care, independent living, retirement living, home care and continuing care.

My name is Elizabeth and this blog will be a place where we can learn about and discuss the trends, the challenges and the ups and downs of senior care.

Like many people my age (43), I am raising young children along with being responsible for my aging father. I’m a nurse, and my boss calls me the “Sandwich Generation Poster Child.”

As an only child with no extended family, I knew there would be a day when I’d be the one in charge, but until about 5 years ago, the idea was largely theoretical.

In 2003, my mother was diagnosed with lung cancer and the story began.

I knew I had been issued my Sandwich Generation membership card the day my mother was in the hospital, my father was in the ER in the same hospital, and I couldn’t get to either one of them because my husband wasn’t there, and I had a 2 year old in tow.

Despite being in relatively poor health at the time of her diagnosis, she actually did pretty well through chemotherapy and radiation. She had a few setbacks along the way, one of which was pneumonia with a recovery course that landed her in a nursing home for rehab.

That was my introduction to finding living arrangements since, for reasons still a bit unclear to me, we had less than 24 hours to find a nursing home for her.

In the summer of 2006, when it became apparent that she didn’t have much longer, my father and I moved her (at her wish) from home to the hospice residence where she died.

I can’t say enough good things about hospice and the kind people who work there.

Less than 48 hours after her funeral, my father’s old back injury became a problem, and he ultimately ended up in a wheelchair for 2 months. He was 74 and worked full-time (still does) and he lived alone, so everything was up to me.

We eventually got into a routine where I’d pick him up in the mornings and take him and his wheelchair to work, get him settled in, go to my job and I picked him up in the afternoon, took him home and got him situated there.

Looking back on it, I guess I had my own little assisted living facility.

He eventually had surgery and made a full recovery, returning to work in less than 3 weeks.

I’m fortunate that he doesn’t live far from me and that he’s fine in his home. However, I know there will be a day when we’ll have to look at different arrangements, and I know I have to be vigilant in monitoring for any changes.

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