Adult children visiting aging parents during the holidays, vacation times, or other short-term visits may be in for a shocking surprise. The pristine house and yard of the past may now look shabby and neglected. Dirty dishes fill the sink, and the kitchen table is covered in crumbs. Unopened bills are stacked haphazardly all over the countertops. Mom seems unfocused, and Dad is having trouble getting around. It's clear that help is needed, but what should family members do?

Adult children should take advantage of the time when everyone is gathered together to initiate a conversation with parents and family members about "what if" scenarios and health and financial concerns.

The holidays are a good time for family members to be alert for signs that elderly relatives may need help — physical, mental, financial, or spiritual. The most important thing is to look for signs of changes in mood, health, and living conditions. Checking in with people who visit the relative frequently can indicate whether there have been recent changes.

Some signs to look for include:

• Personal hygiene problems
• Home in disarray or needing to be cleaned
• Weight loss or weight gain — check for spoiled food or insufficient food at home
• Failure to manage medications or medical appointments
• Increased difficulty with mobility (such as climbing stairs or using a bathtub)
• Changes in judgment, mood, or overall behavior
• Increased forgetfulness; check for unopened mail or unread newspapers
• Missed bill payments or other financial difficulties
• Unusual or extravagant purchases that are out of character
• Decreased social activities or failing to maintain friendships
• Lapse in worship and/or Sunday school attendance

Experts warn that it isn't necessary to panic if you recognize a few changes. Some are simply part of the aging process. Slowing down doesn't automatically mean that your parents are ready to move to a nursing home or into an assisted living facility, or — for that matter — in with you.

However, this is a good time to talk about concerns and to ask parents what kind of help they would like. Start researching the options. There are many organizations that can provide expert advice about a range of senior services ranging from home health aides, visiting nurses, Meals on Wheels and adult day care to financial planning and legal issues. You will also want to check with the local United Methodist church to see what services it provides for older members in the community. For example, many churches sponsor a meals program or have adult day services available.

While you are visiting, take a look around and learn more about the community where your parents live. Visit facilities, contact senior organizations, take notes, and start a file so you will know whom to call when something needs to be done. Keep adding to it, and pretty soon you will be able to treat your parents to home-delivered meals or arrange for a senior companion to take your parents to church and to special events.

When you get back home, check out some of the websites offering gadgets that can help safeguard your parents and ease your worries. Video monitors, for example, enable you to keep an eye on how your parents are coping and automated medication carousels ensure that they are taking their pills in the right dosage and at the right time.

If you feel there are legal, financial, and insurance questions that need discussion, go to the National Association of Area Agencies on Aging website at www.eldercare.gov for a checklist of these topics.

One of the most difficult aspects of dealing with aging parents is dealing with siblings, other family members, and outsiders. Everybody has an opinion or an agenda. Take the lead and encourage everyone in your family to really listen to one another, respond with respect, keep a sense of humor, pray together, and stay focused on the prize — providing your parents with the best possible quality of life.