There's no place like home for the holidays, but what if far-flung children and relatives return for Thanksgiving to find not all is well on the homefront?

Holidays can serve as a wake-up call that elderly relatives made need help, said Mary Lou Harju, regional marketing and community relations coordinator for LIFE Butler County.

LIFE, a partnership of Butler Health Systems and Lutheran Senior Life, provides medical care, adult day care and home care free to older adults wishing to stay in their homes.

Adult children may come home to find aging parents struggling to live on their own or the victims of mental or physical abuse, said Wendy Olean, LIFE social service manager.

There are warning signs, Olean said.

“One of the things that we see in physical abuse, maybe even mental abuse, is they are withdrawn and isolated,” Olean said.

“What we are seeing sometimes is someone who was upbeat, used to socialize, is more sitting off to the side. They may come out in anger,” said Olean. “Or they may look very uncomfortable, shifting back and forth, rubbing their hands together or visibly shaking.”

If they are having difficulty maintaining a checkbook, if there are phantom deposits or unexplained deficits, said Olean, “if there are caregivers involved, many times you will find the older person has been taken advantage of.”

If not abuse, deteriorating health may be causing changes in an older relative's behavior.

“If you find they can't do routine tasks like cooking, bathing or cleaning,” said Marla Frailey, director of LIFE's facility at 231 W. Diamond St. “Is the home that was always kept tidy now disorganized and not kept clean? Are they not dressed for the weather, are they wearing flip-flops in December?”

“You might notice them not wanting to get out of bed. They don't want to shower. They are wearing the same clothes day after day,” said Olean.

“If he or she doesn't want you to come home or doesn't want to participate in holiday activities,” said Harju, “that should be setting off something in your head. There's something they don't want you to see or find.”

But the reasons for strange behavior might not be dementia, said Dr. Abeer Hannah, LIFE physician.

A change in behavior can indicate and undiagnosed infection or pneumonia, Hannah said.

Another cause may be mixing medications or quitting taking medications, Hannah said.

“I've had a patient stop taking water pills, diuretics, because she was going to her daughter's house for the holidays and she didn't want to be going back and forth to the bathroom,” said Hannah. “She had congestive heart failure.”

“Or someone will take more pain pills than prescribed because they want to be more active, and they wind up lapsing into lethargy or unconsciousness,” said Hannah.

Or an older relative could be mixing up medication said Olean.

“If they have a pill box for daily medications, and it's all mixed up or the pills aren't taken, that's a big sign as well as cause for concern,” said Olean.

Harju said check for outdated prescriptions or empty prescription bottles.

“That could be a sign they can't get out of the house or don't have the money to refill a prescription,” Harju said.

And the rich holiday foods could play a part, said Hannah.

“Festive holiday food may be loaded with salt or sugar, which can cause high blood pressure or hyperglycemia,” Hannah said.

Above all, Olean said, “I would encourage people to follow their first instinct. If you are driving home and thinking, 'Mom or Dad just didn't seem themselves,' it's easy to second guess yourself.”

“People don't want something to be wrong. But if you think something's wrong, call their primary care physician or go to the Area Agency on Aging. Let's err on the side of caution,” said Olean.