You have to be willing to look for signs. The denial factor is a main reason people don’t see it coming. You have to accept that it’s a matter of when your parents get into cognitive, physical, or financial trouble—not if. Pay attention when a clear transition happens—retirement, the death of a spouse or even of a beloved pet. Make an effort to visit on their turf as often as possible.

Piles of paper or unopened mail may indicate failing eyesight or memory lapses. One son visited and found notices from the U.S. government; his mother hadn’t paid her taxes for two years. Food stains on the carpet may indicate that they’re dropping things, or falling. If someone is usually tidy, an unkempt house may indicate forgetfulness or frailty. See if there’s any food in the refrigerator. Look for extreme weight loss or gain, or dental problems. Poor hygiene is a huge clue, especially if your mom or dad has always taken pride in how she or he looks.

When you talk on the phone, listen for cues. If they’re starting to complain about how expensive things have gotten, or how fast everybody is driving nowadays, these are clues to an issue they might be having. If they say nothing is new, it might mean they’re not feeling well and becoming more isolated. You want to hear them talk about going out to dinner, or being with friends. Exchange e-mail and phone numbers with the neighbors and let them know they can contact you
If they’re concerned. One client turned her parents’ dog walker into her eyes and ears. Make sure somebody you trust in the neighborhood has a key to the house. The next time you visit, pick up a local phone book; it’s a gold mine of information in an emergency. Get your parents to sign a form allowing their doctors to talk to you, and also execute a medical proxy form, a living will, and a durable health-care power of attorney.