By Austin Senior Advisor Care Team · September 30, 2026
Thanksgiving is often when adult children first see how much a parent has changed. Here is what to check in the first hour, how to tell normal aging from a warning sign, and which Austin numbers to call Monday morning.
The visit that changes the plan
Most families do not decide to look at senior care during a calm week. They decide after a holiday. You fly in or drive down I-35 for Thanksgiving, walk into your mother's house in Tarrytown or your father's condo in Round Rock, and something is off. The refrigerator is bare or full of expired food. The mail is stacked in a pile. He tells the same story three times before dinner.
This guide is for that moment. It is not a diagnosis tool, and nothing here replaces a doctor. It is a way to turn a bad feeling into a short list of things you saw, so that you can make calls the following Monday instead of lying awake. Thanksgiving falls on November 26 this year, and the winter holidays tend to be the one stretch when scattered family is in the same house at the same time.
One caution first. A single odd moment is not a pattern. Illness, a new medication, a urinary tract infection, poor sleep, grief and even a change in routine can all make an older person look worse for a few days. What matters is what you see repeated, and what you can compare against how things were last year.
What to check in the first hour
Do not start with questions. Start by looking. Walk through the house as if you were a guest with good manners and sharp eyes.
The kitchen. Open the refrigerator and the pantry. Look for spoiled food, several of the same item bought over and over, or almost nothing at all. Check dates on milk and meat. A parent who is not eating well loses strength quickly, and a bare kitchen is one of the clearest early signals you will see in person.
The pill bottles. Look at how medications are stored and whether the counts make sense. Full bottles that should be nearly empty, or empty bottles that should have days left, both suggest missed or doubled doses. Take a photo of each label so you have the names and doses to give a doctor.
The mail and bills. Unopened envelopes, past-due notices and stacks of charity solicitations are common. So are checks written twice. The Alzheimer's Association lists problems with numbers and money as one of its warning signs, and it separates that from an occasional accounting error, which is normal at any age.
The person. Notice weight, clothing and hygiene. Look at the shoes and the stairs. Watch how they get out of a chair. Check for bruises, which can point to falls nobody mentioned.
Normal aging or something else
The Alzheimer's Association publishes ten early warning signs and pairs each with what ordinary aging looks like. The contrast is the useful part. Forgetting a name or an appointment and remembering it later is typical. Memory loss that disrupts daily life, such as asking the same question again and again, is not. Getting confused about the day of the week and working it out later is typical. Losing track of dates, seasons or where you are is not.
The same list separates a bad decision now and then from a real change in judgment, and it separates a person who feels less interested in social obligations from one who withdraws from hobbies they used to love. Trouble finding the right word occasionally is normal. New problems speaking or writing are worth mentioning to a doctor.
Two things about this list matter for adult children. First, many of these problems have causes that can be treated, including medication side effects, depression, thyroid problems, vitamin deficiencies and infections. That is a reason to get an evaluation, not a reason to wait. Second, a parent with a real memory problem can often hold it together for an hour with company. Hosts do that. If your sibling says Mom seemed fine at the phone call, believe both of you. Performing well for a short call and struggling alone on a Tuesday afternoon can be the same person.
Ask the questions that get honest answers
Direct questions like "Are you taking your pills?" tend to get a proud, automatic yes. Try questions that need a small story to answer. "What did you have for dinner last night?" "Who's been by this week?" "Show me how you set up the pill box." Ask them to walk you through a normal Tuesday.
Talk to the people who see your parent when you are not there. A neighbor, the person at church, the pharmacist, the woman who cuts their hair. Ask what they have noticed, and ask it gently. These people often know more than the family does, and they are usually relieved to be asked.
Try not to argue with a wrong memory during the holiday itself. Correcting someone in front of the whole family can lead to embarrassment and resistance. Write it down and move on. You are gathering information, not winning a point.
If your parent notices your worry and gets angry, that is common and does not mean you are wrong. Losing independence is frightening. Frame the next step as protecting their independence rather than taking it away. "I want you to stay in this house as long as possible, so let's get a checkup to make sure that happens" lands differently than "I think you have a problem."
The first calls to make in Austin
Start with the doctor, not a facility. Medicare requires providers to detect cognitive impairment as part of the annual wellness visit, and the annual wellness visit is a good reason to book an appointment now. If the doctor finds a problem, Medicare pays for a separate visit for a comprehensive cognitive assessment and care plan, billed under CPT code 99483. According to CMS, that visit runs about 60 minutes, involves both the patient and a family member or caregiver, and covers a cognitive exam, a review of daily activities, high-risk medications, safety and advance care planning. It can be done in an office, at the person's home, in a care facility or by telehealth. Ask the office for it by name.
Bring your written list of what you saw. Doctors get short appointments and a patient who says "I'm fine" often gets a short visit. A written note from family, handed over before the appointment, changes what the doctor looks for. Ask your parent's permission to be in the room, and to speak with the office.
For support, the Alzheimer's Association Capital of Texas Chapter is at 7718 Wood Hollow Drive, Suite 150, in Austin, phone 512-592-0990. Its 24-hour helpline is 800-272-3900. The chapter says it offers support groups, education and individualized planning with master's-level clinicians. Offices are by appointment only, so call ahead.
For local benefits and services, the Aging and Disability Resource Center of the Capital Area takes calls Monday through Friday, 8 a.m. to 5 p.m., at 855-937-2372. Meals on Wheels Central Texas, at 512-477-2273, serves homebound seniors in the Greater Austin area, and AGE of Central Texas, at 512-451-4611, runs adult day health care and caregiver programs. If you need a full walkthrough of the day programs, see our guide to adult day care in Austin.
When it is a safety problem, not just a worry
Some things cannot wait until January. Call 911 for immediate danger. Beyond that, these are the signs that usually mean the current arrangement is not safe: wandering or getting lost in familiar places, leaving the stove on, a recent fall or several near-falls, running out of medication or taking too much, unpaid utilities, and signs that someone is taking advantage of your parent's money.
If you suspect abuse, neglect or exploitation of an adult living at home, the number is Adult Protective Services, 1-800-252-5400, open 24 hours a day. If the problem is happening inside a licensed facility, the number is different: HHSC Complaint and Incident Intake at 1-800-458-9858. Families call the wrong one all the time and lose days. Our page on reporting abuse in Texas explains which is which.
If a fall has already happened, read what to do after a fall. If you are starting to think your parent cannot be alone, see when Mom can't live alone. If a diagnosis has already come, start with the first month after a dementia diagnosis.
What to do before you drive home
Before you leave, pick three small fixes you can do in one afternoon. Clear the expired food. Set up a weekly pill organizer and photograph it. Put emergency numbers on the refrigerator. If your parent lives alone, consider whether a neighbor will agree to check in, and make sure someone besides your parent has the name of the doctor and pharmacy.
Write down what you saw while it is fresh. Date it. Save photos of the medications and the mail. If you later need to talk to a doctor, a lawyer or a facility, a dated note from November is worth more than a memory in March.
Have one conversation with your siblings before you all leave. Decide who will call the doctor, who will check in weekly and who will look at finances. Families tend to drift after the holidays, and the person nearest to your parent ends up carrying it alone. Naming jobs while everyone is in the room is one of the kindest things you can do for that person.
If it does turn out that your parent needs more help, you do not have to decide on a facility. Many families start with a few hours of in-home help or a day program. If care outside the home becomes necessary, there is no published median price for memory care in Texas, and CareScout publishes Texas statewide medians, not Austin figures. Austin generally runs above the state figure, so see our costs page for the published numbers and their caveats. Take your time, tour more than one place, and get the medical evaluation first.
