The holidays bring families together, and provide an opportunity for out of town adult children to check in on their aging parents. According to a survey of long distance caregivers done by MetLife Mature Market Institute, those providing the care live an average of 450 miles from their aging loved ones. Sometimes a face to face visit presents a very different reality than the picture elderly parents paint on the phone.

If you’re visiting aging loved ones this holiday season, watch out for these signs that they may not be “okay”:

Significant weight loss. It can be a sign of numerous health problems – everything from depression to cancer.

Unopened mail piling up. Are they paying their bills? Are they taking care of important paperwork?

Dying Plants / Suffering Pets. How well other life is looked after may reflect how well they can look after their own lives.

Neglected Housework. Look for dirty dishes piling up in the sink, accumulating piles of clutter, grime buildup in the bathrooms, spills that haven’t been cleaned up, and cobwebs. These may be signs that they are unable to maintain their home.

Kitchen Trouble. Are there marks of past fires? Are their multiples of the same food item in their cupboards because they forgot they already purchased them? Is there rotting food in the fridge, or items past their expiration dates? All of these may be signs that your elderly loved ones need help.

If you notice any of the above troublesome things, it may be time to have an honest heart to heart talk with your aging parent about their care and long term plans.

“The number of people calling with questions about policy benefits increases by roughly 15 percent immediately following the holidays,” explains Bill Jones, President of MedAmerica, a family of leading long term care insurance carriers. “Many older Americans eventually need some hands-on assistance and the holidays are often the time of year when families recognize that eventuality has arrived.”