When “I’m fine” is all you have

Was he tired? Was he confused? Was it his medication? Was this connected to the Parkinson’s-related symptoms that were beginning to emerge, or was something else going on?

We got across safely. But I couldn’t stop thinking about one thing:

Freezing of gait is a recognised symptom of Parkinson’s disease. During an episode, a person can temporarily become unable to initiate or continue walking, sometimes describing the sensation as though their feet are stuck to the ground. It can also increase the risk of falling. The Parkinson’s Foundation describes freezing as temporary and involuntary, and notes that it may occur when starting to walk, turning or moving through doorways and other transitions.⁵

I cannot say with certainty that this explains what happened to my father that day.

But that experience stayed with me for a different reason.

I was standing right beside him and still didn’t immediately understand what was happening. What would I have known if I had been thousands of kilometres away?

The information that doesn’t always travel

For years, I managed aspects of my parents’ care while living overseas.

I spoke to them regularly. I knew about their doctor appointments and major health issues. There were family members and others around them.

I thought I was reasonably well informed.

But over time, I realised there was another kind of information that rarely travelled across the distance: the small, everyday changes that nobody necessarily thinks are important enough to mention.

A parent starts walking more slowly.

Food is being left unfinished.

A medicine is occasionally forgotten.

A familiar activity quietly stops.

A question gets repeated.

None of these things necessarily means something is wrong. But sometimes what matters is not the event itself. It is that something has changed from what was normal for that person.

When you are around someone regularly, you may notice these changes without deliberately looking for them.

From another city or country, you depend much more on what gets communicated.

We heard the same uncertainty from other families

When we began listening more systematically to families caring for ageing parents, I realised this wasn’t simply my experience.

In CareIntell’s social-listening research, we analysed 93 anonymised concern clusters containing 361 coded mentions. Of these, 261 related to NRI families.³

Recurring concerns included parents living alone, forgetting medicines, downplaying health problems, possible cognitive changes, and children learning about falls, symptoms or other health events only later.

Our survey revealed another part of the picture.

61% of respondents described a complex health context involving chronic illness, multiple doctors, recent hospitalisation or high dependency. Yet 44% said their parents primarily managed their own health.²

And 54% of respondents reported anxiety scores of 8–10.

These numbers began to put some structure around something I had experienced personally.

A family can be communicating frequently and still not have a complete sense of what is changing.

“I’m fine” may be completely sincere

It would be easy to interpret incomplete information as parents withholding things from their children.

Having cared for my own parents, I think it is more complicated than that.

A parent may genuinely believe something isn’t important enough to mention. They may not want a son or daughter thousands of kilometres away to worry.

Mentioning a fall might lead to another discussion about having an attendant. Difficulty walking might raise uncomfortable questions about independence.

And sometimes the parent themselves may not recognise that something has changed.

In my father’s case, even when I was physically present, I didn’t immediately understand what I was seeing.

That is why I don’t think this is simply a problem of communication.

Some things are easier to notice when you are there.

More data doesn’t always mean more understanding

Technology is giving families new ways to stay connected.

A video call shows more than a telephone call. A connected blood-pressure monitor can transmit readings. A wearable can record movement and activity.

All of these can be useful.

But a wearable might tell me that my father walked less. It would not necessarily tell me why.

A blood pressure reading cannot tell you that your mother seems unusually withdrawn. And a phone conversation may not reveal that the spouse providing most of the care is becoming exhausted.

The answer, in my view, isn’t continuous surveillance.

It is finding ways to notice meaningful change while preserving a parent’s independence.

Four windows into everyday life

Looking back at my own experience, there are four simple things I would want families caring from afar to think about.

And these arrangements should be created with our parents, not around them. Independence and dignity matter just as much as reassurance for the family.

A question I ask differently today

For those of us who have lived away from ageing parents, the instinctive question is often:

Today, I think there is a more useful question:

We may never have complete visibility when families live apart. Nor should the objective be to know everything that happens in a parent’s life.

But when something important changes, we want to give ourselves the best chance of recognising it.

For me, that realisation began on a zebra crossing in Dubai.