Thanksgiving is my favorite holiday. I love the cooking, the noise, the parade, the extra side dishes no one really has room for. Every year I tell my parents I want to “go bigger”: more food, more people, more traditions. And every year, my mother looks at me with a mix of love and exasperation and says some version of, “Can we please do a little less this year? My greatest joy is seeing you rest.”

She lives seven minutes away from me. I see my parents frequently. I’m not flying in once a year, squinting at them across a turkey, trying to decide if they’ve aged. I see the daily changes in real time.

And yet, somehow, Thanksgiving still has a way of putting aging and caregiving in high definition.

[Image of multi-generational family at Thanksgiving]

As a geriatric psychiatrist and an only child, I sit in a strange space at that table. I am both the daughter who wants to recreate every beloved tradition and the physician who knows that my parents’ energy, mobility, and health are not infinite resources. My mother’s plea for me to “do less” is not laziness; it’s the wisdom of someone who understands that spent energy can’t always be recouped anymore, and that my time and rest are precious, too.

It’s taken me a while to realize that Thanksgiving can be more than just a performance of “everything’s fine” with a nice centerpiece. It can also be a gentle, built-in checkpoint: an invitation to look honestly at how our aging parents are doing and whether we have a plan, or just more pie.

The holiday as an accidental health assessment

Even if you see your parents regularly, Thanksgiving is different.

The day asks more of everyone: more standing, more multitasking, more social interaction, more logistics. It’s a natural stress test.

As physicians, we’re trained to notice subtle changes. On Thanksgiving, you don’t need a formal cognitive screen to see that your dad keeps losing track of the conversation, or that your mom is suddenly delegating tasks she once did effortlessly. You don’t need a gait assessment to see that the “quick trip down to the garage” now takes longer and looks more precarious.

But here’s the rub: The second you notice those things, you’re no longer just the host or the guest. You’re the family’s unofficial risk-management department.

• “Do you think Dad should still be driving at night?”
• “Mom almost dropped the casserole; is this a one-time thing or a pattern?”
• “We really should talk about what would happen if one of them got sick.”

For many adult children, physicians or not, Thanksgiving becomes the day all of those questions bubble up. For some, it’s the only time the whole family is physically in the same room to even have those thoughts.

The problem is that we often try to shove all of that existential weight into a single overloaded day, between the stuffing and the pumpkin pie. No wonder everyone ends up snippy, defensive, or in tears.

Why “more pie” isn’t the answer

My instinct, for years, was to respond to that emotional discomfort by making the holiday bigger.

If I couldn’t control the relentless march of time, I could at least control the menu, the tablescape, the guest list. If I couldn’t guarantee many more Thanksgivings, I could make this one “perfect.”

My mom, meanwhile, was quietly doing the math on energy and recovery time. For her, the difference between six side dishes and ten isn’t just more dishes, it’s whether she’s exhausted for days afterward. It’s whether her arthritis flares. It’s whether she spends the next week in pain instead of enjoyment.

Her request for me to rest was also a request for us to prioritize what actually matters.

That’s the pivot I now encourage my patients and their families to consider: Instead of chasing a bigger, busier Thanksgiving, what if we used the holiday as a moment to check in, tell the truth, and start a plan?

Not a dramatic, all-or-nothing care summit that ruins dessert, but a gentle, intentional “state of the union” on how things are going.

Three simple ways to turn Thanksgiving into a soft-care check-in

You don’t need to turn Thanksgiving into a family meeting with an agenda and minutes (please don’t). But a few small shifts can quietly transform the day from performance to preparation.

1. Observe like a clinician, respond like a child

Most physician-children I work with are already observing; they just feel guilty about what they notice. This year, give yourself permission to notice, but delay judgment.

• How easily are your parents moving around the house?
• Are they managing medications and timing without confusion?
• Who is actually doing the work of hosting and how is their body tolerating it?

Instead of confronting them mid-chaos (“You’re not safe on the stairs!”), tuck these observations away. Later, when the house is quiet, you might say: “I noticed you seemed really wiped out after cooking today. I loved being here with you, what would make this holiday feel easier on your body next year?”

You’re bringing your clinical awareness, but you’re leading with curiosity and respect, not control.

2. Ask three questions before the leftovers are gone

At some point over the long weekend (maybe during a walk, maybe while doing dishes side by side) see if you can weave in three key questions:

• “What part of today did you love the most?” This tells you what they value: the cooking, the company, the traditions, or simply having everyone under one roof.
• “What part felt the hardest on your body or your energy?” This identifies pain points we often overlook: standing, bending, noise, driving, social fatigue.
• “If we could change one thing for next year to make it easier on you, what would it be?” This keeps the focus on collaboration instead of unilateral decision-making.

Their answers are your roadmap. If Mom says her greatest joy is “seeing you rest,” that’s data. Maybe next year, ordering part of the meal or rotating hosting isn’t a failure, it’s alignment with her actual wish.

3. Turn one observation into one concrete follow-up

The biggest mistake families make is trying to solve everything at once:

• The will
• The power of attorney
• The “no more driving” conversation
• The knee replacement they’ve been avoiding
• The possibility of home care or assisted living

All of these deserve attention. None of them need to be fully resolved before the cranberry sauce hits the table.

Instead, pick one next step before the weekend is over and treat it like scheduling a follow-up appointment:

• “On Monday, I’ll call and schedule your annual visit so we can ask your physician about the memory changes we’re seeing.”
• “Next month, let’s pick a day to sit down with your paperwork so I know where everything is if there’s an emergency.”
• “Let’s look at whether we can get help with the heavy lifting next year so you’re not on your feet all day.”

From a caregiving standpoint, a single concrete step taken in November is more valuable than three hours of vague arguing over the mashed potatoes.

Protecting your parent and yourself

For physicians, there’s another layer we don’t talk about enough: boundaries that protect both our license and our heart.

We can be invaluable advocates without becoming the sole prescriber, decision-maker, and crisis manager for our families. Simple phrases like:

• “I’m your daughter first; I want your primary physician in the loop on this,” or
• “I can help you prepare questions for your appointment, but I don’t want to be your only medical opinion”

can stop Thanksgiving from becoming a constant curbside consult.

In my own family, honoring my mother’s wish to see me rest has become part of our plan. It means letting go of some Pinterest-worthy expectations so that we all have the bandwidth to enjoy each other, and to face what’s coming with clear eyes.

From performance to preparation

Thanksgiving will always be a holiday of abundance in my mind: food, conversation, stories we’ve all heard a hundred times. But the older my parents get, the more I see it as an annual checkpoint, too.

Not a crisis, not a reckoning, just a moment to ask: Is the way we’re living, hosting, and caring still working for the people we love most?

We don’t actually need more pie. We need the courage to see what’s in front of us, the humility to adjust our traditions, and the willingness to start a plan.

And if, in the middle of all of that, my mother gets to look across the table and see me sitting down, eating slowly, and actually resting? Well, maybe that’s the kind of abundance she’s been trying to give me all along.

Barbara Sparacino is a triple board-certified physician in adult and geriatric psychiatry and addiction medicine, and the founder of The Aging Parent Coach. With over fifteen years of clinical experience, she empowers adult children to navigate the emotional, legal, and caregiving complexities that arise when supporting aging parents. Her expert insights have been featured by major outlets, including NBC, Fox News, CBS, Apple News+, Style, Care.com, and Next Avenue.

Through her signature program, The Aging Parent Plan, Dr. Sparacino helps families make confident, values-based decisions about care while preserving their own mental and emotional well-being. She continues to practice psychiatry and teach through her work with the University of Miami and the Veterans Health Administration, advocating for a compassionate, evidence-informed approach to aging and mental health.

Follow her on Instagram, TikTok, or visit The Aging Parent Coach to learn more.