You called at the usual time. Nobody picked up. You tried again twenty minutes later, then once more before bed. You told yourself she was in the shower, asleep, or on the other line with her sister. Some of those are probably true. The question is what the pattern is telling you, and whether it is the kind of pattern you can check from five hundred miles away.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
Write down the hour, not the feeling
Before you decide anything, open a note and record each call: the time you dialed, how many rings, whether it went to voicemail, and whether she called back. Keep the list for two weeks. Feelings about a missed call are loudest at two in the morning and least useful at nine. A plain list shows whether the gaps cluster at one time of day, on one day of the week, or after a particular routine such as a trash pickup or a standing lunch.
Sort the silence into three kinds
A missed call usually belongs to one of three groups. The first is ordinary life: the phone is in another room, the ringer is off, she went out. The second is a changed routine: she used to answer at the same hour and now does not, and you cannot name a reason. The third is silence that arrives with other changes, such as mail left in the box, a car that has not moved, or lights that are on in daylight. Only the first group is safe to set aside. The second and third are worth a check, and that check does not have to come from you.
Ask the one person who can knock
If your list points toward the second or third group, the fastest test is someone at the door. A neighbor, a relative, or a friend in St. Louis can knock, look at the mail, see the car, and call you back with what they actually saw. Ask for specifics. Did she come to the door, and did she look like herself? Was the mail gathered? Did the lights come on at the usual time? 'She seemed fine' is not a useful report. 'She came to the door in her usual cardigan and asked about the bus schedule' is. If nobody local is available yet, the Local Help for a St. Louis Parent page lists the kinds of people to ask and what to ask them.
What a phone call cannot show
A phone call tells you about her voice, her memory of last Sunday, and how long she was willing to talk. It does not tell you whether she has eaten, whether the stove is off, or whether she has been sleeping in the chair. A good call does not clear the silence, and a short call does not prove decline. Your job is to get the second kind of information, the kind someone at the house can see.
What to do tonight
Start the list tonight. Write down the next three call times, and choose one neighbor or relative to check on her. Send that person three questions: whether she answers the door, whether the house looks the way it usually does, and whether anything has been left outside. Then stop redialing every ten minutes. The list is for the morning, and the check is for the day after.
What to leave with the doctor
Bring the list, and be specific about the pattern: the hours, the number of unanswered calls, and what the helper saw at the door. Ask the doctor whether a change in how she answers the phone or keeps up her days is worth an earlier visit, and ask what would count as a reason to move the appointment sooner. You do not need a diagnosis before you go. A clear list is enough to start that conversation.