The signs almost never arrive in dramatic form.
Most adult children expect to “know” when their parent needs more help — there will be a moment, a fall, an obvious incident, and the family will spring into action. In practice, that moment is usually preceded by months of smaller signs nobody quite registered. A house that’s a little less tidy. Mail that’s piling up. Bills paid a few days late. Mom mentioning she fell, but it was nothing. Dad letting the lawn go a little. Each thing on its own is plausible. The pattern is what tells you something has shifted.
This post is about reading that pattern early. Five categories of sign that almost always mean a parent is starting to need more support, what each looks like up close, and what to do once you see it.
For the dementia-specific version, see How to Assess Cognitive Decline in Aging Parents. This post focuses on broader functional decline, which can happen with or without cognitive change.
Sign 1 — The house starts to slip.
A parent who has kept their home one way for forty years suddenly keeps it differently. Dishes pile up. The bathroom isn’t as clean as it used to be. Laundry sits longer. The yard goes uncared-for. Mail accumulates. The fridge has expired food in it.
What it usually means: the routine tasks of running a household are taking more energy than they used to, and your parent is making invisible decisions to skip steps. It’s not laziness — it’s energy management. They’re spending their available capacity on what feels most important and dropping what they can.
What to do: Visit. Look — gently, without making it obvious. Compare what you see now to what you remember. Don’t draw conclusions from a single visit; patterns over time matter more. A trial of light support — a cleaning service every two weeks, lawn service, a meal delivery — can ease the burden and tell you a lot about what they need.
Sign 2 — Personal care changes.
Your parent’s hygiene shifts. Same outfit multiple days. Hair less kept. Forgetting to shave. A noticeable smell. Showering less. Wearing the same robe most of the day.
What it usually means: showering is harder than it used to be. Maybe physically — getting in and out of the shower is unsafe, balance is failing. Maybe cognitively — they don’t remember whether they showered yesterday. Maybe emotionally — depression or anxiety is sapping the motivation that personal care requires.
What to do: Ask gently — not in a way that shames. “Have you been feeling tired in the mornings? I noticed you mentioned the shower was tricky last week.” If physical safety is the issue, a bath bench or grab bars can transform the experience. If cognition or depression is the issue, the medical conversation matters next.
Sign 3 — Money starts behaving strangely.
Bills go unpaid. Or get paid twice. Bank statements show charges your parent doesn’t remember. The checkbook has unusual entries. They’ve been donating to charities they wouldn’t normally donate to. They’ve taken phone calls from people you don’t know about offers you haven’t heard of.
What it usually means: financial management is one of the highest cognitive-load tasks older adults perform regularly. It’s often the first thing to start slipping. Sometimes it’s normal aging plus a few mistakes. Sometimes it’s early cognitive decline. Sometimes — most concerning — it’s financial exploitation by someone who has identified vulnerability.
What to do: Ask to help review the most recent month of bills and bank statements together. Frame it as “let me help you make sure nothing fell through the cracks” rather than “I think you can’t manage anymore.” If you see scam-related charges or unfamiliar large transactions, act quickly — call the bank, freeze accounts if needed, report to Adult Protective Services if exploitation is suspected.
For the formal financial-management framework, see Estate Planning Checklist for Adult Children and Roles of Elder Law Attorneys in Caregiving.
Sign 4 — Falls or near-falls become more frequent.
Your parent has had a small fall they didn’t tell you about. You only learn because you noticed bruising. Or they “stumbled” but caught themselves. Or you watch them rise from a chair and see them wobble. Or they’re using furniture to stabilize themselves around the house.
What it usually means: physical balance, strength, or coordination is declining. Sometimes due to medication side effects, sometimes muscle weakness, sometimes neurological causes, sometimes inner ear issues. Most are addressable when caught early.
Why it matters: falls are the leading cause of injury for older adults. One in four adults over 65 falls each year, and falls are the leading cause of fatal and nonfatal injuries among older Americans (Centers for Disease Control and Prevention — Older Adult Falls). A single significant fall can permanently change the trajectory of a parent’s independence.
What to do:
- Mention the pattern to their primary care physician (PCP). A fall risk assessment can identify causes.
- Look at the home for fall hazards — loose rugs, poor lighting, clutter, no grab bars in the bathroom.
- Consider physical therapy — much more accessible than most adult children realize, often covered by Medicare.
- A medical alert device (LifeAlert, Apple Watch fall detection, similar) is worth the investment if your parent will accept it.
Sign 5 — Withdrawal and isolation.
Your parent stops doing things they’ve always done. The weekly card game with friends gets skipped. Church attendance drops. They turn down social invitations. They stop calling siblings. They stay home more, watch more TV, sleep more, engage less.
What it usually means: could be many things. Depression in older adults often presents as withdrawal rather than as classic sadness. Untreated hearing loss makes social interaction exhausting. Cognitive change makes group settings overwhelming. Mobility issues make leaving the house harder. Whatever the cause, isolation accelerates further decline — physical, cognitive, and emotional.
What to do: Ask, gently. “You haven’t mentioned cards with the gang lately. How’s everyone doing?” Sometimes the answer reveals the cause. Sometimes the conversation itself helps.
For the practical interventions:
- Hearing evaluation if hearing loss is suspected. Many older adults have undiagnosed hearing loss that profoundly affects social engagement.
- Depression screening with the PCP. Treatment for depression in older adults is effective.
- Senior or community center engagement if mobility allows. Many communities have transportation services for seniors.
- Friends and family scheduling visits or calls even when the parent isn’t initiating.
What to do after you see the signs.
Each sign in isolation may be addressable with a small intervention. Multiple signs together — or any single sign in advanced form — usually warrants a more systematic conversation.
A few patterns that work:
Bring it up gently, with specific examples. “I noticed when I came over Tuesday, the dishes had been in the sink for a few days. Are things feeling like a lot lately?” — better than “I think you can’t manage.”
Lead with care, not capability. Most older adults are sensitive to messaging that suggests they can’t take care of themselves. Frame conversations around making things easier, not around what’s failing.
Start with light interventions. Cleaning service, meal delivery, lawn care, transportation help. Each successful light intervention builds trust for harder conversations later.
Schedule a doctor visit. Many of the signs above have medical components — depression, hearing loss, medication side effects, fall risk, cognitive change. A primary care visit framed as a “general check-in” can surface treatable causes.
Plan, don’t react. A parent showing several of these signs doesn’t need to be moved into assisted living tomorrow. Most situations have a graduated response — light support → more support → home care → care community — that unfolds over months or years. Plan the next step. Don’t panic to the last step. See Home Care vs. Assisted Living: Which Is Right for the larger framework.
“The signs almost never arrive in dramatic form. The pattern of small things — a house that’s a little less tidy, mail piling up, the lawn going uncared-for — is what tells you something has shifted.”
ROM A DAD WHO REFUSED EVERYTHING:
The clearest example I’ve watched of “signs” not being heeded was my own dad.
He didn’t want help with the lawn. Or the meals. Or the driving. Or almost any of it. The one exception was filling his pill box, because the medications had genuinely become beyond him. For years, I respected what he didn’t want me touching. I waited. I asked. I let him say no. My sister and I came over and filled the pill box without commentary about anything else.
The signs were there. The lawn that had once been kept perfectly was a little less so. The fridge had things I knew weren’t fresh. He drove a little slower, took longer routes than he used to. None of it was alarming on its own. All of it was a pattern. And he wasn’t going to take action on any of it himself.
What changed the situation wasn’t a successful conversation. It was a car accident. Nothing fatal — but enough that he couldn’t keep driving, couldn’t keep living the way he had been. The accident was the moment when his refusal stopped being sustainable. The version of his life that had worked for him stopped working.
Looking back, what I’d tell any adult child reading this: the signs in this post are real. The conversation about them is hard. And the alternative to a hard conversation is often a worse moment that takes the choice out of everyone’s hands. I respected my dad’s autonomy as best I could. The respect was right. The trade-off was that decisions got made for him by circumstance instead of made with him in advance.
If I could send a message back to my earlier self, it would be: respect their autonomy AND keep the conversation going. The two aren’t in conflict. “I see this. I’m worried. I’m here when you’re ready” — said periodically, gently, without pushing — keeps the door open without taking over. Some parents come around. Mine eventually did, after the accident. The version of him that came back from that accident was glad I’d been paying attention.
Honor is in the name of our company for a reason: ElderHonor. Honoring our parents includes meeting them where they are while seeing where they’re heading. The signs above aren’t reasons to take over. They’re reasons to start the conversation, gently, again and again, until the right next step becomes clear.
Where to start today.
If you’ve noticed one or two signs:
- Visit and observe specifically and deliberately for two weeks.
- Document the pattern — small notes about what you’re seeing.
- Have the gentle first conversation if appropriate.
- Try a light intervention — cleaning service, meal delivery, transportation help — to see what gets accepted and what doesn’t.
If you’ve noticed multiple signs:
- Schedule a primary care visit for your parent — frame as a routine check.
- Bring your observations to that visit. Doctors get more from specific examples than from general impressions.
- Begin estate-document conversations if not already in place. See Estate Planning Checklist for Adult Children.
- Talk with siblings. Aligned family makes the next steps easier; fractured family makes them harder. See How to Divide Caregiving Roles Among Family when it’s available.
If a single sign is in advanced form (a serious fall, suspected exploitation, dramatic personal-care decline):
- Act faster. Some situations don’t have the luxury of slow conversation.
- Get medical evaluation quickly.
- Consider whether home alone is still safe — and what the alternatives might be.
You’ve got this.
The toolkit’s Roadmap and Documents modules walk through the observation framework, the conversation prompts, and the intervention sequence that turns “I’m worried about Mom” into a clear plan — built so the family can act early instead of reactively.
Some additional articles that might be helpful:
- The How to Assess Cognitive Decline — already linked inline; cognitive-specific signs.
- The How to Help Parents Age Safely in Their Own Home — natural next read.
- The Estate Planning Checklist for Adult Children — already linked inline.
- The Home Care vs. Assisted Living — already linked inline; for next-step decisions.
- The Roles of Elder Law Attorneys in Caregiving — already linked inline.
- Resource Library — Eldercare Locator, AAA, APS entries.
Some additiona notes:
The “depression in older adults presents as withdrawal” framing is supported in geriatric psychiatry literature but specific framing varies.
The medical alert device references (LifeAlert, Apple Watch) are illustrative; we are not endorsing any maker or type of device.
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