How to Assess When an Older Adult Requires Caregiving Assistance

9 warning signs that could mean it’s time to act

Cameron Huddleston,

Updated March 26, 2025

AARP

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En español

Published June 28, 2021

/ Updated March 26, 2025

JGI/Jamie Grill/Getty Images

Before the COVID-19 pandemic, Steve Barlam’s 94-year-old mother had been physically active, engaged in many activities and still drove 45 minutes to and from work five days a week. But lockdown took a toll on her.

“After COVID, we saw a bit of a change,” Barlam says. “Part of that was the social isolation. Part of it was hearing deficits. Some of it was cognitive decline.”

One change, in particular, stood out to him. “When her stockings had all these runs in them, she wanted to go out in public,” he says. As minor as that might seem, it raised a red flag for Barlam, who is a social worker with 40 years of experience managing geriatric care and president of the Aging Life Care Association and CEO of JFS care, a home care service in Los Angeles.

“My mother always was so fastidious and well put together,” he says. The marked change in her appearance signaled that he needed to get more involved with her care.

However, for most people, it can be hard to recognize or accept that an aging loved one needs help. “So often, family members go beyond the times that are optimal to initiate care due to the discomfort of addressing the difficult issues at hand,” Barlam says. “They often wait for the ‘big ticket items’ to emerge, such as when an elder isn’t taking their medications, not bathing, wearing dirty clothing or continually falling. Ideally, it’s about taking action a little earlier in the cycle.”

If you don’t get involved soon enough, your loved one’s well-being can be at risk. That’s why Barlam and other eldercare experts say it’s important to be on the lookout for these signs that an older adult might need caregiving assistance.

1. There is a change in hygiene

If your aging loved ones were always tidy but are now unkempt, it could be a sign of physical or cognitive problems. Keeping your loved ones properly dressed might be as simple as providing them with adaptive clothing, such as shirts with snaps rather than buttons, says Sherri Snelling, a gerontologist and CEO of the Caregiving Club, an educational content creation firm and consultant service. However, you might need to take a more active role in helping your loved ones with personal hygiene by providing hands-on support or hiring someone to assist them with bathing, dressing and grooming.

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Also, be alert to odors and stains on clothing and furniture that can signal changes in continence. If your loved ones have urinary or bowel incontinence, they could be at risk of infections and other problems if this condition isn’t addressed, Barlam says. There are products and treatments that can help.

2. There is a change in physical appearance or mobility

Pay attention to changes in your loved ones’ weight and be alert to signs of malnutrition. Rapid weight loss could be related to an illness or a side effect of the medication they are taking. Your loved ones might have physical issues that make preparing meals challenging. Or, It might be the result of stress, depression or cognitive decline. “You want to explore why it’s happening,” Snelling says.

If your loved ones are having trouble walking or getting in and out of chairs, the bed or the car, it could be a sign that they have a mobility issue that requires assistance. If they don’t get the help they need, they could end up with injuries, says Kate Granigan, who has more than 25 years of experience as a geriatric social worker and is CEO of LifeCare Advocates in Newton, Massachusetts.

3. They have wounds and injuries

Aging loved ones might chalk up scrapes and bruises to clumsiness. But the appearance of more frequent skin wounds may indicate a bigger problem that needs attention, Snelling says. For example, they might be burning themselves while cooking because arthritis is making it difficult to handle pots and pans. They could be bumping into things because of vision loss or dementia-related balance problems. The issues causing minor injuries could lead to major infections, hospitalization or deadly falls if you don’t intervene.

4. There are changes at home

A once-clean home that is now cluttered or unsanitary is a sign that older adults might need caregiving support. Check for expired food in the refrigerator and perishable items left out on the counter. At one client’s home, there were egg splatters on the ceiling, Granger says. It turns out that the client had been boiling eggs but forgetting about them until they exploded.

When the mess gets out of hand, older adults can be at risk of injury. “We’ve had clients who kept papers in their oven or on their stove,” Barlam says. At that point, it’s time to look at what safeguards can be put in place to protect loved ones.

5. They have become socially withdrawn

If your aging loved ones are no longer interested in outings, don’t want to go to events or meetings they typically attended, or withdraw from conversations in social situations, Snelling says this could be a sign that they need help. They might be suffering from depression, having trouble with driving or dealing with a health issue such as hearing loss.

“The social withdrawal could be an early sign of Alzheimer’s or mild cognitive decline,” Snelling says. Memory lapses and trouble communicating could make them afraid to interact for fear of being caught saying the wrong thing or repeating themselves.

6. Their finances are not under control

Several recent studies have found that a pattern of late payments, financial mistakes and impaired financial judgment can be early warning signs of dementia. If aging loved ones are letting bills pile up, making duplicate payments, misplacing money, becoming more susceptible to scams or even donating a lot more to charity, Barlam and Granigan agree that someone should be helping them stay on top of their finances.

You might be able to spot changes in financial behavior by monitoring your loved ones’ mail. You’ll have an even better chance of catching early financial warning signs if your loved ones are willing to give you view-only access to their accounts or sign you up to get transaction alerts.

If you don’t help loved ones manage their money, they could make mistakes that will jeopardize their financial well-being. They also are at risk of scams or fraud. “Someone who is vulnerable can easily be taken advantage of,” Granigan says.

7. They have problems with driving

When visiting with aging loved ones, check their car for scrape and dents, Snelling says. If possible, ask them to drive you somewhere to see if they’re having trouble behind the wheel.

Telling older adults that it’s no longer safe for them to drive is a difficult but essential conversation to have, Barlam says. However, it can create a good opportunity to introduce caregiving by hiring someone to take them places, Barlam says. “All of the sudden, that driver is preparing meals, helping with bathing, helping with other things that are needed,” he says.

8. Their health is declining

Your loved ones might need caregiving support if they can no longer manage chronic health conditions such as diabetes on their own or have developed new issues that impact their ability to care for themselves.

Be alert, though, to more subtle changes in your loved ones’ ability to manage their own health care. For example, you should pay attention to whether they’re taking prescriptions properly. “If they’re missing medications or not refilling medications, that could be an issue where more oversight is needed,” Granigan says.

9. There are changes in cognitive health

It’s important to know the difference between normal memory loss that occurs with aging and signs of dementia, Snelling says. For example, don’t be too alarmed if your loved ones occasionally forget where they put their keys. But you should be concerned if they can’t remember their spouse’s or children’s names.

You should be on the lookout for more subtle signs, though. If your loved ones stop using people’s names and refer to them using generic terms, such as my husband or your dad, it can be a sign they’re trying to overcome memory loss, Snelling says. And ditching a habit such as reading or watching the news can mean they can’t follow the storyline or understand what is going on, she says.

If your loved ones no longer recognize people they should know well, their home or other common places or don’t know what year, month or day it is, it is a sign they can no longer live without additional care., Barlam says. Ideally, though, someone should be involved with their care before they get to that point.

What to do when you see warning signs

If you notice changes in your loved ones’ appearance, behavior, health or finances, start by asking questions to find out what really is going on. “Some of these things don’t require a caregiver at all,” Granigan says. “They just need attention.”

If there isn’t a simple solution, though, Granigan recommends letting your loved ones know that you’ve noticed that they need help with certain tasks. You could say something such as, “These things seem like they’re getting hard. Would you agree to outsource this to have more time for other things you can enjoy?”

Snelling cautions against using the word caregiver if you have to bring someone into the home. Instead, you could say, “Dad, we need to get you a personal assistant — someone who can do the things Mom used to do.”

As you have these conversations, ensure that older adults still feel like they have a sense of control over the situation. Otherwise, they might resist your efforts, Snelling says.

If loved ones aren’t willing to accept help, try asking at what point they would be. You also could bring in a third party, such as an aging life care professional, to talk to loved ones about their care needs. These professionals are experts in helping older adults and their families navigate the challenges of aging and typically charge $150 to $350 an hour for their services, Granigan says. You can find one through the Aging Life Care Association.

Otherwise, the city where your loved one lives should have an area agency on aging that can provide resources. And some physician’s offices have case managers who might help with care coordination if your loved ones have a need for long-term care, Granigan says.

This article, originally published in 2021, was rewritten with new expert sources in 2025.

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Cameron Huddleston is an award-winning personal finance journalist and author of Mom and Dad, We Need to Talk: How to Have Essential Conversations With Your Parents About Their Finances. Her work has appeared in Kiplinger.com, Kiplinger's Personal Finance, Forbes Advisor, Chicago Tribune, Business Insider and many more online and print publications.

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