Visits with your aging parents often are a wake-up call this time of year. Perhaps you haven't seen your loved one for some time and when you do, it's startling. Aging can be a gradual process for some, but for others the changes accelerate so fast it shocks those who haven't seen them in a while. Don't wait for your loved one to bring up a need for help. Too often, they can't face it and are in denial. Those living alone are especially vulnerable as day-to-day, no one is watching. The following are 5 signs to look for that indicate it’s time to step in.

1. Unusually unkempt appearance. A change in personal appearance should not be dismissed as unimportant. Dirty clothing, lack of basic hygiene, failure to notice grooming and personal appearance signal something has changed, and they need help.

2. Inability to track the conversation. An aging parent who, in the past, could participate in a discussion and now can't keep up or follow what is being said is showing signs of cognitive decline. It is not "just getting old," as normal aging does not cause us to lose intelligence.

3. Repeating one's self. Older people start to lose short-term memory when dementia is developing, and short-term memory loss is a classic sign of cognitive impairment. If your loved one keeps asking the same question you just answered or tells the same stories over again, you have a warning that dementia could be in process.

4. Unsteady or recent falls. If your loved one seems wobbly on their feet or has had a fall, you are seeing a big red flag. Falls are unfortunately common among elders and are often the trigger that leads to injury, hospitalization and loss of independence.

5. Unattended paperwork around the house. Unpaid bills, collection notices and requests for renewal or information that has been ignored is a sign your parent is struggling to keep track of important paperwork and there is a need for an adult child to step in.

Many older people are terrified at the thought of being "put in a home" which they see as a form of imprisonment and loss of control. There are other options such as home care, which can be good choice, as it offers support without the need for them to move.