Maybe you’ve noticed that dad’s unopened mail is piling up. Or mom, once meticulous about her appearance, is wearing wrinkled clothes and not doing her hair. Perhaps there are bruises on your aging parent’s arms. When you bring up the subject, you hear, “Everything is fine. There’s no need to worry.”

Admitting they need help would mean they can’t take care of themselves anymore, and no one wants to lose their independence. “Denial is the unrealistic hope that a problem is not really happening and will go away by itself. Admitting they need help and accepting assistance is not easy for people as they age. It represents a loss of independence. Denial plays a major role – and signs get ignored,” says Paul Hogan, Founder and Chairman of Home Instead Senior Care.

The burden often falls on the family to recognize the signs that an aging parent might need help with daily living tasks.

This doesn’t necessarily mean that your loved one has to go to assisted living or a nursing home, but they may need some extra help in their home. If they’re not willing to admit it, how do you know if your elderly parent needs home care? Here are some warning signs to look for:

• Spoiled food that doesn’t get thrown away
• Missing important appointments
• Unexplained bruising
• Trouble getting up from a seated position
• Difficulty with walking, balance and mobility
• Uncertainty and confusion when performing once-familiar tasks
• Forgetfulness
• Unpleasant body odor
• Infrequent showering and bathing
• Strong smell of urine in the house
• Noticeable decline in grooming habits and personal care
• Dirty house, extreme clutter and dirty laundry piling up
• Stacks of unopened mail or an overflowing mailbox
• Late payment notices, bounced checks and calls from bill collectors
• Poor diet or weight loss
• Loss of interest in hobbies and activities
• Changes in mood or extreme mood swings
• Forgetting to take medications – or taking more than the prescribed dosage
• Diagnosis of dementia or early onset Alzheimer’s
• Unexplained dents and scratches on a car

(This article by Marlo Sollitto of Agingcare.com originally appeared on the CareGiver Partnership blog.)