AT LEAST 17.7 MILLION individuals in the U.S. are helping to take care of an older adult with health needs, according to the 2016 report from Families Caring for an Aging America. As we age, the odds of declining physical or cognitive health that affects our ability to function independently steadily increase. The report notes that between ages 85 and 89, more than half of older adults (58.5%) require a family member’s help because of health or functional issues, and about three-fourths of adults age 90 and up (74%) need some help from others.

Of course, some of us need help sooner because illness or an accident can befall us at any age. How do family members know when a loved one has reached the stage where help is needed? And how do they decide where to turn to get the appropriate level of care their loved one requires?

Sometimes the need is obvious. A debilitating health event like a stroke or fall, or a traumatic accident like a car crash can render someone incapable of self-care. But perhaps more common is the case where the signs are subtle and accumulate gradually. Here are some things to look for.