You are back in your hometown and stop by to see Great Aunt Mary and Great Uncle Albert for the first time in a few years. But you become worried when you observe that the busy, meticulous couple of your youth is gone, replaced by a disheveled woman who won't get out of bed and a belligerent man who doesn't recognize you and thinks it is 1959.

What do you do?

"The Emergency Department can always provide an immediate assessment. But first, contact the person's doctor and determine if there is a problem," said Mark DeSilva, MD, medical director, Gottlieb Emergency Department, part of Loyola University Health System. "If there is, we will admit the patient to the hospital and begin immediate care."

With the trend of relatives living miles apart, planned family reunions during the holidays sometimes include a trip to the Emergency Department for an ailing senior relative.

Here are DeSilva's five tips on how to tell if a senior relative needs immediate medical attention:

The person is unkempt with poor personal hygiene.

The home is very messy, dirty and has a foul odor.

Minimal movement by the person appears to be painful.

Mentally, the person is agitated or confused.

The person has not seen a physician in several months and is visibly unwell.

"Try to contact the primary-care physician first and alert them to the situation," DeSilva said. But if holiday schedules or lack of information prevent that, bring them to the closest Emergency Department.

In the Emergency Department, you can expect the following:

Patients will be asked their name, the date, where they are and who the president is.

Medical staff will listen to lungs while patient takes deep breaths.

Patient will be checked for signs of cardiac distress.

Patients will be asked to walk so their gait can be observed.

Patients' vital signs will be checked, including respiration, blood pressure and temperature.

Patients' breathing will be monitored.

Patients will be checked for pressure ulcers, bruises and dehydration.

Patients' pupils will be checked to see if they react equally on both sides.

Patients will take part in a hand-grasp test to determine if grasp is even on both sides.

Their height and weight will be recorded.

Their urine will be checked for infection.

"There is always room at the inn at the ED even on Christmas," DeSilva said. "And proper medical care may be a better gift than a box of chocolates or fruitcake."