It never hurts to ask, except that one time I walked up to a car and it was only when I was a couple feet away that I saw the sole-up high-heels and the car rocking ... I tiptoed away and try to be more careful.
Cell phones have made a lot of situations easier but assuming that if they were in trouble they would have called for help might make certain situations harder. In one case the father of a friend had a minor stroke, as if any stroke can be really minor, but that's what they said, and he simply forgot where he was, who he was, where he was driving to, and why he wanted to go there. He had a cell phone but, other than a strong feeling something was wrong, didn't think he was in trouble.
So there he sat. In his car. At the side of the road. A couple blocks from his house. What saved him was that a neighbor saw him when she went to the store and then saw him, in the same spot, when she returned five minutes later. She pulled up and asked what was going on. He hadn't the foggiest idea. Being on good terms and having a relative who had a stroke she started to think something was seriously wrong even as he kept saying he was fine.
The EMTs found cooperative but completely unconcerned other than him thinking something, something he couldn't put his finger on, was wrong.
Diabetics can also have situations where they are not mentally capable of telling they are in trouble. In one sad case the driver had pulled off the road and was tasered over a dozen times because the police assumed he was drunk and uncooperative. Only after he had been tasered, beat, hogtied and collapsed in the drunk tank did they call the EMTs. Who started to suspect he wasn't drunk because he didn't smell of alcohol. On examination they found the Medi-alert pendant around his neck and started appropriate treatment. Word is he had no retirement plan before the incident. After the settlement it is well funded. Makes me wonder if calling the police is any better than just taking your chances. I keep telling myself that the vast majority of police are conscientious and trying to do the right thing. Even if a few fall well short of the mark.
Outside my divergence the larger point is that some people who need help, ever more people as the population ages, may not be able to use a cell phone or erect a flag. Walking up on a couple at maximum engagement might get you a thrashing, or shot, but everyone has to make an effort to look out for people who may need help, even if they don't realize it.