Frontotemporal Dementia: What Caregivers Can Expect

As a primary caregiver of a loved one with frontotemporal dementia (FTD), it can be difficult navigating the points between the diagnosis and knowing what to expect on your journey. With chronic illnesses and various forms of dementia on the rise, many of us will likely be tasked with taking care of a loved one or family member at some point in our lives.

According to The Association for Frontotemporal Dementia, an estimated 250,000 Americans have FTD, which counts for 10-20 percent of all dementia cases. It is known as one of the most prevalent types of presenile dementia, affecting people of younger or middle age. The onset of FTD can happen as young as 40 years of age and affects both genders equally.

Getting as informed as possible is the first step in learning to manage FTD as a caregiver. The earlier you can do this, the more you’ll be prepared for the arduous journey ahead and have an idea of what to expect. Managing expectations counts for a large part of the effort, helping you to look after yourself and your loved one to the best of your ability.

In this article, we’ll cover what frontotemporal dementia is, symptoms and methods for diagnosis, and actionable advice you can implement as a close caregiver. Caregiving isn’t easy by all accounts, but knowing your options and planning can make all the difference.

What Is Frontotemporal Dementia?

Frontotemporal dementia, otherwise known as Frontotemporal Degeneration, Frontotemporal Lobar Degeneration (FTLD), Frontal Lobe Dementia, or Pick’s disease, is a group of disorders that causes progressive degeneration (or atrophy — wasting away) of nerve cells in the brain. Particularly targeted are the frontal and temporal lobes, areas that are responsible for behavior, movement, and personality. Not only do those affected experience a change of personality and behavior, but there is also a progressive loss of speech and language skills. It is also possible to experience tremors and spasms.

This type of dementia is very distressing to witness as a loved one because of the behavioral changes associated with the disease. The person you knew so well can suddenly become aggressive, talk inappropriately, lose their ability to coordinate, and a whole host of other functional disabilities.

FTD can manifest in various types. Subtypes of FTD are identified clinically according to the symptoms that appear first and most prominently. Some of the most common types of FTD are:

  • Frontal/behavioral variant frontotemporal dementia(bvFTD). This type of FTD presents the more typical manifestations associated with the disease, such as character changes and behavioral issues. This is the most common type. It can also affect language and thinking skills. 
  • Primary progressive aphasia (PPA). This type of FTD is commonly divided into two secondary forms:
  • Non-fluent variant (nfvPPA). This subtype affects speech ability. Those affected with this variant find it increasingly difficult to speak, though they still recall the understanding of individual words. They suffer from apraxia of speech. They may be physically struggling for their words.
  • Semantic variant (svPPA). This subtype affects knowledge and the use of language. It is characterized by the progressive loss of the meaning of words. If there is also a problem with being able to identify people or objects, this is called semantic dementia. Their speech becomes vague as they omit or substitute words they don’t understand.
Frontotemporal dementia is the 5th most common cause of dementia.

The Causes Of Frontotemporal Dementia

There is no known cause of frontotemporal dementia. In some people suffering from FTD, some substances accumulate in their brain cells — very small structures called Pick bodies. These contain an abnormal amount of protein called tau and TDP-43 proteins, which disrupt the brain cell’s ability to communicate with other cells. It is unknown why these proteins suddenly accumulate in such large numbers.

One of the most plausible theories is linked to genetics. About 10 to 15 percent of people with FTD have a family history of dementia. Research has shown that various subtypes of FTD are caused by gene mutations and can be inherited. The most common FTD variant that can be inherited is the behavioral variant, and less common in the semantic variant.  However, this is still unproven as the majority of people diagnosed with FTD have no family history of the disease or related dementias.

There does seem to be a link between frontotemporal dementia and amyotrophic lateral sclerosis (ALS) also known as Lou Gehrig’s disease or motor neurone disease. It has been found that the C9orf72 gene is the most common gene causing hereditary FTD, ALS, and ALS with FTD. ALS is an incurable neurodegenerative disease affecting the loss of upper and lower motor neurons. This leads to paralysis, dysphagia, dysarthria, and eventually to respiratory failure. A small number of people affected by FTD also develop ALS. However, more research needs to be done to confirm the shared genetics and molecular pathways.

What Is The Difference Between Frontotemporal Dementia And Other Types of Dementia?

Frontotemporal Dementia is separate from other common dementias and illnesses such as Alzheimer’s Disease, though can often be misconstrued because of overlapping symptoms. FTD sets itself apart from the rest in a few distinct ways. One of the main differences is that the onset of FTD starts at a younger age than the average sufferer of dementia. First symptoms usually begin to appear in middle age, around 50 years old. It takes time for the symptoms to develop, often up to 10 years before FTD is diagnosed. This is because the symptoms are usually thought to be a sign of mental illness, affecting the person’s work and home life in the process.

A surefire sign of FTD is a progressive deficit in social behavior and gradual loss of language — not impaired memory, but slurs and difficulties with expression. As expected with these types of symptoms, life for caregivers becomes very difficult and relationships tend to get under a lot of strain.

What To Expect With Frontotemporal Dementia

Frontotemporal dementia life expectancy ranges from 2 to over 20 years, with an average course of 8 years from the onset of symptoms. Because of the nature of these symptoms (and the fact that a patient is often “too young” for dementia to be considered), FTD is often initially misdiagnosed as a psychiatric problem or movement disorder, such as Parkinson’s disease. Alzheimer’s disease is another possible misdiagnosis. Accurate diagnosis is crucial, as some medications used to treat other disorders may be harmful in a person with FTD.

Existing care facilities and programs may not be appropriate for—indeed, many do not accept–younger individuals as patients without additional education and support about FTD. To accurately diagnose your loved one, pay attention to any symptoms that may occur.

Symptoms of frontotemporal dementia: Symptoms of FTD start gradually and progress steadily, and in some cases, rapidly. They vary from person to person, depending on the areas of the brain involved. These are common symptoms:

  • Socially inappropriate, impulsive, obsessive or repetitive behaviors
  • Unusual verbal, sexual, or physical behavior
  • Weight gain due to dramatic overeating
  • Impaired judgment
  • Apathy
  • Lack of empathy
  • Decreased self-awareness
  • Behavior and/or dramatic personality changes, such as swearing, stealing, increased interest in sex, or a deterioration in personal hygiene habits
  • Loss of interest in normal daily activities
  • Emotional withdrawal from others
  • Loss of energy and motivation
  • Inability to use or understand language; this may include difficulty naming objects, expressing words, or understanding the meanings of words
  • Hesitation when speaking
  • Less frequent speech
  • Distractibility
  • Difficulty planning and organizing
  • Frequent mood changes
  • Agitation
  • Increasing dependence

Some people have physical or psychiatric symptoms, such as tremors, muscle spasms or weakness, rigidity, poor coordination, and/or balance, difficulty swallowing, hallucinations, or delusions. These signs are not as common as behavioral and language changes.

Family members are often the first to notice subtle changes in a person’s behavior or language skills. A person needs to see a doctor as early as possible to discuss:

  • Symptoms, including which symptoms, when they began, and how often they occur
  • Medical history and previous medical problems
  • Medical histories of family members
  • Prescription medications, over-the-counter medicines, and dietary supplements taken

Diagnosis of Frontotemporal Dementia

No single test can diagnose FTD. Typically, doctors will order routine blood tests and perform physical exams to rule out other conditions that cause similar symptoms. If they suspect dementia, they may:

  • Evaluate the person’s neurological health–reflexes, muscle strength, muscle tone, sense of touch and sight, coordination, and balance.
  • Assess the person’s neuropsychological status–memory, problem-solving ability, attention span, and counting skills–and language abilities.
  • Order magnetic resonance imaging (MRI) or computed tomography scans of the brain.
  • Order lumbar puncture, also called a spinal tap, to rule out any rare infections, inflammatory processes, or cancers that mimic FTD.

Frontotemporal Dementia Stages

Once diagnosed, it may be helpful to determine a loose timeline as to the progression of the disease. As mentioned before, FTD has an average course of 8 years. However, every case is different and there is no set timeline for each person. To gauge some semblance of a timeline, it is helpful to determine what stage they may be in. Here is an outline of each FTD stage:Early-stage frontotemporal dementia:

Behavioral variant: may disregard normal social boundaries or do things seen as inappropriate. They are impulsive, careless, and even commit crimes. Empathy and judgment are lacking as the person begins to become apathetic.

Semantic variant: forgets names of people, places, and objects. Has trouble finding the right word or remembering what a word means. May have behavior issues as well such as trouble sleeping, irritability, emotional withdrawal, and depression.

Non-fluent variant: Instead of forgetting individual words, grammar becomes difficult and misused. Those affected have labored and halting speech. 

Middle stage frontotemporal dementia:

As FTD progresses, the symptoms start to resemble those of Alzheimer’s patients and other dementias. In this stage, those with the behavioral variant will likely need more help with activities of daily living, or ADLs. This could include dressing, toileting, bathing, etc. They also may start to have more language difficulties. Similarly, those variants who started with language difficulties will start to develop behavioral issues.

Late-stage frontotemporal dementia:

This stage especially resembles those of Alzheimer’s patients. Language and behavior are both issues, as well as memory deterioration and possibly memory loss. At this point, constant care may be necessary. This is to ensure the comfort and care of the patient. It is possible for the affected to die of an infection such as pneumonia at this stage.

Talk with your healthcare providers about when to call them. Your healthcare provider will likely advise calling if symptoms become worse, or if there are obvious or sudden changes in behavior, personality, or speech. This includes mood changes, such as increasing depression or feeling suicidal. Here are some tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down the questions you want to be answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also, write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also, know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.
Fortunately, there are different treatments for Frontotemporal dementia.

Types Of Treatments Available

Currently, no treatments are available to cure or slow the progression of FTD. Doctors may prescribe medications to treat symptoms. Antidepressant medications may help treat anxiety and control obsessive-compulsive behaviors and other symptoms. Prescription sleeping medications can help ease insomnia and other sleep disturbances. Antipsychotic medications may reduce irrational and compulsive behaviors.  

Little solid evidence exists that antioxidants and other supplements help those with FTD. You and your family members should talk with your healthcare provider about whether to try antioxidants and other supplements, such as coenzyme Q10, vitamin E, vitamin C, and B vitamins to support brain health.

There are many forms of therapies that can assist a person to adjust to some of the changes caused by FTD. Some of those include:

  • Occupational therapy: Occupational therapists can help the patient identify problem areas in life, like getting dressed, and help work out solutions.
  • Speech and language therapy: Speech therapy can help improve language problems and swallowing problems.
  • Physiotherapy: This will help with movement problems.
  • Relaxation therapy: This includes massage, music, or dance therapy.
  • Social interaction/leisure: Memory cafes are held for dementia patients with memory issues to get support and advice. 

What You Can Do as a Caregiver

Coping with FTD can be frightening, frustrating, and embarrassing for both the person with the disease and family members. Since some symptoms can’t be controlled, family members shouldn’t take their loved one’s behaviors personally. Families need to maintain their well-being while ensuring that their loved one is treated with dignity and respect.

Caregivers should learn all they can about FTD and assemble a team of experts to help the family meet the medical, financial, and emotional challenges they are facing. It’s important to find a doctor knowledgeable about FTD. Other health care specialists who may play a role on the team are home-care nurses, neuropsychologists, genetic counselors, and speech and language, physical, and occupational therapists. Social workers can help patients and caregivers find community resources, such as medical supplies and equipment, nursing care, support groups, respite care, and financial assistance.

As a caregiver, it is important to begin to plan for what is to come. Attorney and financial advisors can help families prepare for the later stages of the disease. Advanced planning will help smooth future transitions for the person and family members and may allow the afflicted person to participate in the decision-making process.

It can be very stressful for a caregiver to take care of a loved one with FTD. It’s normal to have feelings of denial, anger, and irritability. Caregivers may also have anxiety, depression, exhaustion, and health problems of their own. Caregivers should contact their healthcare provider if they have any of these signs of stress. Keep in mind that caregiving for others takes away from time you care for yourself. Try to take time out for self-care, which will end up benefiting you and your loved one.

We hope that you now have a better understanding of frontotemporal dementia and that you have gained a little more confidence to get yourself through this arduous journey. By knowing what you can expect and the resources available to help your loved one, you can map out a plan to make it as smooth as possible. 

13 Best Balance Exercises for Seniors to Avoid Falls

The best balance exercises for seniors aren’t as difficult as you may imagine them to be. There are numerous ways older adults can improve their mobility and strength to prevent falls. In this article, we’ll go through 13 of the best exercise programs that’ll address balance problems, relieve lower back pain, and increase core-strength for better movement and quality of life.

The Reasons Balance Declines With Age

It often comes as a surprise when seniors discover they are more accident-prone. One minute you could be brushing your teeth as normal, the next, you may strain your elbow while doing so! Some of the more anxiety-inducing injuries, like sudden falls, are directly related to balance and can be more frightening to deal with.

Certain medical conditions that affect our elderly loved ones, such as Parkinson’s disease, Alzheimer’s disease, heart disease, various forms of dementia, arthritis, and more, can severely impact an individual’s sense of balance. This causes a feeling of uncertainty and difficulties remaining steady, which then leads to falls that can sometimes have catastrophic consequences.

Here are just some of the most shocking statistics about falls in the elderly:

Alongside the typical causes of balance decline, there are also ailments commonly associated with age that can lead to falls, such as:

  • A decline in vision: Not seeing clearly or purely relying on memory to map movement can make you more prone to falls.
  • Weakness in your hips and legs: Less range of movement can make walking more difficult.
  • Poor posture/spinal degeneration: Makes it harder to stand up straight and have a greater vantage point.
  • Heaviness in legs: Decreases ability to lift feet so tripping up becomes more commonplace.
  • Slower reflexes: Less able to react on time when something could cause a fall.
  • Medicine: Some drugs contribute to loss of balance, which is why many advise against operating vehicles or other machinery.
  • Low iron count/blood pressure: Lightheadedness caused by these conditions could increase the likelihood of a fall.

Although a decline in balance is to be expected as we age, there are certain exercises, activities, and strength training programs we can do to help us improve our freedom of movement and function, rather than only relying on external health care. Focusing on balance training within all our daily activities is a start to ensuring our bodies remain in good working order so we can carry on leading independent lives, and help prevent falls.

Helping seniors practice balancing will prevent fall in the future.

Three Main Sensory Points That Affect Balance 

There are three main sensory points that affect balance in our body. These are located within our eyes, vestibular system (inner ear), and joints. When these work well in coordination with our musculoskeletal system, balance is greatly improved and helps us live a better quality, independent life without having to worry about suddenly losing footing.

Many of us take balance for granted until we are challenged with it. Maintaining balance is as much of a skill has staying active, and should be incorporated into regular workouts and other activities as much as possible.

As we move about, get up out of chairs or navigate difficult pathways, our three main sensory points work together with our bones, muscles, central nervous system, and brain to coordinate our balance to get from A to B.

  • The first sensory point comes from our eyes. Our eyes are the first port of call when informing our brain of the surroundings, helping us to assess potential danger zones that could lead to a possible fall.
  • The second sensory point is located in the inner ear, otherwise known as our vestibular system. Containing a fluid-filled semicircular canal, the inner sends a signal to the brain informing it of the position of the body in relation to gravity. Quite often, those that suffer from travel sickness or dizziness tend to have issues with inner ear fluid.
  • The third sensory point is in our joints. The activities sensed by the body through the joints is what helps us to stand up straight and have better coordination, especially important for activities like dancing or hiking.

While there are many more elements involved for maintaining balance than our sensory points, a lot of problems can be traced to an increase in sedentary lifestyles centred around comfort rather than activity. Chronic illness may play a part, however, a severe decline in balance can be prevented with regular balance exercises specifically designed for seniors.

The exercises listed further on in this article will help you optimize your upper and lower body strength, while working on improving balance and coordination using the three sensory points in conjunction with the rest of your body.

Take Precautions: Practice Balance Exercises Safely

The exercises listed in this article are designed for seniors who already have problems with balance and steadiness, as a result of inactivity over an extended period of time. To make sure you are practicing these exercises safely, whether at home, or in the gym, do take note of the following common-sense precautions:

  • Consult your doctor or physician before commencing any new exercise. There may be some medication that will prevent you from moving in certain ways because of contraindications that may include dizziness. It’s also important to rule out any other balance disorders such as vertigo or an ear infection.
  • Supervision. If you have a poorer balance, make sure you have someone nearby to help you should you get stuck on a particular exercise.
  • Do not do any exercise you are uncertain of. Get advice from a qualified trainer or have a physical therapist guide you through.
  • Only increase resistance when ready. Do not move onto the next level until you are sure it can be done safely.
  • Maintain good posture. Be aware of your body throughout all movements.
  • Do not move fast, or turn too quickly. This can inadvertently cause injury. Always ensure you move slowly when getting out of a chair or up off the floor.
  • Make sure there is a steady surface to hold on to. For these exercises you’ll sometimes need to hold on to a sturdy chair or lean your hand on the wall or kitchen top counter.
  • Don’t close your eyes. Blinking is OK of course, but closing your eyes while exercising may cause you to lose balance as your brain isn’t receiving consistent visual cues.

At first, the balance exercises may seem challenging, but the more you do the better you’ll become. Do as many exercises as you feel comfortable with, and slowly build up to more to continue your progression.

Before You Begin: Check You Have The Right Equipment

Before you begin, it’s a good idea to check that your surroundings will support the exercises you need to perform. As well as having someone on hand to help you if you need, here is a quick checklist of objects that’ll assist your workout:

The right footwear: As the idea is to work on your balance, try not to wear shoes that have a lot of “grip” to them. A simple, flexible leather sole should be enough, such as a soft, closed slipper.

A nearby countertop: Whether it’s your kitchen counter or a sturdy shelf, make sure you have a steady surface nearby to hold onto for balance, for e.g. when lifting your leg out to the side.

A chair: Use a steady dining room chair or any other chair that is stable and tall enough to hold onto. There may also be exercises where you’ll need to sit in a chair too.

Strap-on weights: If you feel like increasing the resistance of your exercise, you may want to include strap-on arm or ankle weights. Be sure to never add more weight than you are ready for. There is no shame in using small one to two pound weights. In fact, this may be more than enough otherwise you may be prone to injury.

Masking tape: If you have trouble keeping a straight line, take some masking tape and create a line on your floor to help with movements that require symmetry. 

13 Best Balance Exercises For Seniors To Avoid Falls

Now that you have all your equipment and have taken heed of all the precautions, it’s now time to start the following balance and strength exercises! So here goes:

Balance Exercise 1: The ‘Heel to Toe’ Walk

  • This exercise helps to improve balance by strengthening the range of movement between the ball of your foot and toes. Stronger feet means a sturdier footing while walking.
  • As you walk, place your right foot in front of your left foot, with the heel of your right foot touching the toes of your left foot. As you walk, shift the weight from your heel to your toes. Continue this movement with each foot as you walk through.
  • Repeat for 20 steps on each foot.

Balance Exercise 2: Leg Lift

  • This is a very simple exercise that’s ideal to do at any time of day, when you find yourself standing in the kitchen for example.
  • Hold on to the back of a steady chair.
  • Lift up your left foot while balancing on the right foot for as long as possible.
  • Switch to the opposite leg.
  • Work up to not needing a chair to hold on to.

Balance Exercise 3: Static March

  • This exercise can be done while you hold onto a countertop, if you need help with balance.
  • With your posture upright, lift your left knee up high, then lower it, and switch the movement for your right leg.
  • Aim for a repetition of 20 times per leg.

Balance Exercise 4: Toe Lifts

  • This exercise is great for strengthening the muscles in your toes and calves, which will give you more stability in your movements.
  • You may need a chair or countertop to lean on.
  • Standing upright with your arms out in front, raise high up on your toes and then lower down gently.
  • Repeat this movement 20-25 times, or as much as you can.

Balance Exercise 5: Single Leg Raise

  • This exercise works your outer thigh muscles for improved balance.
  • Use a chair to lean on if needed.
  • Stand with your feet hip-width apart. Lift your left leg slowly out to the side with your toe facing forward, while looking straight in front of you. Lower your leg to the starting position slowly.
  • Switch legs and repeat for 15 times per leg.

Balance Exercise 6: The Cane

  • This balance exercise for seniors is fun and can even be used as a party trick once you get good at it!
  • You can sit down for this exercise, or stay standing up with your back straight.
  • The idea is to hold your cane, or any kind of straight stick upright in the palm of your hand.
  • Try to avoid the stick falling down for as long as you can.
  • Switch hands for balance benefits on both sides.

Balance Exercise 7: Back Leg Raise

  • This exercise is great for strength-training your lower body, especially problem areas such as the lower back, for increased mobility, and better balance.
  • Much like the side leg raise, begin by standing behind a chair to lean on for support.
  • Slowly lift your right leg behind you, while keeping it straight, never bent at either the knees or toes.
  • Hold for a few moments, then slowly bring your leg back down.
  • Aim for a repetition of 20 times for each leg.

Balance Exercise 8: Side To Side

  • Stand upright with your feet hip-width apart and pressed sturdily into the floor.
  • Shift your weight onto your left foot, while slowly lifting your right foot off the floor.
  • Hold for a few moments, up to 35 seconds.
  • Bring your right foot back down slowly, then shift your weight on to your right foot with your left foot slowly coming off the floor.
  • Hold for the same amount of time as before, then move your left foot back down.
  • Repeat this movement as many times as you can per side.

Balance Exercise 9: Calf Stretches

  • Stretching the calf muscles are important for stability and the prevention of cramps.
  • You can perform these stretches by standing in front of a wall, or in a seated position on the floor.
  • For the standing version, place your hands in front of you against a wall for balance. Put your right leg behind your left leg and push your heel into the floor. You’ll feel your calf muscle stretch. Hold this position for up to 20 seconds, or more if you feel you can handle it.
  • Repeat for 5 times per leg.
  • For the sitting version, sit on the floor with your legs stretched before you. Using an exercise band or rolled up towel, place around one foot and hold either end. Pull the bands/towel towards you while keeping your leg straight.
  • Hold for up to 20 seconds, then repeat for 5 times per leg.

Balance Exercise 10: Wall Pushups

  • Stand in front of a wall at arm’s length and plae both palms flat against it.
  • With feet firmly on the floor, lower your body against the wall bending at the elbows.
  • Push yourself back to the starting position slowly until your arms are straight and at arm’s length from the wall.
  • Repeat this movement up to 15 times.

Balance Exercise 11: Arm Lifts

  • This standing exercise is great for improving the coordination of your arms, and helps to facilitate better reflexes.
  • Next to a chair (in case you need to lean on for support), stand upright with your feet together and arms at your side.
  • Lift your right hand over your head and gently lift your right foot off the floor.
  • Hold for a few moments and repeat on the opposite side.
  • Repeat on each side up to 15 times.

Balance Exercise 12: Hand and Finger Stretches

  • These exercises can be done in a seated position and are aimed at improving the nimbleness and reactivity of the hand and finger joints.
  • Hold your arms out in front of your and scale an imaginary wall with your fingers. While doing this movement, move your arms above your head and hold for up to 15 seconds, then slowly come back down.
  • To progress further with this exercise, continue movement of your arms until you reach behind your back and touch your hands together. Hold in that position for up to 10 seconds and slowly go back to the starting position while still moving your fingers.

Balance Exercise 13: Shoulder Rotations

  • This exercise can be done standing, or while sitting down.
  • Lift both your shoulders at the same time up to your ears, rotate towards your back and slowly bring back down. Roll your shoulders forward slowly, and lift back up to your ears, then behind your back as before, in a continuous, rotating fashion.
  • Repeat this movement in the opposite direction.
  • Aim for 10 repetitions per direction.
Practice is the key to a great balancing routine.

Keep Practicing: Consistency Is Key

As we mentioned earlier in this article, balance exercises for seniors don’t have to be difficult. In fact, they can be very easily incorporated into everyday activities. As long as there is an awareness of trying to implement balance, you can find opportunities to practice these wherever you go.

Small actions equal big results, as long as you stay consistent and remember that the quality of your life is mainly a personal responsibility. You don’t need a gym membership, but having someone for support nearby always helps. That is, until you become confident enough in your balance again to exercise on your own.

As always, consult a doctor or physician before you start your new balance exercise routine. 

If you think you may need some extra help finding a caregiver who can assist you with your exercises, post a job with us and you may find just the person you are looking for.

Personal Care Agreements & Contracts: The Complete Guide

Putting together a caregiver contract for a family member or loved one is often an afterthought, rather than something that is planned for in advance. Unfortunately, it’s an unpleasant reality of life that someday we may have to face the responsibility of caring for someone we love. Being prepared for that reality can help us navigate life in a way that’s best for both the caregiver and person that needs assistance.

It is usually an adult child of a sick parent that takes on the role of caregiver, or in case of no heirs, a close friend or spouse. The signs of ailing health in the elderly usually point towards dementia symptoms: difficulties with short-term memory, trouble navigating previously well-known journeys, problems concentrating, forgetting words, a higher tendency to trip up or fall, and generally, more vulnerability concerning everyday tasks. Sometimes, these symptoms take time to build up, providing the caregiver a false sense of control over the situation. As caregiving becomes more challenging with the increasing needs of the ill person, organizing a personal care agreement is the first step towards simplifying the lives of everyone involved.

The main care provider may often find themselves having to make large sacrifices to meet the time commitments and demands necessary for quality care. It may cause them to cut down on hours at work, give up employment benefits, and completely reorganize their lifestyle. While there may be other relatives or caregivers in the picture, a formal agreement could help to better set boundaries and prepare for any future financial need, while providing a way to compensate the caregiver.

Putting the care relationship in writing is a binding agreement and called a personal care agreement. It can also be called elder care, caregiver, family care, or long-term care personal support services contract. The contract offers both caregivers and the person they are looking after a secure framework of how things should be done financially as the illness progresses. The agreement also provides peace of mind in terms of who will advocate on the loved one’s behalf, in accordance with their wishes.

About Personal Care Agreements

A caregiver contract or personal care agreement are contracts that tend to be drawn up between a family member, most often an adult child or adult grandchild, and the person receiving care. Other relatives may also be included in the contract, or indeed close friends or other nominated, paid caregivers.

A caregiver contract is designed to define all the tasks required for giving care and the amount of money that should be compensated in return. It’s a useful tool in preventing conflict between family members and the main caregiver about the amount of care provided and where the financing should come from. With that in mind, the agreement should be discussed with all involved to examine all possibilities and concerns before it is written up.

Treating the contract as a legal document is a good idea, as it will show the state authorities where the money is being spent and for what products or services. This is especially important if your loved one is in receipt of state-supported home care. Additionally, a personal care agreement could help to clear any potential misunderstandings over inheritance later on, with the caregiver’s compensation clearly laid out.

Personal care contracts are usually signed by a close relative.

The Three Basic Requirements 

A personal care agreement comprises three basic requirements that outline the contract between a caregiver and the person paying for the care.

  • Requirement one: Any agreement or contract must be in writing.
  • Requirement two: Any payments or compensation must be for services or care that are to take place in the future, not for any that have already come to pass.
  • Requirement three: Compensation must match the same as the type of care services already offered in your local area or state. Fees and tasks performed should be “reasonable” and in line with costs offered by other 3rd parties.

Here is what a sample caregiver agreement should contain:

  • The starting date of the commencement of care
  • A detailed list of tasks/services that the caregiver will undertake, such as grocery runs, errands, transportation to and from medical appointments, medical care, accompaniment to adult daycare, preparing meals, cleaning, etc.
  • How much time will be dedicated to providing services over a certain period, e.g. up to 30 hours a week, or 120 hours a month.
  • How often and how much the caregiver will receive their compensation (weekly, biweekly, monthly, bimonthly, a lump sum payment, or whatever is decided)
  • The set agreement time. How long is the contract going to last, over the person’s lifetime, or only a few years? How many exactly? Will a new agreement need to be created for future care?
  • A declaration by all contract parties agreeing to modification in writing only by mutual agreement.
  • Locations where the caregiving services will be provided, e.g. the person’s home, caregiver’s home, nursing home, or another place. 
  • Date of the completed agreement with signatures of all parties involved.

Providing Room for Additional Agreement Details 

As mentioned in the previous section, there is always room for leeway or modifications to the agreement if all the contract parties allow. Sometimes, there may be a need for flexibility, e.g. if the caregiver themselves become ill or other circumstances prevent them from taking on the main role.

Another event that may occur is that one party may want to withdraw from the contract and terminate their involvement. In this case, you will need to include a clause that allows parties to do so as long as they state their intentions in writing. You may also want to include a backup plan for the next designated carer, in case they need to take over for a while or permanently.

In terms of allowances for extra expenses, perhaps consider whether the caregiver should receive some sort of provisions for sharing boarding costs (if they live with the care recipient), including utilities, rent, etc. You’ll also need to include specific details about what will happen if the person is moved into a care facility and whether a health insurance policy will cover the needs of the caregiver as well.

Depending on the illness the person has, you may need the assistance of a healthcare professional to determine the level of care anticipated for the future. Consult with a physician or local service provider to conduct a home care assessment. You may be charged a fee for this service, however, it is very helpful to get an expert opinion to avoid any pitfalls in the future.

Caregiving can be defined as any one of the following acts of support: helping with banking and finance management, transportation (factor in distances for gas costs), grocery shopping, cooking, general cleaning, assistance with taking medications/injections, keeping track of medical markers (blood pressure, blood glucose, etc), liaising with physicians and hospitals, plus personal hygiene.

As you draft your contract, define each caregiving activity with specific tasks needed to be done within each, and the time it will take for the caregiver to complete them. This will result in a more accurate presentation of the responsibilities undertaken.

Like other jobs closely related to health and safety, caregivers should write a daily log of what they have done and keep the activity list up to date. Any details and documentation journaled will support your activities should they need to be proved at a later time.

The contract being drafted between the care recipient and the giver is viewed exactly the same as the relationship between an employer and employee. For this reason, you’ll need to consider whether to factor in caregiver benefits such as vacation pay, or health insurance. In this instance, it’s best to consult an attorney to help you apply exactly what is needed for your particular circumstance.

Organizing Personal Care Agreements With Others

Family caregivers often have the uncomfortable task of consulting with others when it comes to discussing what will happen with an ill relative and who will take on the role of the main carer. One way to make this process a lot easier for everyone is to organize a dedicated family meeting, with all documents and information ready to digest and talk about. Include distant family members via video call as well, to speed up the decision-making.

One important element to consider when organizing the personal care agreement is whether to include the person in receipt of the care. Depending on their current condition, they may or may not have the cognitive capacity to advocate for themselves. You’ll also need to be wary of any potential areas of discussion that may be sensitive to your loved one, or private. Perhaps they may only need to attend some part of the meeting, or at the very end to ensure they feel comfortable with the plans.

To ensure your meeting goes as smoothly as possible, schedule a date and time that everyone can attend. Write out an agenda and share documents/materials beforehand so that everyone is on board with the information, and ready to start at the same point. Here are just some examples of the documents you may need:

  • Research showing the fees and quotes of caregivers in your location. Try to gather as much information as you can from nursing homes and other professional caregiving services.
  • The patient’s medical records that’ll detail caregiving tasks needed
  • A care assessment completed at the patient’s home with care recommendations
  • Medicaid planning: Your state’s rules in terms of eligibility for covered long-term care
  • Legal documents that may include: the Power of Attorney, a will, finance agreements, insurance policies, and other relevant documents.

Nominate a family member to take notes, just as you would have in an office environment. This will help you ensure all points have been covered and everyone’s input is considered. You may even want to share the meeting notes for future reference or use it to create a shared folder where everyone can access information related to the personal care agreement. If you can anticipate the meeting getting out of control, it may be a good idea to enlist the help of a professional mediator or trusted community member, such as a pastor to facilitate. A few meetings might have to take place before everyone is on board with the final decisions.

To keep the discussions on track, here are some points you may want to go over during the meeting:

  • The start and end of the agreement/contract
  • The exact role of the caregiver, with tasks listed and defined
  • The caregiver’s compensation and how often it shall be paid out
  • Who will serve as a deputy caregiver and step in when necessary?
  • If not the main caregiver, who holds Power of Attorney?
  • Estate planning and managing financial assets: are all areas covered in the patient’s will?
  • Who is the main physician or healthcare worker to contact in case of any questions?
  • What are the wishes of the family member with the illness?
  • What happens if caregiving needs to be moved to a 24/7 care home?
  • Does the patient have an advance health care directive to ensure their end-of-life wishes will be carried out? 
  • What could be considered as an asset “spend down” if needed to qualify for Medicaid?

If you find that the meeting is still not having the desired conclusion, contacting the National Care Planning Council may be your best resource for seeking adequate family mediation with an eldercare expert.

Hiring a lawyer is an option for many family members.

Hiring An Attorney

It may not always be necessary, but when there are more than 2-3 people involved in the financial and caregiving decisions of the patient, it may be wise to hire an attorney to iron out the details and make sure the contract is seamless. Depending on the complexity of your contract and unique situation, the professional services of a lawyer will help you avoid any potential family conflict in the future. You may consider drawing up a lump-sum contract for your caregiver, however, it may be difficult to track expenses especially if needed for Medicaid later on. A regular salary, e.g. monthly, for the caregiving services is easier for this reason.

Another situation you may need legal intervention for is if the patient is unable to participate in or sign the contract. The conservator or Power of Attorney may sign on their behalf.

Personal Care Agreements and Medicaid

Medicaid is a joint state and federal government program that helps those with low income or assets access health care for free. It covers the costs of doctor visits, hospital stays, and long-term care such as for Alzheimer’s disease and dementia patients, as well as those who are terminally ill. They may also cover the costs of in-home caregiving services, though this does not include custodial care, i.e. personal care (help with bathing, eating, using the bathroom, getting in and out of chairs, etc).  

In terms of qualifying for Medicaid as part of a personal care agreement, the patient’s assets and spending habits are assessed for the past 5 years. This is called a “look-back” period, and the assets subject to liquidation to go towards care, a “spend down.” Before entering a facility that Medicaid may cover for the patient, the program will “look-back” at the patient’s expenditure and judge how much care they are entitled to accordingly. Having a personal care agreement is a good way to show authorities that assets have not been hidden or given away to family members or caregivers as gifts, but rather used towards legitimately caring for their loved one.

Without having a caregiver agreement in place, the patient’s Medicaid eligibility may be questioned, as well as face delays with processing. You may be penalized, when all along you have been taking care of your family member as much as a professionally-employed caregiver. This is why personal care agreements and contracts are so important, as regulations can be very complex and vary according to state. To be on the safe side, always consult an elder law attorney or your local Medicaid office to check the rules pertaining to your state. Based on federal requirements, the general program rules for Medicaid eligibility and what services are financed have some flexibility on how they may work, meaning that you’ll likely find the experience of others may differ from yours.

Personal Care Agreements: A Saving Grace

A care contract may be just the saving grace you and your loved one may need at the end of an arduous, yet rewarding journey. Relying on social security services like Medicaid isn’t an ideal circumstance for providing care, but for many people may be the only option. A written agreement, such as that of your care plan, will not only help you factor in long-term care costs, but also protect you and your loved one from future financial difficulties when needing more specialized care.

To start with, why not look up one of the several sample caregiver contract forms offered online, which give you the option of saving formats for free in Word or PDF.

There are also many free resources on the subject of personal care services and caregiving on the following websites:

Caring for Someone with Dementia: 5 Important Tips

Dealing with dementia of a loved one is a hardship that’s difficult to be prepared for. After all, nobody plans their life thinking that one day they’ll have to be a caregiver of a family member, or worse still, become a burden due to their own health problems.

The fact of the matter is that most of us at some point will be affected by age-related illnesses like dementia, either directly or indirectly. According to The World Health Organization (WHO), around 50 million people across the globe are currently suffering from dementia. What’s more, it’s a growing problem. Each year the number of cases increases by 10 million people as a result of increasingly stressful, modern lifestyles. By 2030, the total number of people with dementia is projected to reach 82 million.

In the U.S, Alzheimer’s disease, one of the leading causes of dementia, is the sixth-leading cause of death, as reported by the Centers for Disease Control and Prevention. Mostly occurring in older adults over 60, the estimated proportion of those with dementia at a given time is between 5-8%. With an aging population overall, the number of people dealing with dementia will increase, and therefore, it is important to understand how to recognize the various types and symptoms and plan for the future.

Symptoms and Types of Dementia

There is often some confusion about the relationship between dementia and Alzheimer’s disease. While they are intrinsically linked, the distinction is that dementia describes a group of symptoms that affect memory and cognitive abilities, whereas Alzheimer’s disease presents just one of the causes. There are also several other diseases that cause dementia, such as Parkinson’s or Huntington’s disease.

Symptoms of dementia are characterized as the following:

  • Loss of memory
  • Difficulty finding the right words
  • Getting lost easily
  • Less ability in maintaining eye contact
  • Struggling with complex tasks or problem-solving
  • Disorientation and confusion
  • Impaired motor function and coordination
  • Depression, paranoia, and anxiety
  • Tactless or inappropriate behavior
  • Hallucinations, seeing people or objects that aren’t there

Dementia is caused by underlying diseases or injuries that affect the brain and damage nerve cells. Depending on the area of the brain affected, dementia can cause different symptoms in different people.

Types of dementias and causes include:

  • Alzheimer’s disease: The most common cause of dementia, Alzheimer’s disease is brought on by the mutation of several different genes, most notably the apolipoprotein E4 (APOE) gene. It can run through families. In Alzheimer’s disease, plaques and tangles are formed in the brain and cause damage to healthy neurons and fiber.
  • Vascular dementia: The second most common type of dementia, Vascular dementia damages the brain’s blood vessels and causes various problems due to reduced blood supply, such as strokes. Common symptoms include difficulties thinking, focusing, and problem-solving, which tend to be more pronounced than short-term memory.
  • Huntington’s disease: This disease is commonly discovered in earlier age adults around 30 or 40. Huntington’s disease is caused by a genetic mutation that makes specific brain cells and the spinal cord waste away. Symptoms are often shown as an acute decline in thinking abilities.
  • Traumatic brain injury (TBI): This is a condition caused by repetitive head trauma, often present in athletes of contact sports, such as boxers and football players. TBI can bring on dementia symptoms, like loss of memory, depression and slurred speech, and sometimes may appear years after the injury.
  • Creutzfeldt-Jakob disease: A rare brain disorder, Creutzfeldt-Jakob disease is caused by deposits of infectious proteins called prions, or can come about as a result of exposure to diseased brain tissue during surgery. It can also be inherited.
  • Parkinson’s disease: While Parkinson’s disease starts out as a movement disorder (where muscles become tight and rigid), patients eventually develop dementia symptoms at a later stage, commonly referred to as Parkinson’s disease dementia.
  • Frontotemporal dementia: Characterized by a group of diseases that cause the degeneration of nerve cells and their connections in the frontal and temporal lobes of the brain, this type of dementia is closely associated with personality changes, behavior, thinking, and judgment.
  • Lewy body dementia: A common type of progressive dementia, Lewy body dementia refers to Lewy bodies — abnormal clumps of protein in the brain, often present in Alzheimer’s disease and Parkinson’s disease. Symptoms include visual hallucinations, difficulties with focus and attention, uncoordinated movement, and tremors.
  • Mixed dementia: As the name suggests, a combination of several underlying causes that show up as dementia symptoms.
Planning ahead will help you keep your loved ones safe.

5 Important Tips For Caring For Someone With Dementia

Dealing with dementia is never easy. While prevention through lifestyle is one of the first things we think of, there are also genetic factors to take into consideration. Most times, a diagnosis takes us by surprise, so here are 5 important tips to consider if you find yourself caring for someone with dementia:

Tip One: Plan Ahead

The early stages of dementia are certainly less challenging than the later stages, but getting in a plan of care as soon as you learn of the diagnosis will help you better prepare for the future. Initially, your loved one may only need support with daily activities, but as the dementia progresses they may eventually need long-term, 24-hour care at a nursing home.

Planning ahead will help your loved one have more autonomy with decision-making, which will certainly prevent conflict with other family members involved in the caregiving. Paying for long-term care can be very expensive, so you’ll want to make sure all options are explored in advance. Although it can be quite traumatic having to talk about the morbid outcomes, it’s in the dementia patient’s and caregiver’s best interests to organize the legal and financials as soon as possible.

Things you’ll need to consider in preparing for dementia care:

  • Who will take care of all decisions once the dementia patient is unable to?
  • Who will be the main caregiver, and will there be a schedule for changeovers with other caregivers?
  • Quality of life: Is it best for the dementia patient to stay at home or move to a specialized healthcare facility?

Tip Two: Learn Communication Techniques

Dealing with dementia behaviors can at times be very frustrating, especially if you’re having to repeat yourself often or navigate difficult and inappropriate conduct. Learning new communication techniques can be a challenge, but ultimately, it will help your caregiving become less stressful and even help to deepen your bond with the person.

Here are just some of the ways you can improve communication:

  • Convey positive body language. Dementia patients are still able to pick up on mood and will be less anxious if your attitude and body language is pleasant and respectful. Be mindful of facial expressions, your tone of voice, and touch. 
  • Limit distractions for better attention. It can be confusing for the person to listen to you if the TV is turned on, or if there is a lot of activity happening in the room. Quieten the environment before attempting to speak with your loved one, using a combination of nonverbal cues and touch to keep focus.
  • Speak slowly, simply, clearly, and calmly. It may feel unnatural at first, or condescending, but if you speak slowly, simply, and in a reassuring tone you’ll receive a better response. Avoid raising your voice if you get frustrated. Try rephrasing the sentence, or wait a few minutes and try again. Refrain from using pronouns (he, she, they) or abbreviations.
  • Ask closed questions. Questions that need a yes or no answers are best. Avoid giving too many choices or asking open-ended questions that’ll confuse.
  • Be patient. It might take your loved one some time to answer your question. Look for answers in nonverbal cues, such as a particular look that may convey an underlying emotion. You can suggest words sensitively, but if they get frustrated, try to listen and respond with patience.
  • Break down tasks into manageable steps. This will help your loved one feel more independent. Make sure they know that skipping a step is OK, but gently lead them through completing their task or daily routine.
  • Change the subject. If either you or your loved one become annoyed or upset because of communication problems, switch up the subject, or try and move to a different room or place. This can help to ease tension and redirect the mind to something else.
  • Reminisce. Focus on long-term memories, i.e, remembering the past rather than something recent. People with dementia are more likely to retain information from the past. Reminiscing is often received well and can be very comforting, as well as a source of joy.
  • Laugh! It’s important to keep a sense of humor, though avoid directing jokes at the person’s expense. People with dementia still like to have a laugh and socialize. 

Tip Three: Check Your Environment

Coping with difficult behavior of a family member or loved one with dementia is one of the greatest challenges to deal with as a caregiver. Learning to deal with personality changes, aggression, inappropriate comments, wandering around and getting lost, is stressful and burdensome.

Oftentimes, subtle changes to your environment can make all the difference. Difficult behavior is usually brought on by your loved-ones inability to express their needs as they used to. You can improve the general well-being of all by taking notice of the following:

  • Bedrooms: Try to improve the person’s bedroom design to be simple, accessible, and easily recognizable. The bedroom needs to be a private, comfortable and safe place where they can go to decompress and have a good night’s sleep. 
  • Bathrooms: Remove stress from this area by incorporating walk-in showers or baths, and toilets with handles on either side. Helping a person with dementia to retain as much independence as possible is key to reducing stress, both for themselves and the caregiver.
  • Lighting: Try to get as much natural daylight as possible and reduce artificial lighting, especially at night time.
  • Backyards: Backyards offer fresh air, open space, chances to exercise, and lots of sunlight, which is essential for good health. Make sure boundaries are secure as well as outdoor furniture. 
  • Kitchen and dining areas: People with dementia often lose their appetite and capacity to cook for themselves. Try to keep this area as clutter-free and simple to use as possible, with a clear lay-out and attractive colors.
  • Assistive technology: There are many technological solutions to help people with dementia, ranging from stair lifts to large button telephones. Adding some of these devices to your household will help your loved one maintain independence for longer.
  • Avoid overstimulation and noise: People with dementia are often distressed by noises that may not seem to be a problem for others, so be wary of accidentally raising your tone of voice, or listening to the radio/TV too loudly. Try including noise absorbing materials in your decor, e.g, heavier curtains, carpets instead of exposed flooring, or change furniture that’s overly creaky.

Tip Four: Manage Your Expectations

Accepting what is happening to a family member or loved one is one of the most heart-breaking challenges of dealing with dementia. Each new stage of the disease calls for an adjustment of expectations and coming to terms with a new reality.

Coping with emotional loss and grief while your loved one is still alive can be hard to bear. By taking the time to reflect on events and accept the new way of life, you can work towards managing your expectations better and being more present as a caregiver. 

Keep a daily journal to list your daily gratitudes to help you count your blessings and celebrate what your loved one can still do, rather than what they cannot. With this in mind, try to organize activities you can both participate in and enjoy.

Even the most mindful and emotionally-aware caregiver can be tremendously challenged by the responsibilities involved with caring for someone with dementia, so remember to give yourself grace on a daily basis.

Getting the help of a nurse or caretaker is always an option.

Tip Five: Get Help

With so many of us conditioned to try coping on our own, it is unrealistic to take on the enormous responsibility of taking care of someone with dementia without factoring in some sort of assistance or help along the way. After all, everyone has their own physical and emotional needs to deal with, and cannot pour from an empty cup.

  • The first step is to seek out help in local support groups, charities, or volunteer organizations. Widening your support network can be immensely helpful for sharing experiences with others going through the same. Making connections in the care provider community can help you feel less alone and isolated.
  • Reach out to other family members. It can be uneasy asking for help, but many won’t explicility come forward unless they are asked. It’s important to not feel any shame for asking to share the burden of daily mundane tasks, such as shopping or cleaning. Make sure you schedule breaks as often as you can and fill up your free time with activities that bring you joy, or rest. Family caregivers that take time for themselves are often better at caring and also find more peace in the situation.
  • Take part in workshops. Nobody is born knowing all the ins and outs of caregiving. Take advantage of various caregiving workshops in your neighbourhood, or use online resources to help you stay up-to-date on what’s working best.
  • Don’t abandon yourself. It’s tempting to want to give your all to your loved one, but sometimes this can be counterproductive and cause you to have health issues on top of stress. Make sure you carry on scheduling medical appointments and checkups for yourself, as well as make time for self-care activities like exercise, socializing, and relaxation. You may even want to take up a new relaxtion hobby, such as yoga or breathing meditations.
  • Find someone to talk to. Other than your support group, confide in a trusted friend, religious leader, or therapist about your troubles. It’s important to have your feelings heard and validated to be able to get rid of stress.
  • Research in-home help. Some caregivers may not have the luxury of having supportive family members to assist them. Arranging a regular, or as needed, home assistance from professional care providers to help with basic, and/or complex tasks will certainly make life easier for everyone.
  • Adult day care. Adult day care services can offer your loved one a wide variety of activities and opportunities to socialize with others living with dementia, giving you some time to yourself to do other things or tend to other needs.
  • Respite care. Extending from adult day care services, there are also other services you can use for respite, allowing you time to rest from caregiving. Volunteers, nursing homes, or paid in-home help services may have respite programs that provide hot meals, watching over, or running errands whenever you need a break.

How to Help Dementia Caregivers

If you find yourself on the other side of the fence as an observer, never underestimate the simplest offer of help for dementia caregivers. Quite often, it’s a good idea to not wait to be asked for help, but offer it in passing, for e.g, call to see if they need anything while you are out grocery shopping. Doing this regularly can help to reinforce your presence as someone the caregiver can learn to rely on and trust. Offer your help for even the most mundane tasks, such as coming over to make a cup of tea and be with the patient while the caregiver tends to something else. You can also tell them about Care As One, so they know they can hire qualified help if need be.

Creating space for the caregiver to recharge their batteries is the best gift you can give them as a friend, allowing them to take care of their loved one as they want to. Even if you can’t be there for them physically, let them know you are thinking of them with phone calls, texts, or emails, keeping the line of communication open. This way, you will be able to recognize any worrying signs of burnout and encourage the caregiver to take time for their own well-being. 

The 10-Minute Stretching Routine Seniors Should Do Daily

Incorporating stretching exercises for seniors is a core principle at Care As One for improving quality of life. As we get older, building flexibility is a key component of staying strong, mobile, and full of vitality, leaving us feeling capable of doing anything we want to do.

Quite often, a decrease in mobility isn’t noticed until a surprising injury occurs, e.g. pulling a muscle while reaching for something in the cupboard or slipping a disc picking up something from the floor.

Since the effects of aging are gradual, many do not notice at first the loss of bone density or deterioration of muscles that make them more susceptible to dangerous accidents and injuries.

Introducing a stretching routine alongside a more active lifestyle is crucial for longevity. Having a full range of motion in your joints and stamina will help you gain more independence while relying less on medical assistance and equipment for your daily activities.

Benefits Of Stretching

It’s no secret that dancers, yoga practitioners, and other fitness professionals tend to enjoy greater flexibility and strength in older age. While having a lifetime of practice is a certain advantage, it is never too late to aim for the same even at a later stage in life.

Here are just some of the benefits of introducing regular stretching exercises as a senior:

Improves blood circulation: Just moving your body and stretching it in all directions helps to increase blood flow, allowing more oxygen and nutrients to circulate and revitalize muscles and joints. Feeling sluggish? Getting a good stretch in or a brisk walk will instantly unfog the mind, lift your spirits, and leave you energized!

Prepares your body for action: Stretching first thing in the morning or before partaking in any exercise or activity, helps your muscles loosen up and get ready to take on higher impact movement than it is used to. Much like revving up a car engine, sometimes our bodies need a similar warm-up to signal our next movements.

Slows down joint degeneration: Daily stretching increases the range of motion in your joints, preventing muscle stiffness and age-related joint degeneration. If you don’t use it, you lose it, so make sure your joints remember all the directions they can go in!

Aids recovery: Stretching after exercise helps your muscles recover a lot faster by keeping them loose, limber, and supple, rather than tightened, stiff, and painful. Warming-down with stretches is just as important as warming-up

Supports posture: All muscles are important, but those supporting your lower back, shoulders, and chest are critical for the protection of your spine. Keeping your back strong and flexible is key to maintaining a good posture and avoiding spine-related illnesses or diseases. Maintaining hamstring, hip flexor and pelvic muscle flexibility also helps to relieve stress on the lumbar spine, which decreases pain in the lower back.

Reduces injury risk: Flexible muscles are less susceptible to injury, especially if you make a sudden move that is out of the ordinary. Stretching increases the range of motion in your joints, while strengthening surrounding muscle tissue for further protection.

Manages stress: It may not feel that way when you first start stretching, but over time, you’ll start to feel muscle tension wear away, which in turn induces relaxation. Stretching allows your muscles to ease up, while increasing circulation of essential nutrients and oxygen to where it is needed in the body.

Boosts brain power: Stretching is great for the mind as it increases your blood flow and circulation, resulting in a better mood and sharper thinking. Makes a fantastic combination with sudoku and crosswords!

Stretching isn’t just great for young people but seniors as well.

Different Types Of Stretches

When talking about stretching, there are generally two types you can do. Static, or dynamic stretching.

Static stretching: As the name suggests, static stretching is usually performed in one place and involves holding a stretch for 30 seconds to one minute. The focus is on extending a particular muscle, or muscle group with a stretch is held steady and static, with not much movement.  Static stretches are great for beginners and those wanting to maintain flexibility with minimal physical exertion.

Dynamic stretching: Unlike static stretching, dynamic stretching is focused on mimicking real-life movements to stretch muscles and increase their range of motion. This type of stretching is more active and in the long-term, more effective for improving flexibility and stamina. It also helps to increase circulation and get oxygen pumping throughout the body.

The Do’s And Don’ts Of Stretching

A lot of people tend to put off exercise because of fear of injury. Certainly, there are some more strenuous activities that need watching over by an instructor, such as yoga, however, stretching is something anyone can do at any age with minimal risk. Still, here are a few things you need to bear in mind before you start:

The Do’s of Stretching:

  • Warm up beforehand. A mild jog on the spot or quick walk to get your heart rate up will help your body respond to the stretches.
  • Warm down after stretching too. This is a great time to take your dog for a walk, if you have one.
  • Remember to breathe. Always exhale on exertion
  • Be gentle with yourself. Mild discomfort is OK, pain is not.
  • Consult a doctor, or physical therapist, if you have any underlying health conditions or injuries before you start a stretching exercise routine.

The Don’ts of Stretching:

  • Work through pain. Leave the old saying “no pain, no gain” behind. In your senior years, pain can mean gaining a whole host of problems you never had before. As mentioned earlier, mild discomfort is natural whereas pain should be avoided as much as possible.
  • Hold your breath. Make sure you inhale as you get back to your starting position and then exhale as you move through exertion. It is important to keep breathing so that oxygen can circulate throughout your body and support your exercise.
  • Bounce around. Unless it’s part of a dynamic stretch, you don’t want to add any additional movements to what is instructed. This can cause you to be unsteady and injure yourself in the process. 
  • Turn and bend your back at the same time. This can inadvertently cause nerves to get trapped in your spine during a backstretch and cause injury.
  • Press your head backward during head rolls or neck stretches. You should only move your head from side to side. Moving your head backward can damage the vertebrae in your neck.

10-Minute Stretching Routine For Seniors

Now that you have some idea of what you should and shouldn’t do during your stretching sessions, it’s time to start with these simple stretches.

Each of the following 10 static stretch exercises is designed to last 1 minute each, for a total duration of 10 minutes. Ideally, these exercises should be done once a day for maximum effect, but if you can do more, e.g. at the start and end of each day, your body will thank you greatly.

Once you get used to the movements, feel free to switch up the order of the stretches. One day, you can start with your upper body, the next, your lower body, or just mix up the exercises as you please. Bonus points if you can remember to stretch at multiple points throughout the day!

Warm-Up: First of all, do a quick warm-up to get the blood flowing to your muscles. This could be a brisk walk around the block, or a minute or two jogging on the spot. You want to make sure there is enough circulation of blood and oxygen to support your stretching without injury.

Stretch One: Arm Raises

  • Stand in one place with arms comfortable at your sides. 
  • Keep your shoulders relaxed, back straight, and lift your ribs for correct posture.
  • Inhale, and lift your arms overhead reaching for the sky. 
  • Hold for 6-7 seconds, and slowly bring your arms down while exhaling. 
  • Repeat 3-4 times. 
  • For added effect, you can incorporate wrist weights, if you feel ready.

Stretch Two: Hands and Wrists

  • Hold your hands out in front of you with your palms facing downwards. 
  • Open and close your hands, stretching your fingers out and circling your wrists as you do so. If your arms get tired, lower them down towards your body and out the side. 
  • Repeat 10 times, or for 1 minute.

Stretch Three: Chest

  • Sitting in a chair, raise your arms, and place your hands behind your head. 
  • While inhaling, bring your neck and shoulders back to stretch your chest. 
  • Hold for a few seconds, then exhale and move back to the starting position. 
  • Repeat 3-4 times.

Stretch Four: Upper Back

  • Stand with a chair behind you, and intertwine your fingers with your hands behind your back.
  • Exhale while moving your arms further back behind you.
  • Hold for a few seconds, then exhale and move back to the starting position. 
  • Repeat 10 times.

Stretch Five: Lower Back

  • Standing up with your feet shoulder-width apart, your hands on your hips and palms resting on your bottom, arch your spine backward.
  • Hold for 6-7 seconds.
  • Repeat 7 times.

Stretch Six: Hamstrings

  • Sit on the floor or on a steady surface that allows you to extend your leg fully, such as a massage table.
  • Extend one leg out onto the surface.  Lean forward slowly and reach out first for your knee, then ankle.
  • Hold for 25 seconds.
  • Switch legs and repeat.

Stretch Seven: Quadriceps

  • Stand next to a chair and hold on to it with your left hand.
  • Bend your right knee and grab your ankle with your right hand.
  • Gently pull your leg up towards your bottom.
  • Hold for 20 seconds.
  • Switch legs and repeat.

Stretch Eight: Knees

  • Sitting on a chair comfortably, grab your knee and pull up slowly towards your chest.
  • Hold for 10 seconds.
  • Repeat with your other leg.

Stretch Nine: Calves

  • While standing facing a wall, place your palms in front of you on the wall.
  • Step forward with one foot and lean your hips toward the wall.
  • Keeping your back leg straight, push your heel into the floor.
  • Hold 30 seconds. 
  • Repeat with your other leg.

Stretch Ten: Ankles

  • Sitting comfortably in your chair, extend your leg out or cross over your leg.
  • Circle your ankle 10-12 times in each direction.
  • Repeat with your other leg.

Dynamic Stretches

If you like the idea of trying out more challenging, dynamic stretches, you can also start including some of the following in your routine:

Stretch One: Hip Circles 

  • Using a countertop for support, stand on one leg and swing the opposite leg in circles, slowly. 
  • Circle 20 times in each direction. 
  • Repeat with your other leg and increase the size of the circles as they become easier.

Stretch Two: Arm Circles

  • Hold out arms to the sides at shoulder height
  • Circle 20 times in each direction. 
  •  Increase the size of the circles as they become easier.

Stretch Three: Arm Swings

  • Stand up and put your arms out in front of you, with your palms facing down.
  • Walk forward and swing both arms to the right, and then to the left.
  • Keep your torso and head facing straight as you walk, focusing movement only on the shoulder joints.
  • Perform for 30 seconds.

Stretch Four: Heel-to-Toe Walk

  • Take a small step forward by placing your heel on the ground and rolling forward onto the ball of your foot. 
  • Extend out on to your tip-toe.
  • Repeat with the other foot.
  • Perform five heel-to-toe walks on each foot.

Stretch Five: Lunges with a Twist

  • With one hand on a wall for balance and legs hip-width apart, take an exaggerated step forward with your right foot, bending at the knee and hip slowly.
  • Slightly lower your left knee towards the ground, as much as your flexibility allows.
  • Return upright.
  • Repeat 5 times with each foot.
Stretching with a partner or two is always a good idea.

Stretching Sports

To make stretching an activity that’s more interesting, you can take up a hobby or sport that helps incorporate stretching movements naturally while giving you a skill to build on at the same time. Here are a few ideas:

Yoga: A popular choice for seniors, and with good reason. Yoga not only helps to improve flexibility, but also encourages better flow of energy throughout the body, leading to a feeling of lightness and relaxation. People suffering with osteoporosis are often advised to take up yoga to increase bone density, which can be achieved with consistent effort over time.

Pilates: If you’re not keen on engaging in the spiritual aspects of yoga, then pilates might be more for you. Invented by dancer and bodybuilder Joseph Pilates in the 1920s, pilates focuses on small, controlled movements that help to improve balance, strength and flexibility while focusing on correct breathing techniques. As with yoga, pilates can easily be modified for any level of fitness or age.

Swimming: While not as stretch-focused as yoga and pilates, swimming still requires a certain level of stretch to execute all the different swimming strokes. The range of motion in swimming helps to lengthen muscles and make joints more flexible, while improving cardiovascular performance. The buoyancy of being in water also helps to remove strain from the muscles, resulting in a more effective workout and easier recovery.

Stretch For Flexibility At Any Age

It’s never too late to work on improving your flexibility. Stretching should be an important part of anyone’s daily fitness routine, not just the elderly. Done regularly with the correct form and duration of stretch, most older adults and seniors can safely perform stretches without assistance.

As we age, our muscles are more prone to atrophy — wasting away. This comes as a result of long periods of inactivity, where muscles are not used and then broken down by the body to conserve energy. Injury, illness, poor nutrition, and genetics are all key contributing factors that cause muscle atrophy, which can then lead to other mobility issues.

Seniors can offset the effects of normal muscle and joint decline by focusing on exercises that promote flexibility and strength. Stretching regularly along with resistance training may help to reverse muscle atrophy, and even transform to muscle hypertrophy — gaining muscle!

Indeed, there are many seniors that take up bodybuilding as a form of physical therapy, to retain mobility, build muscle, and increase bone density. Of course, this should be supplemented by a diet rich in locally-sourced wholefoods and tailored to individual nutritional needs.

The great thing about stretching is that it is a good place to start being active for just about anyone. If you feel able to, you can do your 10-minute stretching routine multiple times throughout the day, and even throw in a few exercises while waiting in line somewhere or at the bus stop. Once you get used to the movements, you can think about adding strength training to your exercise program to combat muscle atrophy, or engage in a new hobby, like swimming or pilates.

Whatever you do, make it fun! The more enjoyable you find the activity, the longer you’ll be able to stick to it. Remember, stretching is beneficial for arthritis, back pain, posture, and general wellbeing.  If you wish, you can even hire someone through us to help you with the exercise until you feel confident enough to do them yourself. Whatever or however you decide to do it, just get started.

Elderly Strength Training: 10 Exercises Safe for Seniors

We all want independence. As we get older and our bodies change, we begin to depend on others more and more. It is inevitable that as older adults we will begin to lose muscle mass, and thus strength. However, with a consistent weight training program, this process of muscle loss can be delayed. With strength training, you can maintain bone density and improve your balance, coordination, and mobility. There is also a reduction in the risk of falling, one of the greatest dangers for elderly people. Besides all of these rewarding benefits of muscle strength, you will just feel happier and healthy having the freedom to perform all your favorite daily life activities.

Getting Started

So you’ve decided to make a change in your life and get active! Congratulations! Or perhaps you are a caregiver looking for some tips for your client’s strength program. Either way, before getting started, make sure to talk to a doctor to determine what exercises are best for you or your client. Keep in mind any injuries or illnesses that may affect the ability to strength train. Weightlifting can also be responsible for a temporary increase in blood pressure, especially if you are lifting more weight than is comfortable for you. Keep this in mind when starting. If you do it right, weightlifting will end up having a positive effect on your blood pressure.

A new exercise program goes hand in hand with a healthy lifestyle. This includes a healthy diet full of protein that helps muscles grow stronger. Limit alcohol and smoking to see improved results. And get good rest to allow your muscles to properly relax. It is important that through this process of building muscle that you listen to your body. Every day will be different. You may feel more soreness some days than others. Pay attention to any pains that come up and stop immediately if so. Do not exercise again until you no longer feel the pain. Ease into the process. It takes time, but it is so worth it! If you need help getting motivated, think about hiring a personal trainer to challenge you, and ensure good form. They will know what exercises that will suit you best and can tailor the workout to your exact needs. 


Warming up is imperative before physical activity, regardless of the duration or intensity of the workout. Incorporating a warm-up will slowly raise your heart rate without putting too much stress on your heart. It will also help supply oxygen to your muscles. Aim for about 5 minutes of warm-up time. Focus on the areas that you will be working out that day. Some examples of warm-ups would be shoulder rolls, toe touches, ankle circles, and marching in place. Now that we’re all ready to go, here are the exercises!

Seniors can decide to train with or without a trainer, through having a trainer is always a smart move.

Seniors Weight Training Exercises

We have compiled a list of the best exercises that focus on full-body strength training. These exercises are especially helpful for older people as they focus on safety and easy movements. If done regularly, you will see an improvement in strength, flexibility, balance, and range of motion. Try starting at 2 days a week at a low-intensity, and steadily increasing the amount of regular exercise as you begin to feel stronger. You can work up to 3 to 4 times a week. We have included both bodyweight exercises and free weight exercises. We recommend starting with bodyweight exercises so as not to strain your muscles too much. When you start to feel more comfortable, you can incorporate dumbbells, resistance bands, and medicine balls. Conversely, if you aren’t comfortable with the resistance training exercises that incorporate weightlifting, feel free to leave the weights out. Pay attention to your body and what it can and can’t handle. We hope you enjoy these exercises and feel proud of yourself as you see your body grow healthier, happier, and stronger!

1. Squats

This is one of the most important exercises for seniors, if not the most important. Being able to squat means you will be able to get up from a chair, get out of bed, lift something from the ground, and get out of a car. Squats are critical for building a strong foundation in your lower body. This strength will also carry over to supporting the rest of your strength exercises. This exercise targets your hamstrings, quads, and glutes. You may do squats holding onto a table or a wall if you are unable to maintain balance.

  • Stand with your feet hip-width to shoulder-width apart, and your toes pointing forward. Look forward, keep your heels planted, and raise your chest as you lower your hips backward. Make sure your knees hover above your ankles and are not caving inward. Raise your arms in front of you to keep balanced. Squat back as far as you can comfortably and hold for 1 to 2 seconds.
  • Push through your heels and return to the starting position.
  • Repeat 10 times, or as many as you can do. 
  • Easier: If you have issues with your knees, you can try making the squats easier. Sit in a chair and keep your feet flat on the floor.  Keep your chest raised and your knees out as you push off the chair a few inches or as far as is comfortable for you. Return to sitting and repeat. 
  • Harder: You can increase the intensity by doing more of them, slowing the movement down, or adding weights. You can do squats while holding a dumbbell, kettlebell, or medicine ball. 

2. Lunges

These are especially important for the strengthening of your quads, glutes, and hips. Doing lunges will keep you stable for standing and walking. Stand with your feet shoulder-width apart and your hands on your hips.

  • Step forward with your right foot flat on the floor while keeping your torso straight. Step as far as is comfortable for you.
  • Return right foot to starting position.
  • Switch to your left foot.
  • Repeat 10 times or as many times as are comfortable for you.
  • Easier: Hold onto a chair or railing for balance.
  • Harder: You can add a 2 to 5-pound weight in each hand for extra resistance

3. Wall Push-Ups

This variation of regular push-ups is much more convenient for seniors. You don’t have to get on the floor and struggle to get back up afterward! The exercise focuses on upper body strength, particularly the arms and chest.

  • Stand about 2 feet in front of a sturdy wall, or as close as is comfortable for you.
  • Place your hands against the walls directly in front of your shoulders.
  • Keep your body straight and bend your elbows. Keep your elbows close to your sides as you bend them, as opposed to sticking out.
  • Stop as your face approaches the wall and push back to the starting position.
  • Repeat 10 times or as many times as are comfortable for you.

4. Step-Ups

This is an important leg strengthening exercise as it focuses on one very important skill: stepping up. Being unable to climb stairs seriously limits places you can go. This balance exercise will help build your glutes and quadriceps so you can climb stairs and step over things. For an extra challenge, add 2 to 5-pound ankle weights to each foot.

  • Stand up straight at the bottom of the stairs. Hold onto the railing for support.
  • Slowly step up with your right foot, firmly planting it fully on the step.
  • Follow with your left foot.
  • Slowly step back down with your right foot, then with your left.
  • Repeat 10 times or as many times as is comfortable for you.
  • Slowly step back down with your right leg, then with your left. 

5. Seated Bicycle Crunches

Doing bicycle crunches are a good way to work the abs to develop core strength. We recommend doing them seated so seniors can avoid having to get up and down off the floor.

  • Sit in a firm chair with your feet planted flat on the floor. Put your hands behind your head with your elbows pointing out. 
  • Twist at your core as you raise your left knee to meet your right elbow. 
  • Untwist and return to the starting position. Do not be discouraged if you are not able to join your elbow and knee immediately. It takes time and practice to build your muscles. Keep practicing!
  • Switch sides, raising your right knee to your left elbow. 
  • Repeat 10 times for each side, or as many times as is comfortable for you.

6. Overhead Press and Shoulder Press

This is a dumbbell exercise that can be a good challenge for seniors. It targets the shoulder muscles and helps stabilize and strengthen your back and arms. This will increase your ability to lift things or reach over your head. We recommend starting with a one-pound weight, or no weight at all. You must ease into it slowly so as not to injure yourself. Pay attention to what feels right for you. You can perform the overhead press either standing or sitting. We recommend sitting so as not to strain your back.

  • Sitting in a chair with your chest high, keep your feet flat on the ground while shoulder-width apart. Hold your weights at chest level with your palms facing forward.
  • Raise your arms overhead till fully extended. 
  • Lower your arms to the starting position.
  • Repeat 10 times or as many times as is comfortable for you.
Bicep curls are great for the arms and can be done almost anywhere.

7. Bicep Curls

This is an important dumbbell exercise for strengthening the biceps. You use your biceps every day to lift, reach, open, and carry things. They are essential for maintaining your independence. We recommend sitting in a chair while doing this exercise so as not to strain your back. Do not do this exercise if you have elbow pain.

  • Sitting in a chair with your feet flat on the floor, hold the dumbbell in one hand down close at your side. Your shoulders should be straight and your palm should be facing inward, towards you.
  • Lift the weight toward your shoulder as you rotate your palm to face up.
  • Return the weight to the starting position.
  • Repeat 10 times or as many times as is comfortable for you.
  • Switch to the other arm.

8. Triceps Extension

This is another dumbbell exercise that works great for arm strength. The triceps muscle group is located in the back of your upper arm and helps you move your shoulders and elbows. You will see an improvement in your stability and flexibility of these areas, plus an increased range of motion. We again recommend to first try this exercise in a chair so as not to strain your back. Do not do this exercise if you have elbow pain.

  • Sit with your back straight in a chair with your feet flat on the ground, hip-width apart. Lift your right hand with the dumbbell in it behind your head, next to the ear. Place your left hand on your right elbow, supporting it. 
  • Straighten your right arm while extending your right hand toward the ceiling. Keep your elbow supported.
  • Return to the starting position.
  • Repeat 10 times or as many times as is comfortable for you.
  • Switch sides, and try with your left arm. 

9. Front Shoulder Raises

Another great dumbbell exercise for your shoulders and back are front raises. You can use dumbbells, a resistance band, or a medicine ball. We recommend sitting in a chair for this exercise, to protect your lower back and shoulders from injury. Do not do this exercise if you have any elbow pain. 

  • Sit up straight in a chair with your hips as far back as possible. Make sure your shoulders and chest are raised and feet are flat on the floor. 
  • If using dumbbells, let your arms hang to the sides with the palms facing inward toward your body. 
  • If using a resistance band, slide it under the seat, or sit on it until it has equal length on both sides. Holding each side of the band in each hand, hang your arms to the side with your palms facing inward toward your body.
  • If using a medicine ball, rest it on your knees while holding onto it from both sides.
  • Keep your arms straight as you raise the weight level with your shoulders. They should be parallel to the floor. Also, make sure not to turn your palms in any direction other than inwards. 
  • Slowly return to the starting position.
  • Repeat 10 times, or as many times as is comfortable for you.

10. Bent-Over Rows

This dumbbell exercise is great for the back, shoulders, arms, and core. You mustn’t do this exercise if you have pain in any of these areas, most especially including back pain and elbow pain. Good posture for bent-over rows is imperative to prevent any injuries. Make sure to keep your back straight in the following exercise.

  • Stand behind a sturdy chair with your right hand resting on it. Take one step back from the chair and hinge at the hips as you bend over, with your back straight. Your knees should be slightly bent and your left hand will hang straight at your side, holding a dumbbell. 
  • Pull the dumbbell up as you bend at the left elbow, raising it till it is level with your shoulder. 
  • Slowly return to the starting position.
  • Repeat 10 times or as many times as is comfortable for you.
  • Switch the dumbbell to the right hand and continue on the other side. 

Well-Balanced Workout

Compliment your strength training exercises with some cardio to get a full workout. Take a walk around the neighborhood to get your heart rate up and combat heart disease. Not only will it get your muscles moving, but you can also enjoy the sunshine, nature, and neighbors. Keeping as active as you can means you can keep active for longer, so try to incorporate some type of movement into your day every day. This can also include yoga or tai chi. Both are great for balance and flexibility, which in turn will positively affect your strength exercises. Not only that, but they also promote a meditative quality of the mind that will calm and soothe you. 

Rest and Take Care of Yourself

As much as we are advocates for movement, we know that rest is also important for your well-being. We urge you to listen to your body every day. Take time off when you are sore or in pain. Do a cool down to gradually recover your blood pressure and heart rate. Overtraining is a common problem and leads to injury. The point of weight training for seniors is to help you, not to hurt you. Take care of yourself. We hope that you have learned a few tips and exercises to get you started on your senior’s weight training. We are confident that following the information here will greatly improve your quality of life and that of your loved one/client. Be patient and persistent. You will see the results. For more information, check out this helpful pamphlet on strength training for older adults from the Centers for Disease Control (CDC).

Do Antibiotics Make You Tired & Sleepy?

Antibiotics are medicines that treat bacterial infections. They either stop or completely kill off the harmful bacteria. Antibiotics, also called antibacterials, have saved many lives. They are used to treat illnesses such as respiratory tract infections (whooping cough, pneumonia), sepsis, and skin infections. Sometimes antibiotics are used to prevent illnesses, rather than treat them. This prophylactic use of antibiotics is especially prevalent before bowel or orthopedic surgery. Despite being so beneficial, antibiotics have many side effects. They even are said to shorten life span in certain instances. Because of these dangers, it is important to know exactly what these medications are, how they can affect you, and if they are the right solution to your problem. Some antibiotics in particular can make you tired and sleepy or weak. Although this side effect is said to be rare, this fatigue can seriously harm you in some ways. We will dive deep into the world of antibiotics to understand their history, benefits, side effects, and what to do if you feel tired from taking them. Understanding them in depth will give you a better idea if they are right for you.

How Antibiotics Work

As mentioned before, antibiotics stop or kill harmful bacteria in our bodies. It is normal to have a certain amount of bacteria. As bacteria multiplies, our immune systems usually kick in to fight and kill them. White blood cells go to battle with the multiplying army of bacteria and usually win. However, sometimes the amount of bacteria overpowers the strength of our immune system. This is where antibiotics come into play. Antibiotics work in one of two ways:

  1. Kills the bacteria: A bactericidal antibiotic, such as penicillin, destroys the cell wall or its contents. 
  2. Stops the bacteria from multiplying: A bacteriostatic inhibits bacterial protein synthesis.

It is important to be aware that though antibiotics work against many life-threatening illnesses, they do not work against viruses. For instance, antibiotics will not cure COVID-19 or upper respiratory tract infections (URTIs) like the common cold or flu. You must first determine whether the illness is bacterial or viral to determine the proper medication. If someone has coronavirus and also develops a bacterial infection as a complication, antibiotics can help cure the bacterial infection, but not the coronavirus. 

Antibiotics are used for treating bacterial infections, not viral infections.

Types of Antibiotics

Antibiotics have not been around all that long. The first natural antibiotic was penicillin, which was first discovered in 1928 by Sir Alexander Fleming of England. And the discovery happened purely by accident! Fleming, known to be a careless lab technician, had been experimenting with the influenza virus. While he was away for two weeks on vacation, upon his return he discovered mold had been growing on the staphylococcus culture. And the mold had prevented its growth. This accidental breakthrough changed the face of medicine as we knew it. At the time of the discovery, bacterial endocarditis, bacterial meningitis, and pneumococcal pneumonia were all fatal diseases. After the penicillin was discovered, these illnesses could be easily treated. And this group of drugs has continued to save millions of lives since the first discovery. Today penicillin-based antibiotics are still very much in use. Penicillin is, in fact, the most widely used antibiotic in the world.  Some common penicillin-based antibiotics include ampicillin, amoxicillin, and penicillin G. 

Antibiotics are diverse. There are many types of modern antibiotics and some that are still being invented today. Then there are also topical antibiotics in the form of over-the-counter ointments, lotions, and creams that are used for skin infections. Antibiotics can be taken orally in the form of liquids, tablets, or capsules. They can also be given by injection. Some antibiotics work for a broad spectrum of illnesses, while others treat a few specific bacterias. Some attack aerobic bacteria that need oxygen, while others attack anaerobic bacteria which does not need oxygen. Antibiotics are incredibly useful in that they are fast-acting. Some will even begin working within a few hours. This is so important when dealing with a quickly-spreading illness. As you can see, the convenience, diversity, and availability make antibiotics practically a miracle drug for the modern-day. But, we know that the effects of antibiotics aren’t all good. Let’s take a look at some of the downsides of antibiotics.

Which Antibiotics Can Make You Tired and Sleepy?

Feeling fatigued can happen when taking some antibiotics. This rare but potentially serious side effect occurs in some common antibiotics prescribed today. The exact reason as to why fatigue occurs in some individuals is still not known today. Some have speculated it is a result of the change in nutrient absorption or dehydration that occurs when the digestive system’s biome has been disrupted. Since the helpful bacteria have been wiped out, the body may become fatigued. However, not all antibiotics cause fatigue. We will discuss a few of the most common ones that do. And the side effect of sleepiness or tiredness is said to be relatively rare. Pay attention if you are taking the following medications and are feeling fatigued: 

  • Amoxicillin: Commonly going by the names Amoxil or Moxatag, amoxicillin is a highly effective penicillin antibiotic. It is typically used to treat bronchitis, pneumonia, and urinary tract infections (UTI), among other things. If you are feeling excessively tired or weak after taking amoxicillin, immediately contact your doctor. It may have affected your nervous system. It is normal to feel tired when taking this medication, but be cautious if you are feeling weak or faint or fighting to stay awake. Sulfamethoxazole (Bactrim) could be a helpful alternative to Amoxicillin. 
  • Azithromycin: Another common antibiotic with extreme tiredness as a side effect, azithromycin goes by the names Z-Pak, Zithromax, and Zmax. It is used to treat bacterial infections such as respiratory, skin, ear, and eye infections. It is also used against some sexually transmitted diseases. If azithromycin causes fatigue, talk to your doctor about clarithromycin (Biaxin) as an alternative. 
  • Ciprofloxacin: This is one of many fluoroquinolones and yet another antibiotic that can cause fatigue. Also known as Cipro or Proquin, ciprofloxacin is often used to treat infections of the skin, prostate, and bone, among others. Ciprofloxacin was first known as a cure for anthrax poisoning. Side effects can include dizziness, drowsiness, and being generally less alert. Another alternative to Cipro is Vibramycin (doxycycline), a tetracycline antibiotic. This is a good choice especially if you are allergic to penicillin. 

It is important to remember that everyone responds to antibiotics differently. Talk to your doctor about these potential side effects and if this medication is right for you. Make sure to inform him or her on other medications you are taking as well. You can also talk to your pharmacist about these potential side effects.

Other Possible Causes of Tiredness to Rule Out

It is important to first rule out that your fatigue is being caused by your illness, not the medication. Talk to your doctor about the symptoms of your illness to see if this could be a possibility. Also, be sure your doctor is well aware of any other medications you are taking. This is important information for your doctor to know because your antibiotic treatment could potentially react with other medications you are taking. Here are some other medications that antibiotics have been known to clash with:

  • Antacids
  • Antifungal drugs
  • Anti-inflammatory drugs
  • Muscle relaxants
  • Diuretics
  • Antihistamines
  • Blood thinners

When you talk to your doctor about what could be causing the fatigue, be sure to rule out your other medications themselves as well. They could have their possible side effects. Fatigue could also be a symptom of any treatments you may be under. Talk to your doctor in detail about your other medications and treatments. Determine whether they could be the culprit, rather than the antibiotics. Here is a list of a few other medications and treatments that can cause you to be tired and sleepy:

  • Blood pressure medication
  • Antidepressants
  • Anti-anxiety medication
  • Radiation therapy
  • Chemotherapy
  • Heart drugs
  • Pain drugs
  • Antihistamines
  • Cough medications

One last to consider is whether or not you are taking your medications properly. To reduce side effects, ask yourself the following questions to make sure you are properly taking your prescribed antibiotic medications:

  • Am I taking the antibiotics as directed? Some antibiotics should only be taken with water. And some are supposed to be taken with a meal. Make sure you are taking yours when directed. 
  • Have I taken the whole course of antibiotics or stopped short? You should be finishing the course of antibiotics, even if the symptoms have cleared up.
  • Am I taking the correct dosage? So it is wise to pick and choose in your life when taking them will be most beneficial for your health.
  • Am I abstaining from alcohol?
  • Am I taking a probiotic? Research shows that people taking a probiotic will reduce their chance of getting diarrhea by 42%.
  • Have I notified my doctor about my side effects? Keep your doctor informed of any changes that have occurred since you’ve taken the medication, including sleepiness, diarrhea, and mood changes.  

What to Do if You Feel Tired and Sleepy From Antibiotics

So you have at this point ruled out other medications and treatments as being the culprit. You are sure that the fatigue is not caused by the illness or other medicinal interactions. Now it is time to determine if the antibiotics are making you tired. Perhaps you are at a point where fatigue is keeping you from doing your job correctly. Or maybe you are unable to focus when driving. Perhaps you are unable to do your normal favorite activities due to being drowsy. Drowsiness significantly increases your risk of falling or getting into a car accident. You could find yourself being permanently injured due to this side effect. If you do end up feeling tired and sleepy from the antibiotics, what do you do? The one thing you shouldn’t do is immediately stop the medication. This may allow the infection to worsen and can also lead to antibiotic resistance. If you just started to take the medication and the fatigue doesn’t fade within the first couple of days, or it gets worse, here are a few things we recommend to do:

  • Talk to your doctor about potentially switching to another medication, or trying a different dosage. 
  • Do not drive or do any activities that require your full attention and focus. You could potentially cause yourself or others harm. Avoid these things until you know exactly how the antibiotics are affecting you.
  • Do not drink alcohol, particularly when taking metronidazole (Flagyl)or trimethoprim-sulfamethoxazole (Bactrim). The combination will cause many other unpleasant side effects.
  • Avoid any other substances that make you sleepy.
  • Be sure to be getting enough sleep.

The Case Against Antibiotics

Not only can antibiotics make you sleepy, but there are many other potential side effects of antibiotics. There is a long list of serious side effects for each medication. You need to determine whether the potential side effects are worth the benefits of the medication. Here are a few other common side effects that occur with antibiotics:

  • Digestive problems (diarrhea, nausea, vomiting, abdominal pain)
  • Headaches 
  • Sensitivity to the sun
  • Photosensitivity
  • Depression 
  • Anxiety
  • Fungal infections, such as yeast infections
  • Allergic reaction; sometimes life-threatening (rash, hives, anaphylaxis, shortness of breath)

Besides the potential side effects, one must consider when taking antibiotics the overall health of the person. Because of the bacteria-killing nature of antibiotics, bacteria can be completely wiped from your body. This includes not only the bad bacteria but the good bacteria as well. This leaves your body easy prey to an infection that could take a toll on your health. One example is the bacterium called clostridium difficile. C. difficile typically develops after antibiotic treatment and can cause anything from diarrhea to life-threatening inflammation of the colon. This is due to the destruction of the normal, helpful bacteria from the treatment. And taking antibiotics often can cause your body to develop a resistance to them in general. Additionally, keep in mind that antibiotics mostly work well for short-term use. In most people, new good bacteria develop quickly afterward to balance the immune system. But you must consider the consequences of using a course of antibiotics for long-term treatment. The longer the course of treatment, the more damage is being done to your immune system.  So it is wise to pick and choose in your lifetime when to take them, and what times will be most beneficial for your health.

It’s important to always follow the prescribed dose with antibiotics.

Effects of Overprescription & Misuse

It is imperative that if you are to take antibiotics that you understand all the risks involved. Some of the common problems associated with antibiotics are caused by their overprescription or misuse. Antibiotics are very much overprescribed these days. And due to the overuse or misuse of these medications, the number of bacterial infections is growing. The CDC reports that more than 2.8 million infections occur every year that are resistant to antibiotics. Sadly, 35,000 people in the United States die yearly as a result. The infections have become resistant to antibiotics due to the bacterium’s improved defenses. This was predicted by Alexander Fleming, the discoverer of penicillin. Only take the antibiotics when they are prescribed, and follow the dosage and label instructions. Make sure the antibiotic has been approved by the FDA. If you stop taking your antibiotics before the illness is completely gone, the surviving bacteria may build a resistance to the medication. Then the bacteria will be resistant to the antibiotic in the future due to previous exposure. Do not simply stop the medication when your symptoms improve. It is also important to pay attention to when to take the medication, and what foods or drinks you can have while on it. Following these instructions could determine whether the medication works for you or not. 

Do not be afraid to question your doctor and ask for alternative medicines if you think antibiotics are not right in your case. About 30% of antibiotics prescriptions (47 million prescriptions) are prescribed unnecessarily. Oftentimes bacterial infections get better on their own. Particularly antibiotics aren’t really necessary for many sinus infections, and some ear infections. It might also be helpful to talk to a pharmacist with a PharmD to direct you in the right direction. Although pharmacists cannot prescribe the right antibiotics for you, they have a wealth of knowledge about dosage and side effects that can be just what you need to know.

With Antibiotics, Knowledge is Power

Antibiotics can be a double-edged sword. After their surprise discovery in 1928, they have impacted so many people’s lives. Some for the better, and some for the worse. While saving many people’s lives over the years, they have also included some damage in the way of side effects. The destruction of bacteria has left some immune systems devastated, and sometimes unable to recover. The lingering side effects also sometimes cause their problems that can send your health into a tailspin. Now you know a little bit more about antibiotics and the influence they have on your body and overall health. We hope you or your caregiver use this information to make the right informed decision for you. We are here for you. For more information on antibiotics, their side effects, and finding what works for you or your loved ones, please visit

The Hidden Side Effects of Nutritional Drinks for Seniors

From meal replacement weight loss plans to protein shakes for building muscle, people of all ages frequently turn to nutritious sustenance in liquid form for a variety of reasons. After all, it’s easy to pack nutritional supplements and multivitamins into a beverage and still make it taste good. Unfortunately, some people have an over-reliance on these nutritional drinks and don’t realize how harmful they can be if used incorrectly. Nowhere is that more apparent than in care for elderly people. 

Studies of appetite decline indicate that older adults frequently experience a loss of appetite for a wide variety of reasons, from physiological changes in the digestive tract, disease, weakening of related senses like taste and smell, and psychosocial causes like depression or delirium. The medication elderly people have to take is also likely to have one or more of these changes or causes as a side effect. 

This loss of appetite can lead to conditions like weight loss, poor bone health, undernutrition, and loss of energy. Sweet nutrition drinks can be a great way to occasionally replace calories that would have been consumed in a meal, but they rarely have the same nutrients as a healthy diet would offer. 

Over-reliance on high-calorie nutritional drinks can lead to harmful health problems related to obesity like high blood pressure and kidney disease. A certain amount of weight gain is great for elderly people who have lost too much weight, but too much can cause harmful effects.

Caring for a loved one as they age is no easy task and nutritional drinks too frequently present as relief for caretakers and family members. But without the proper considerations of the effects of those drinks and the advice of a registered dietitian or a physician, elderly people could face harmful side effects. 

Why Do Elderly People Experience a Loss of Appetite?

Older adults – sometimes as young as fifty – start to experience physiological changes that can lead to a loss of appetite. Health problems can exacerbate this process, but even elderly people in otherwise good health naturally tend to become less active and thus their bodies require less energy to get through the day. Metabolism tends to slow down as a response to this. 

But if they don’t need as many calories each day, then eating less should be okay, right? Actually, simultaneously as their metabolism is slowing down, elderly people’s bodies’ ability to process nutrients and put them to use in our various bodily processes becomes less efficient. So they need less energy, but they need more nutrients. 

That’s why so many people, including some registered dietitians and nutritionists, rely on nutrient drinks for elderly people who have trouble getting enough to eat. They aren’t a good long-term strategy, but for older adults with chronic health issues and those on medications that can affect appetite a nutritional shake every now and then could help. 

Another reason elderly people might experience a loss of appetite is because of reduced mobility. That could make it hard to get to the grocery store or even to feed themselves. Studies and anecdotal evidence from registered dietitians who work with older adults indicate that many elderly people who experience loss of appetite from lost mobility or because of medical issues like memory loss, nutritional drinks are easier to drink. 

Ensure, one of the most popular nutritional drinks on the market, has 220 calories and 14 grams of sugar.

What Nutrients Do Elderly People Need Most?

As with people of all ages, older adults need a few key macronutrients like protein, healthy fat, and carbs. They don’t need nearly as many carbs, especially if they’re not able to move as well. Nutritionists have long debated and studied the effect of various nutrients on elderly people. For example, short trial studies once led professionals to believe that higher protein intake led to less protein in urine, which in turn led to increased bone loss. However, in 2000, a study found that the exact opposite is true: a higher protein intake reduces bone loss in elderly people. 

Dietary fiber is another important nutrient for older adults. It promotes heart health, intestinal health, and protects against other metabolic issues. Also important are omega-3 fatty acids, which are found in many vegetable oils like walnut, flaxseed, and hemp oil as well as animal fats from fish, chicken eggs, and squid. These acids protect against cardiovascular issues and may also guard against diabetes and cognitive decline, although its full range of benefits are still being studied.

Fiber is also important for maintaining digestive health. Micronutrients like Vitamin E, Vitamin B6, Magnesium, Vitamin B12, Folic Acid, and Vitamin D are also chronically missing or underconsumed in the diets of most elderly people. 

Unfortunately, while most nutrition drinks might have some of these nutrients on the label, they aren’t an effective source for satisfying the nutritional needs of elderly people, or anyone else for that matter. 

What is in Nutritional Drinks?

Some of these nutrition shakes and other drinks might have large amounts of vitamins on the label, but there are also frequently high amounts of sugar, which can lead to unhealthy weight gain for elderly people. As an example, one 16 oz. bottle of Ensure, one of the most popular nutritional drinks on the market, has 220 calories and 14 grams of sugar. They say that much sugar only represents 28% of the daily value, but that’s based on a 2,000 calorie daily diet. Elderly people very rarely reach anywhere near that amount. 

Even for someone who does eat 2,000 calories a day, drinking almost a third of your sugar intake in a single sitting and getting only 10% of your calories from it is not a healthy balance. For elederly people who are struggling with glucose control or have blood sugar problems, this can be a huge issue. 

Furthermore, a bottle of Ensure lists 14 vitamins and 13 minerals. That single serving represents anywhere between 20 and 50% of the recommended daily value for vitamins like vitamin C, vitamin D, vitamin K, biotin, choline, niacin, and riboflavin, among others. It’s a similar situation with the minerals. 

That may sound nice enough, and for people who do need around 2,000 calories per day and want to make sure they get some healthy nutrients, a bottle of Ensure can be a nice supplement. But if an elderly person is drinking more than one or two bottles per day, they can get way more nutrients than they need. 

For some of these vitamins and minerals, that won’t lead to any huge issues. If they’re on medication, there can be complications from high levels of certain things that interact badly with what’s in their medicine. 

Over consuming vitamins and minerals can also cause side effects like dizziness, vomiting, and diarrhea, and might even increase the likelihood of heart disease and cancer. Vitamin deficiency is bad, but if an elderly person is already experiencing a loss of appetite and they begin to have problems with their digestive system because they overconsume nutritional drinks on a daily basis, they’re going to stay away from food even more to avoid trips to the bathroom

3 Ways to Fit Nutritional Drinks Into Elder Care Diets

Whether you’re looking after a loved one or working as an elder care professional, there are many ways to effectively use nutritional drinks like Ensure or Boost to help people who are experiencing appetite loss. However, take care to meet with a licensed dietician or a physician before settling on a diet plan to make sure you don’t cause any health issues.

1. Use Nutritional Drinks as a Snack

The nice thing about these drinks is they aren’t very good at satiating appetite. Since they don’t cause people to get that “full” feeling, they can be consumed in the afternoon or between meals. Doing so will allow the elderly person to keep doing what they should be doing, which is getting the majority of their nutrients from real, whole foods like veggies and high-quality protein from meat or dairy products. 

When you are experiencing loss of appetite, mealtime can be more like a dreaded chore than the break in the day that most of us might see it as. Filling in the gaps, or even using one of these drinks as a reward for eating a meal earlier in the day, can be a nice way to help elderly people avoid repetitive patterns that can cause depression after long periods of time. 

2. Make Your Own High-Protein Nutritional Shakes

If the appeal is the easy digestion, the smartest thing to do is make them from scratch using real, whole foods so that the elderly person is still getting the food they would get from a healthy diet of solid foods. Using egg whites, milk, or nut ingredients can help boost their protein consumption, which will be good for maintaining lean muscle mass and keeping the immune system in working order. 

You may also be able to find a protein powder that isn’t too high-calorie. Making nutrient shakes with protein ingredients is also a great way to use ingredients that are sweet enough to taste even when the sense of smell and taste are receding. Peanut butter is a great option to add to a nutrient shake. You can even add some ice cream or rich chocolate for an additional treat. 

There is some evidence that blending certain fibrous ingredients reduces their usefulness in the body. Some ingredients like bananas and flax seed blend up without destroying their nutritional content. With a little research, it’s easy and fun to find out what ingredients work best and suit the taste of the older adult best. 

3. Prevent Dehydration with Nutritional Drinks

Dehydration is a serious problem with older adults. This is doubly true if they have reduced mobility or don’t tend to work up a sweat during the day or if they have incontinence issues they feel embarrassed about. There are some homemade versions of these drinks that aren’t dairy-based but rather involve substantial amounts of water. Mix fruit or citrus together with water and it will be much more palatable. 

The nutritional benefits of drinking enough water are numerous no matter how old you are. It helps with all bodily processes and it might even help build up a little bit of an appetite, depending on the reasons for the loss of appetite in the first place. 

Drinking enough water can also help maintain the urinary system, although if there’s a background cause this may not be the case. Metabolism may get a boost when the elderly person isn’t dehydrated, plus brain function could improve and the likelihood of kidney disease will go down.

How Many Nutritional Supplement Drinks Can You Drink in a Day?

This is a critical question, even for younger adults who use drinks like Boost or Ensure as nutritional meal replacement. There’s a different answer for manufactured drinks with lots of sugar and the healthier homemade kind. 

For the drinks you can buy from companies like Nestle or Ensure, it’s really not wise to drink more than two a day. Now, the advice is split on this point. Some registered dietitians say you should only drink one of these nutritional drinks if it’s replacing a meal, while others say they should only work as a snack because they don’t actually give the same well-rounded nutritional value of a healthy diet made up of solid whole foods. 

Using these drinks for meal replacement is really only advisable if it’s temporary, irregular, or due to an emergency condition and therefore recommended by a physician or registered dietitian. The bottom line is they can create problems of their own and only real whole foods will give elderly people the nutritional balance they need to enjoy their older years. 

Ensure’s website says elderly people can have up to size of these drinks a day, but that would give them three times the amount of vitamins they need based on a 2,000 calorie diet. If someone is in a state where they’re drinking that many nutritional drinks a day, they’re creating new problems with their diet. 

Many times, organic juices are a great supplement to a healthy meal instead of other “nutritional drinks”.

Hidden Side Effects of Nutritional Drinks

The issue with many elderly care diets is that either the person themselves or the people taking care of them are still thinking about diets as if it were for a younger person. It might not be the case that low-fat options are always the best choice. In the end, if you can get them to eat any kind of solid, whole food, it will always be preferable. Bodily processes will be regulated and it can help boost the mood of the elderly person. 

The mental side effect of over-reliance on these drinks is often overlooked. But elderly people, even if they have memory loss or other cognitive issues, are frequently aware that they are living on a liquid diet. This can also lead to diarrhea, and that’s even more embarrassing. The feeling that they are no longer normal or capable is one of the worst feelings, and feeding them a steady diet of nutritional drinks might make that situation worse. 

Another side effect of nutritional drinks for seniors is that they can be habit-forming. It’s not that they’re addictive or anything that bad, but if they become the routine it can be difficult to break out of that. If the structure of the elder care is such that there isn’t someone around to cook at all times and the elderly person can’t do it themselves, then the nutritional shake will become the norm. If they contain a lot of sugar, they’ll be increasingly appealing as people build up a taste for them. Breaking out of that cycle with whole foods can be difficult. 


The bottom line is that these nutritional drinks can be a great help if they’re just used to fill in gaps a few times a week. There are plenty of ways to use smoothies and other nutritional drinks to build a healthy diet in elder care. Using them to prevent dehydration is one way. They can also be high-protein and help to keep the body working normally. 

If you are going to use nutritional drinks in elder care, the best way to do it is to use whole foods and blenderize them to make a drink that is full of nutrients and won’t oversaturate the body with a flood of vitamins and minerals. Overconsumption of vitamins and minerals can lead to diarrhea and other issues, to say nothing of consuming loads of sugar in manufactured drinks like Ensure or Boost. The homemade shakes are almost sure to be tastier than the store bought variety anyway, and it will add more variety to the diet to prevent repetition and brighten the elderly person’s mood overall. 

Nutritional drinks can interact poorly with medications. If you are trying to formulate a healthy diet for an elder care patient, check with medical professionals and registered dietitians before making significant changes. Many times, you can bring a list of current medications and work out a healthy diet with a registered dietitian so that you can be sure it’s tailored to the individual person. 

How to Find Transportation Services for Seniors

Chronic diseases like arthritis and the effects of aging on physical activity levels, strength, and balance can all lead to reduced mobility in seniors. Just because they may have some degree of doesn’t mean older adults don’t still have regular errands like medical appointments, trips to the grocery store, pharmacy runs and other healthcare-related necessities, or visits to loved ones. Transportation for seniors can be challenging to navigate, but luckily, current technology is making it easier and faster to get a loved one safely where they need to go.

Standard transportation options such as the metro or bus may not be feasible given the health and range of mobility of a given elderly person. There are other options, though, such as paratransit services, ridesharing apps like Lyft or Uber, or volunteer drivers who are happy to help seniors get around. 

Emergency transportation to a doctor’s appointment or the emergency room might be covered under Medicare/Medicaid or private insurance providers. These types of plans might even have some allowance for transportation options, including ridesharing apps. For older adults who aren’t able or just prefer not to use smartphones, there are other apps like GoGoGrandparent that will allow them to use rideshare apps like Lyft and Uber in the USA by calling one of a pair of phone numbers. 

Security is one of the biggest concerns most people have when they use one of these transportation options for a loved one. Rideshare apps like Lyft and Uber typically display the make, model, and license plate of the car. Family members can see exactly where their loved ones are through the app and set an exact pick-up and drop-off point. Some private transportation options even have door-through-door service, which means the driver will help elderly fares to the front desk or lobby of a building. 

Finding transportation for seniors can be worrying, but it doesn’t have to be. Read on to find out all the different ways to help seniors with limited mobility continue their daily routine safely.

Loss of Mobility and Its Adverse Effects

Beyond directly impacting their ability to move around on their own, loss of mobility can also have lasting repercussions on elderly people’s mental health, social life, and physical wellbeing. In fact, as this study mentions, mobility is a crucial determinant of health and quality of life among elderly people. 

If the loss of mobility is less severe, like minor arthritis, then it might only prevent the elderly person from walking sometimes. However, more serious medical conditions or loss of strength can cause elderly people to stay inside all day. If loss of mobility leaves someone stuck sitting down for most of the day, the amount of lean muscle in their body will continue to dwindle, meaning their mobility level will be on a continuing downward slope. 

In the most severe cases, the inability to get up and go to the restroom can lead to physical problems like UTIs or body sores. People weren’t meant to stay inside all day with little contact. As elderly people with limited mobility lose touch with friends and loved ones or go through entire days with little to no stimulation, they can quickly become depressed. That can have adverse effects on their appetite, leading to many other health problems. 

Finding transportation for seniors is not just about getting their errands done. It’s the only way to make sure they can continue truly enjoying their golden years the way that they want to. For some seniors, a loss of mobility reduces the activities they can take part in. But there are still plenty of ways for them to get around. 

Public transport can be one of the cheapest option for elderly people if they are able and if you can come with them.

Public Transit for Older Adults

Navigating a metro or bus system can be frightening for elderly people. Unlike private transportation, the other people on public transit systems won’t necessarily concern themselves with the needs and conditions of elderly people sharing their bus or train. 

In the United States, most cities have buses if they have any public transit available at all. However, in some places, there are additional public transportation options. The Americans with Disabilities Act (ADA) has set forth requirements for fixed-route public transit, making it more accessible and easier to use. For older adults who are able, one of the following might be a great way to get around:

Above-Ground Public Transit

Your city might have bus routes, light rail, or streetcars to help people traverse a few blocks or several miles. Many people may not be familiar with how the public transit in their system works, but the ADA lays out some standards that make buses, rail, and stations much easier for older adults. For example, the ADA says every public transit facility must have accessibility equipment like lifts, ramps, and security devices to keep wheelchairs from moving. 

Signs and communication devices (i.e., stop announcements) must also be clear and accessible to everyone. They offer braille and large print options. As long as the elderly person is capable of navigating the route, there are many ways that public transit has been made accessible thanks to the ADA.

Below-Ground Public Transit

In the USA, only about 15 cities have subway systems. In some cities like Atlanta and Charlotte, the commute time can be twice as long on the metro than it would be with private transportation. However, in larger cities like New York City and Chicago, the subway can be the fastest way to get around. It may seem scary sending an older loved one off on a metro train. Still, these forms of public transit are also obliged by the ADA to give priority seating and accessibility options, just like the above-ground transportation options. 

The most important consideration to make with regards to public transit is whether an elderly person has had experience with navigating such a system before. If they have never lived anywhere with a subway, sending them into the cavernous NYC Subway is probably going to overwhelming. However, if they took buses and trains in their younger years, continuing to use them while they’re able could not be the best way, but it could also be a comfort to them to take public transit.

Paratransit Services

Vans specially tailored for people with impacted mobility are mandated by the ADA, albeit only where fixed-route services already exist. It’s up to the specific public transit area agency to decide whether they want to offer door-to-door service or curb-to-curb service. If an elderly person does have extreme difficulties getting from the curb to the door, or if there are barriers in the way, the driver may also be obligated to help them to the entrance or lobby of their destination. 

These paratransit services are only required to cover a distance of ¾ of a mile past either end of an existing fixed-route service, so they’re only handy in cities that have a robust public transportation system. However, they are specifically aimed at elderly people who have suffered a loss of mobility or have a disability, so if they are available, they’re a great help. 

How to Find Transportation Services for Seniors

Besides public transit, there are many private transportation options to help seniors go about their daily business, visit loved ones, and go to doctor’s appointments. Here are some of the most convenient ways for older adults to travel:

1. Rideshare Apps (Lyft, Uber, etc.)

The gig economy is still in its infancy, but companies like Lyft and Uber have made it easier than ever for a car to pick up riders at their doorstep and take them to a specified drop-off point. They are geared toward people who can use a smartphone, but services like GoGoGrandparent allow elderly people to use Lyft and Uber by calling a phone number rather than having to learn how the app works. 

Most of the time, Lyft and Uber rides function as private transportation, meaning there won’t be anyone else in the car other than the rider. For elderly people, a caretaker or loved one can ride along without any added expense. These apps are generally inexpensive, usually costing less than a taxi, but there are fare increases at peak hours. As a fringe benefit, the elderly person will have someone to talk to during the ride. 

One beneficial thing about rideshare apps is that they might be covered by Medicare/Medicaid or private insurance. Frequently, to provide non-emergency transport to the insured without ado and at the lowest possible cost, the insurance company will call an Uber or Lyft driver. That means the insured won’t have to bother with an app or a phone call, and the insurance will get billed. 

2. Taxi Services

Perhaps the first idea many people think of when they need fast transportation, traditional taxis can still be hailed by phone and trips scheduled in advance. However, in many places, taxis have fallen behind rideshare apps like Lyft and Uber in terms of technology, which means they might be difficult for elderly people to use. They’re often quite expensive. 

If the cost is not so important, then taxis can be a great form of non-emergency transportation for short distances. Like public transit, taxis are most appealing to elderly people who have spent their lives riding in taxi cabs. 

3. Demand Response, a.k.a. Dial-A-Ride

Many municipalities provide a service where senior citizens can schedule a pick-up and drop-off with an accessible vehicle. Usually, there are many people with individual pick-up and drop-off points, so these are different than the paratransit option that depends on the existence of fixed-route public transit.

If there is no public transit available, demand response might be the best option. For example, Santa Barbara, in California, doesn’t have a metro, but it does have a bus system. To use the Dial-A-Ride service there, people must be physically or mentally unable to use the bus service. That way, it’s guaranteed the service reserves to help seniors who need it.

4. Medicaid Non-Emergency Medical Transportation

For Medicaid beneficiaries who need help getting to medical appointments, the Non-Emergency Medical Transportation (NEMT) Medicaid provides is likely to be the best way to get to the doctor. Medicaid doesn’t require pre-approval for emergency medical transportation like ambulances or medical aircraft. They do, however, pre-approve the type of destination that NEMT will cover. 

While it only works for transportation to doctor’s appointments, hospitals, and other pre-approved locations that have to do with health care, it’s convenient for elderly people who are already covered by Medicaid. If they are covered, NEMT is the only transportation service that is free for Medicaid beneficiaries. Unfortunately, the same coverage is not offered to Medicare beneficiaries. 

5. Transportation Voucher Programs

Local and state governments are typically involved with the implementation of transportation voucher programs. Participants receive an allowance of either trips, miles, or dollar amounts to use for school, religious trips, health care appointments, shopping, and other categories. These vouchers might be awarded on economic status or based on mental or physical faculty. 

Each town, city, municipality, or state runs its voucher programs differently, and there aren’t necessarily voucher programs in every place. Check with the local governments or use the Eldercare Locator to see if there’s one in your area.

Transport services like Uber can be convenient for elderly people who might not be able to drive any longer.

6. Volunteer Transportation Programs

Frequently operated by faith-based organizations, these programs are a great way to get rides with customized pick-up and drop-off points with a volunteer driver who is kind and friendly. Just like all the other transportation options, the presence and availability of volunteer programs vary with location. Some may have limitations in distance or number of trips per week, and they definitely should only be used as non-emergency transportation. 

One nice thing about volunteer programs is that volunteer drivers are frequently young people or family-oriented. Plus, they’re doing it entirely as a service, so they’re much more likely to be conversational and allow for more customized journeys.

Learning to Use Public Transit for Seniors

There are also many programs, frequently operated by the public transit authority itself, that will introduce public transit and teach elderly people how to do it. If the loss of mobility isn’t severe or the elderly person is completely capable, then learning how to travel with public transit can be a fun learning experience. Of course, these programs are as limited as access to public transit is in the USA. But many cities have bus systems and might have travel training with a local area agency to help seniors get around on public transit on their own. 

Private Transportation & Senior Care Services

Where the budget allows, hiring an in-home caretaker might be the best way to ensure an aging loved one is protected and can still live normally. In many cases, the caretaker might have their own vehicle, so offering the client some transportation from time to time could be included in the payment. This will require discussion, but it’s not an unusual request for caretakers to occasionally drive clients around. 

This option also gives elderly people the ability to have one person they’re familiar with helping them. Look out when shopping around for a caretaker, though. Many of them are working for home care services that want to maximize their client base to make more money, so the caretaker may only have an hour or less to visit and take care of meals and other things for the client. If you want transportation options with a family caregiver, it will probably have to be a private agreement for long-term care to make sure they’re concentrating on your loved one.

When to Use Senior Transportation Services

When an aging loved one can’t get around quickly enough, the choice to use other transportation options is clear. However, many older adults have trouble recognizing when they should give up driving in their own personal vehicles. It can be a tough choice because, as we all remember from our teenage years, driving is tantamount to personal freedom. 

In one article, the University of Alabama recommends asking two questions to help determine whether alternative transportation options are needed. 

  1. For health or physical reasons, do you have difficulty climbing up ten steps or walking a quarter of a mile?
  2. Because of underlying health or physical reasons, have you modified the way you walk ten steps or walk a quarter of a mile?

These two questions are a helpful test of mobility loss because it still leaves the person in question in control. Hearing that you can’t drive anymore from a doctor is one thing, but admitting it to yourself on your own terms is more manageable. 

Also, remember that failing eyesight and mental ability, including reaction time and spatial awareness, can also affect the decision to stop driving or to use more independent transportation options like public transit. It will take some serious consideration, but in the end, it will depend on the unique condition of the elderly person. 


Finding a low-cost transportation option for seniors can be challenging, especially in areas without public transit options. Senior citizens have many options for scheduling transportation, or they may have access to travel training programs that can show them how to use public transit. 

For those who are uncomfortable or not capable of making their way to a bus stop and navigating the fixed-route transit system in their city, there are also options from Medicaid and volunteer programs that work to fill the gaps. 

Deciding to stop driving is painful and emotionally challenging for many senior citizens. Transportation needs don’t change just because we can no longer drive ourselves. However, when that time comes, there are still plenty of other transportation options that allow aging loved ones to get around on their own or with help so they can spend their golden years the way they want. 

How You Can Get Paid for Being a Family Caregiver

Becoming a family caregiver is done unexpectedly for most people. Normally, it’s brought on by unforeseen circumstances or a sudden change in the health of an aging parent or loved one. It can begin with small tasks and then balloon until a family member is taking care of filling prescriptions, doing laundry, cooking, and even bathing and feeding a loved one.

According to the Family Caregiver Alliance, approximately 43.5 million caregivers provided unpaid care to an adult or child in 2015. All the evidence indicates that that number is increasing every year as the baby boomer generation ages. Unfortunately, although the economic value of unpaid caregiver services was estimated to be $470 billion in 2013, it’s very rare that there is any way to be paid for any of the work. 

Unless the care is paid for by Medicaid or another organization, the only way to get paid is to have the family member receiving care or other family members contribute to the payment of the caretaker. There are a few ways to reach such an agreement, but it can be complicated and many families find themselves arguing or overreacting about such payment when under duress because of the failing health of a loved one. 

Of the ways that family caretakers do manage to get paid for their efforts, Medicaid is one of the most popular. Medicare does not cover any payment to family caregivers at all, but Medicaid has a provision called the 1915(c) HCBS waiver that might allow it. However, it’s left up to the state to define how Medicaid is rolled out and how their home- and community-based services (HCBS) are implemented and what the eligibility requirements are. 

Eldercare can be incredibly taxing on families. Long-term care can stretch budgets and strain relationships, and while the amount of reimbursement the limited options available do give family caregivers is not much, it can help with daily costs and, in some cases, defer the opportunity cost of giving up a paying job to take care of a loved one. 

Money payment for senior care done by a family member is hard to come by. To get it, you might have to live in the right place or have the right kind of insurance. There are many organizations out there to help family caregivers get financial assistance or reimbursement for certain types of home care. The whole process can seem overwhelming and an elder law attorney might be required to truly know whether there’s a way to get paid. 

It would be impossible to write a guide that could say for sure whether a given reader could get money for eldercare. But this article will serve as a solid jumping-off point and hopefully give you some ideas of where to look if you want to be a paid caregiver for an elderly parent or other family members. 

What is Eldercare? Home Services vs. Health Services

First things first, you should make sure you’re doing the type of thing that’s widely considered family caregiving. There is a wide range of duties that a family member might take on for another who needs it. These can be divided into two categories, which are home services and health services. Home services are non-medical and don’t require a license to perform, which is why family members so often become responsible for them. 

Examples of home care services include what are referred to as Activities of Daily Living, or ADL. Everything we have to do in our daily lives becomes an activity of daily living for aging people who can no longer perform all or some of these tasks themselves. 

It might be grocery shopping, cooking, cleaning, transportation, or laundry for elderly parents. It could also be assistance with doctor’s appointments, taking medicine, getting dressed, using the bathroom, or bathing. If there’s a bigger loss of mobility, it might be necessary to help with getting out of bed or performing medical assistance with physical therapy, breathing treatments, wound cleanings, injections, or feeding tubes. 

Health services are more complicated and should be taken care of by a physician or trained professional. Day-to-day medical case management is often done by an RN appointed by the physician. Catheters, IVs, parenteral nutrition, speech therapy, occupational therapy, and serious wound care all fall under this category.

Then there are all the legal and financial things we all have to handle. Between monitoring payments, bank accounts, wills, and insurance payments, eldercare is essentially doing the work of two lives at once. If there aren’t other family members to help and the care recipient is completely unable, a single person can quickly be overwhelmed. 

One role of a caregiver to to help their patients perform tasks they are no longer able to perform as easily on their own.

10 Ways to Get Paid for Family Caregiving

As difficult as providing for an elderly parent or other care recipient is, navigating the complicated system of government eligibility requirements, classifications, local regulations, and health insurance policies to try and get paid for family caregiving can be a nearly endless process and that payment may well never come. 

Luckily, so many people are family caregivers that it’s easy to say which methods are most likely to get you paid as the primary caregiver. Here are 10 places to start your search:

1. Veteran’s Aid

There are many government programs that could possibly pay family members for senior care, but the U.S. Department of Veteran’s Affairs (VA) is one of the most likely. They have a Family Caregiver Assistance program that has two eligibility requirements. The person rendering care services must be either a spouse, son, daughter, stepfamily, or extended family member, and they have to live full-time with the care recipient or be willing to do so once designated as a family caregiver. Secondly, the care recipient must have been discharged from the U.S. military or have a date of medical discharge and have a serious injury (including TBI, psychological trauma, mental disorder, etc.) that was caused or made worse by their active duty service on or after September 11, 2001.

The care recipient should also require a family caregiver for at least six months. This program allows the care recipient to appoint one primary and two secondary family caregivers. They may receive a monthly stipend, health care benefits through the VA’s civilian health department (CHAMPVA), and up to 30 days of respite care per year in addition to education and counseling resources and transportation reimbursement if the care recipient needs to travel to receive care. 

In case the care recipient is a veteran but doesn’t qualify for the Family Caregiver Assistance program, they might be covered under the VA’s Program of General Caregiver Support Services, which has much more general eligibility requirements. The VA also has Caregiver support coordinators and a helpline. 

2. Social Security Supplemental Security Income Benefits

If the care recipient is eligible for and at least apply for regular social security benefits to qualify for SSI. Other eligibility requirements include being between the ages of 18 and 65, having never been married, not being blind, being a U.S. citizen residing in one of the 50 states, D.C., or the Northern Mariana Islands, and not having received SSI benefits in the past. Unlike regular Social Security payments, the SSI program doesn’t depend on contributions from paychecks in the past. 

There are some other benefits that are typically available to care recipients who qualify for SSI, such as SNAP or regular Social Security payments. Just like these other programs, SSI is reserved for low-income individuals. 

3. Medicaid Cash and Counseling Program

Cash and Counseling provides payments to a care recipient for the duration of the time they need care. Of course, since it’s a Medicaid program, its exact parameters are decided at the state level, which means you’ll have to see what the eligibility requirements are and how much caregiver support you can expect to get from a cash and counseling program. 

Cash and Counseling is a self-directed program. The basic idea is that in order to better align with individual preference and reserve professional medical facilities for those who have no other options, Medicaid recipients should be able to hire their own caretakers. This is done after a physician assesses the care recipient’s needs with the caretaker and outlines a weekly personalized care plan that allows for an estimate of hours per week or month that will be required for the caretaker to deliver the care. From that care program estimate, a budget amount is decided and monthly stipend granted.

Qualifying Medicaid beneficiaries can benefit from more control and a more personalized care plan with a Cash and Counseling program, but make sure that the family caregiver isn’t overworked. Some states may have additional steps for the assigned caretaker, such as licensing or paying some payroll tax out of payments they receive through the Cash and Counseling program.

4. Family Caregivers Tax Credits

The IRS has something called the Family Caregivers and Self-Employment tax. As with all taxes, this one is a bit complicated to understand. Generally, it applies to people who are employed to provide in-home care whether or not they are related to the care recipient. If the caregiver is a family member, there is a chance that no tax will be owed, but the caregiver could still be obligated to pay an employment tax on the payment received. In almost all cases, payment received for rendering home care services should be reported on the family caregiver’s taxes, even if the caregiver isn’t required to pay taxes on it. 

Claiming an elderly parent as a dependent when they are housebound or otherwise unable to care for themselves might be the most direct way to deduct payments for medical services and other needed health care from your taxes. Generally speaking, it’s required that you pay for 50% or more of their cost of living to be able to claim elderly parents as dependents. It’s even possible to claim a friend or honorary family member as a dependent if they have lived with you for a year or more. 

Deductions for medical care are mostly only available for bills paid out that have not been reimbursed by health insurance, including flex spending and health savings accounts. If the situation surrounding the care recipient meets the eligibility requirements, the family caregiver can claim up to $3,000 per individual and up to $6,000 for two or more. 

5. The National Family Caregiver Support Program

This government program gives grants to states based on the amount of their population that is over 70 years old. One of the central goals of this program is to assist family caregivers and make it easier to care for elderly parents at home as long as possible, rather than sending them to an institution or nursing home. It covers several things, including:

  • Assistance and information to caregivers about accessing services
  • Counseling, support groups, and caregiver training
  • Supplemental services
  • Respite care

The availability to have paid respite care is essential for family caregivers to avoid burnout, especially when rendering long-term care. If there’s only one primary caregiver, going long periods without any breaks can lead to stress and have negative effects on overall mental health. This could cause resentment for the entire situation. Here are the eligibility requirements for the National Family Caregiver Support Program:

  • Adult family members or other informal caregivers age 18 and older providing care to individuals 60 years of age and older
  • Adult family members or other informal caregivers age 18 and older providing care to individuals of any age with Alzheimer’s disease and related disorders
  • Older relatives (not parents) age 55 and older providing care to children under the age of 18; and
  • Older relatives, including parents, age 55 and older providing care to adults ages 18-59 with disabilities

For more information on the NFCSP, click here.

A long-term healthcare policy can potentially cover a caregiver’s expenses.

6. Purchase a Long-Term Care Insurance Policy

The best way to stay prepared for the financial burden of the high level of care aging parents will need in their later years is to buy a long-term care insurance policy through a well-known company like AARP well ahead of time. The downside to these plans is that they can be quite expensive, but if you are protected by one, these policies can cover medical expenses that aren’t covered by traditional health insurance. It will vary with the policy, but they are generally used to cover the activities of daily living like bathing, dressing, and getting in and out of bed. 

Long-term care insurance policies are tricky because most won’t let the care recipient apply for coverage if they already have a debilitating condition like Alzheimer’s. It’s wisest to buy the coverage in your 50s or 60s well before you need it. In the end, it will be much cheaper to have coverage through one of these policies, which are great ways to make up for what normal health insurance and Medicare don’t cover.

Another thing to make sure of when you buy the policy is whether or not it will cover payments to family caregivers. Not all long term care insurance does, and even worse, if they don’t offer this coverage then the insurance agent won’t even bring it up most of the time. Asking about it upfront is critical to get coverage and have a family member as a live-in paid caregiver.

7. Take Paid Family Leave

These days proper paid family leave seems to be vanishing at most companies, but if you are lucky enough to have it then it might include payments for family caregiving. Check and see if your paid leave does have this provision and see how long it lasts for. The worst part about this strategy is that it likely won’t last long, so it’s a better stopgap option than a long-term plan. Large companies tend to offer something like 3 – 4 months for family caregiving, but if it appears the care recipient will be in need longer than that, paid leave can still be a nice way to get paid while the family figures out a game plan.

8. Pay for it As a Family

If there is more than one primary caregiver or at least some siblings or other family members to help, then there are two ways that the family can pay the caregiver. The simplest way is to simply pool some money together and give it to the caregiver for expenses. Many families that try this run into trouble, though, because the stress of the situation can lead to arguments and occasionally even ruined relationships. 

If the care recipient has some money put away, it can also be used to pay for the care. Just like the pooling option, though, this one can lead to disputes. In both cases, it would be extremely wise to work with an elder law attorney beforehand to draw up a personal care agreement that clearly states the duration, amount, and duties of the primary caregiver. It’s the smartest way to keep everyone in the family on the same page, plus everyone can come together to work on the personal care agreement together. 

9. Medicaid Waivers and HCBS

HCBS, or home- and community-based services, are implemented using Medicaid waivers that allow states to come up with custom ways to roll out the Medicaid program. Like the other options that stem from Medicaid, HCBS will depend on the care recipient’s Medicaid eligibility. HCBS is a way to offer in-home supportive services and personal care services to those who need it. 

Here are the eligibility requirements for states’ HCBS programs:

  • Waiver services mustn’t cost more than providing these services in an institution
  • Care recipients and other participants’ health and welfare must be ensured
  • Standards used to meet the care needs of the target population must be reasonable and effective
  • The plan should create individualized and person-centered plans of care

For now, almost all states have some form of HCBS programs in place. The waiver programs that most consistently lead to personalized consumer-directed care plans are in states like New Jersey, Rhode Island, New York, and California. State Medicaid programs vary widely, so you’ll have to check with your state’s Medicaid website.

10. Find Funding Through Private Organizations

There aren’t many organizations that will pay family care providers and the ones that do exist tend to concentrate their efforts on care recipients with specific mental health or cognitive issues like Alzheimer’s or Parkinson’s. However, care recipients with these diseases do have long-term care needs that are more intense than others. Regardless of whether your loved one has these specific issues, it’s fairly easy to check for private charities or faith-based organizations that can help out, even if it’s only a little bit. 


As relatives age, the relationship dynamic changes between them and younger family members. Sometimes, they can be more like adult children than grandparents, aunts, or uncles. Regardless, almost everyone needs some degree of home health care at some point and the vast majority of people rely on family members to tend to their care needs. 

This arrangement can be very stressful for family members and a significant reason for that is the financial strain. Many people forsake their own careers and life goals for a time to care for an elderly parent or relative and getting paid for that effort can reduce stress, burnout, and other negative mental health effects. 

There are many ways to attempt to recoup the costs of eldercare. State Medicaid programs are a great place to start depending on the care recipient’s Medicaid eligibility. Other government programs may have long waiting lists and, just like long-term care insurance, it’s best to investigate coverage before it’s needed. 

Many places have area agencies for location-specific plans like HCBS. Finally, arrangements with family members to pool money or make a personalized care plan are great options if there are enough people, but it’s wisest to hire an elder law attorney to avoid disputes. If you are able to find a way to get paid for being a family caregiver, it can be a huge relief.