Month: June 2022

As people get older, there are a number of changes that may occur in their sleep schedule. There are a number of sleep problems that become common among elderly adults. Often, elderly people have trouble falling asleep or have poor sleep schedules.

This is often caused by waking up in the middle of the night due to decreased bladder control or trouble falling asleep, to begin with, due to chronic pain or some other type of discomfort. 

However, on the other side of things, another condition that may arise is sleeping too much. There are many elderly people who engage in daytime sleeping in addition to a full night’s sleep. This can be worrisome for both the elderly person sleeping so much and an elderly person’s family members or caregivers.  

This is why it is so important to find the underlying causes that might make an elderly person sleep so much. Usually sleeping too much is a sign of a different problem, and it is important to figure out what that problem is. Aging has a number of effects on a person’s health, and sleep is one of the main factors that determine a person’s health.

In this article, we briefly go into some of the common effects aging has on elderly people’s sleep habits. Then we will delve deeper into why an elderly person might be sleeping so much. We end the article with some suggestions for optimizing the sleep schedule of the elderly. 

How Does Aging Affect Sleep? 

Aging affects everyone in a different way. There are many people that suffer no severe sleep disturbances as they age, while there are other people whose sleep quality is deeply affected. Despite people being affected differently, experts have found some common sleep changes that aging may have on people. Below, we list some of the most common effects of aging on sleep. 

What is Excessive Sleep in the Elderly?

It can be difficult to know what is normal when it comes to sleep and what is a sign that there’s a bigger issue at play. No matter your age, good sleep is one of the most important aspects of overall health.

It allows our bodies to heal and repair, curbs inflammation, wards off depression, improves our ability to think clearly and reason, improves memory, lowers our risk of obesity, and much more. When we don’t get enough sleep, we are at a higher risk for many physical and emotional illnesses, as well as poor judgment, falls, and other types of accidents.

Some sleep experts suggest that seniors actually need less sleep than other age groups. Most people need between 7 and 9 hours of sleep whereas many seniors can get away with 7.5 hours. Other experts believe that seniors need just as much sleep as the rest of the population.

One way to gauge excessive sleep is to not be alarmed if an elderly person is sleeping as much as is recommended for the average adult population but take notice if they are sleeping more than the average population. Another sign of excessive sleep is if an elderly person is sleeping at strange times during the day.

Since a lot of elderly people actually suffer from sleeping problems, causing them to have poorer sleep quality and numerous impediments to a full night’s rest, it can be perfectly normal for an elderly person to take a sort of regenerating nap during the day. These kinds of sleeping habits can go too far, however.

If they are sleeping for large portions of the day in addition to sleeping at night, this can be cause for concern. Below, we go over some of the common reasons that elderly people may be dealing with excessive sleeping problems.

Reasons for Excessive Sleep in the Elderly

1. Boredom and Lack of Engagement

As people age, they may suffer from chronic health conditions and age-related changes that affect their ability to do the things they enjoy. When options for outings, activities and entertainment are limited, it can deal a serious blow to an elder’s quality of life.

They aren’t working anymore, they may struggle with reading or puzzles because of poor eyesight, and watching TV eventually gets old. In these cases, elders may not be clinically depressed or even all that tired. Instead, their fatigue stems from the fact that they are incredibly bored. With no schedule to keep and not much to look forward to in their lives, they slide into the habit of napping throughout most of the day. 

In other words, an elderly person might suffer from daytime sleepiness simply because there is nothing else to do. If you are a loved one or a caregiver, one of the first steps you should take if you notice that your elderly loved one or person in your care is sleeping to much is to make sure that they are able to find engagement in various activities and that they do not deal with excessive boredom.

So much entertainment is geared towards younger generations, and even something like going out with friends for coffee or tea may not be as easily available for elderly people since movement can be difficult and it can be difficult to maintain friendships in later years.

This is especially the case if your elderly loved one has many friends who have passed away, as does, unfortunately, commonly happen. This only shows that it is imperative to organize activities to keep elderly people engaged. 

Ask the elderly person in your care what it is that interests them. If they like books, either make sure they have access to books that they can read by themselves, or, if they have trouble with eyesight, then try and find someone who can read to them.

Audiobooks are another great choice. Of course, reading is just one of an innumerable amount of possible interests, so it is important to gear these activities to things that actually interest the elderly person, rather than to impose what some might say an elderly person should be interested in. 

If you make sure that the elderly person in your care is not so bored and is more engaged with life, there is a high chance that they will start to change their sleep habits and stop excessively sleeping. 

2. Medication Problems 

Prescribing for older patients presents unique challenges. Premarketing drug trials often exclude older adults, and approved doses may not be appropriate for older adults [1]. Many medications need to be used with special caution because of age-related changes in pharmacokinetics (ie, absorption, distribution, metabolism, and excretion) and pharmacodynamics (the physiologic effects of the drug).

A survey in the United States of a representative sampling of 2206 community-dwelling adults (aged 62 through 85 years) was conducted by in-home interviews and use of medication logs between 2010 and 2011. At least one prescription medication was used by 87 percent. Five or more prescription medications were used by 36 percent, and 38 percent used over-the-counter medications.

These numbers just pertain to prescription drugs. Elderly people also take many more supplements and herbal remedies than the general population of adults.Use of herbal or dietary supplements (eg, ginseng, ginkgo biloba extract, and glucosamine) by older adults has been increasing, from 14 percent in 1998 to 63 percent in 2010.

In one study of over 3000 ambulatory adults ages 75 years or older, almost three-quarters used at least one prescription drug and one dietary supplement [12]. Often, clinicians do not question patients about use of herbal medicines, and patients do not routinely volunteer this information.

In one United States survey, three-quarters of respondents aged 18 years and older reported that they did not inform their clinician that they were using unconventional medications. Unfortunately, despite easy access to herbal remedies, herbal medicines may interact with prescribed drug therapies and lead to adverse events.

With the potential for so many prescription drugs and herbal remedies being used by elderly adults, there is a high risk that an elderly person’s medications could be a cause of excessive sleep.  All medications have side effects, so it should come as no surprise that taking multiple drugs can produce interactions that magnify these effects.

In addition, older individuals metabolize medications differently than their younger counterparts, meaning they are even more susceptible to adverse effects like drowsiness and dizziness.

Prescription drugs and over-the-counter medications for conditions like anxiety, depression, high blood pressure, insomnia, chronic pain, Parkinson’s disease, nausea, and allergies can all cause excessive sleepiness. Atypical (second generation) antipsychotics are notoriously hard on most elderly patients as well, especially those with dementia. 

If your loved one is using one or more of these drugs, discuss the side effects and alternative treatment options with their physician. You may even find that there are some medications in their regimen that could be reduced to smaller dosages or discontinued completely. Sometimes simply altering the timing of a senior’s doses can improve their alertness during the day.

3. Depression and Low Energy 

Although depression is not necessarily a normal part of aging, it can be mental health problems can be a common symptom as elderly people lose interest in life and often lose dear friends.

Given the wide array of factors that can lead to excessive sleep and daytime napping, it is often very difficult to pinpoint whether the cause is from a depressive disorder or some other factor.

Often other detrimental factors, such as chronic pain or lack of engagement can lead to depression, so a diagnosis of depression simply is not enough. However, it can be a good first step toward proper care.

If an elderly person in your care is sleeping excessively, it is prudent to discuss with their physician about whether they are dealing with depression. From there, better treatment, such as antidepressants, and (hopefully a recovery) may follow. 

4. Advancing Dementia

Seniors with Alzheimer’s disease or other forms of dementia often experience a wide array of sleep problems and changing sleep patterns, such as excessive daytime sleepiness, especially in the latter stages of the disease.

As the brain deteriorates, issues arise with circadian rhythms and temporal awareness, making it difficult for dementia patients to sleep through the night and keep a normal schedule. In some cases, sleeping during the day is the only way that patients can make up for the shuteye they lose at night.

Sleep deprivation can exacerbate symptoms of dementia like sundowning and agitation, and the resulting odd schedules can be frustrating for caregivers. Unfortunately, there aren’t many foolproof methods for helping a dementia patient sleep through the night and stay awake during the day, and neither over-the-counter nor prescription sleeping pills are typically advisable.

The Alzheimer’s Association recommends planning engaging activities during the daytime, scheduling brief naps as needed during the day and sticking to a set sleep schedule as the best nonpharmaceutical methods for encouraging good sleep habits.

A solid routine can be very effective in helping a loved one stay oriented and managing dementia behaviors. If an elderly person is suffering from advancing dementia, it may be a good idea to check them into a nursing home or set up home care for proper treatment. 

5. Poor Sleep Hygiene 

What might be perceived as excessive sleep may very well simply be a reflection of poor sleep hygiene at night. From chronic pain to restless leg syndrome, there are many potential contributing factors that may prevent an elderly person from getting a good night’s sleep or to fall into rem and deep sleep.

If an elderly person has trouble sleeping at night, their body might try to make up for it in the day. This might seem like the elderly person is getting an amount of sleep that is too much but, in fact, it could be that this sleep is necessary and only appears that they are sleeping too much.

This is why it is good to practice good sleep hygiene, and we have a few recommendations on how elderly people can get combat sleep disorders and get better sleep at night so that they don’t spend their days trying to catch up.

Sleep Hygiene Tips

1. Exercise: 

Older people who exercise regularly fall asleep faster, sleep longer, and report better quality of sleep. Exercise is one of the best things older people can do for their health. The National Institute of Aging offers helpful tips for exercising safely as an older person.

2. Reduce bedroom distractions:

Televisions, cellphones, and bright lights can make it more challenging to fall asleep. Keep the television in another room and try not to fall asleep with it turned on. 

3. Avoid substances that discourage sleep: 

Substances like alcohol, tobacco, caffeine, and even large meals late in the day can make sleep more challenging. Try quitting smoking, reducing caffeine intake, and eating dinner at least four hours before bedtime.

4. Keep a regular sleep schedule: 

Remember that aging makes it more difficult to recover from lost sleep. Avoid sudden changes in sleep schedules. This means going to bed and waking up at the same time every day and being careful about napping too long.

5. Develop a bedtime routine:

Find activities that help you relax before bed. Many older people enjoy a bath, reading, or finding some quiet time before getting into bed.

Moving Towards a Better Sleep Schedule

As we have shown in this article, there are a number of possible factors that may contribute to an elderly person sleeping excessively. Sleeping excessively is more likely than not an indication of some other health problem or other medical conditions that need to be fixed.

In order to improve the quality of life of an elderly person suffering from excessive sleep, it is important to contact a physician and get to the bottom of what’s going on, so the elderly person in your care can get healthy sleep consistent with normal aging nighttime sleep. 

UTIs or urinary tract infections in the elderly can cause serious health problems, making it all the more necessary to know the signs, the symptoms, and the treatment for UTIs in the elderly population.

What Are Urinary Tract Infections?

UTIs happen when bacteria enter the body through the urethra, which is the opening that carries urine from the bladder, and the immune system cannot fight off the bacteria. As a result, the bacteria multiply and can spread to the bladder and kidneys, causing an infection.

Typically, women are more susceptible to UTIs because the urethra is shorter, meaning bacteria doesn’t have to travel as far to reach the kidneys or bladder. However, seniors are also at a higher risk of a UTI because of weaker immune systems, chronic health conditions, urinary incontinence, reliance on catheters, or other factors.

UTIs can be treated with medication to kill off the bacteria. However, if left untreated, a UTI can cause kidney infections, kidney failure, sepsis, and other health problems. In fact, the infection can even spread into the bloodstream, leading to life-threatening infection and a long road to recovery. However, with proper care and attention, many UTIs can be avoided.

Why Are the Elderly More Susceptible to Urinary Tract Infections? 

Seniors are more vulnerable for many reasons, including their overall susceptibility to infections due to a weakened immune system. According to the National Institutes of Health (NIH), the following conditions make older individuals more susceptible to UTIs:

1. Diabetes

Diabetes is a serious disease and healthcare problem, and it affects many older adults. People get diabetes when their blood glucose, also called blood sugar, is too high.

There are two main kinds of diabetes:

• In Type 1 diabetes, the body does not make insulin. Although older adults can develop this type of diabetes, it begins most often in children and young adults, who then have diabetes for life.

• In Type 2 diabetes, the body does not make or use insulin well. It is the most common kind of diabetes. It occurs most often in middle-aged and older adults, but it can also affect children. Your chance of getting type 2 diabetes is higher if you are overweight, inactive, or have a family history of diabetes. Women with a history of gestational diabetes (a type of diabetes that develops during pregnancy) also have a greater chance of developing type 2 diabetes later in life.

2. Urine retention

Weakening of the bladder and pelvic floor muscles can lead to incomplete emptying of the bladder and incontinence. Urinary retention is the inability to voluntarily urinate. Acute urinary retention is the sudden and often painful inability to void despite having a full bladder.

Chronic urinary retention is painless retention associated with an increased volume of residual urine.2 Patients with urinary retention can present with a complete lack of voiding, incomplete bladder emptying, or overflow incontinence. Complications include infection and renal failure.

3. Use of a urinary catheter

Urinary catheters are used to help alleviate the symptoms of urinary retention and urinary incontinence, both of which increase the likelihood of getting a UTI. Unfortunately, the use of urinary catheters can also increase the chance of getting a UTI since, if not properly sanitized, it can introduce unwanted bacteria into your organs. 

4. Bowel incontinence

Types of bacteria that are normally found in stool, such as E. coli, are commonly responsible for UTIs. Bowel incontinence is an inability to control bowel movements, resulting in involuntary soiling. It’s also sometimes known as fecal incontinence.

The experience of bowel incontinence can vary from person to person. Some people feel a sudden need to go to the toilet but are unable to reach a toilet in time. This is known as urge bowel incontinence.

Other people experience no sensation before soiling themselves, known as passive incontinence or passive soiling, or there might be slight soiling when passing wind. Some people experience incontinence on a daily basis, whereas for others it only happens from time to time.

It’s thought 1 in 10 people will be affected by it at some point in their life. It can affect people of any age, although it’s more common in elderly people. It’s also more common in women than men

5. Urinary incontinence

Urinary incontinence means a person leaks urine by accident. While it can happen to anyone, urinary incontinence, also known as overactive bladder, is more common in older people, especially women. Bladder control issues can be embarrassing and cause people to avoid their normal activities. 

In fact, urinary incontinence is often a symptom of UTIs, but the reason that it can actually cause UTIs or increase the risk of a UTI is that using urinary catheters is one of the most effective treatments for UTIs, and we have already discussed how that can increase one’s risk for UTIs.

6. Enlarged prostate

Benign prostate enlargement (BPE) is the medical term to describe an enlarged prostate, a condition that can affect how you pee (urinate). BPE is common in men aged over 50. It’s not a cancer and it’s not usually a serious threat to health.

Many men worry that having an enlarged prostate means they have an increased risk of developing prostate cancer. This is not the case. The risk of prostate cancer is no greater for men with an enlarged prostate than it is for men without an enlarged prostate.

However, enlarged prostates can increase the risk of a UTI since some of the common symptoms are a difficulty starting to pee and a difficulty emptying one’s bladder.

7. Immobility

Immobility (for example, those who must lie in bed for extended periods of time) is known to increase the risk of UTI, with older people being particularly at risk.

Urinary retention fosters infection so normal urinary flow is essential to flush bacteria such as Staphylococcus aureus and E. coli from the bladder. In addition, over-distension of the bladder can cause small cuts or tears in its epithelial lining, providing sites for opportunistic infection.

8. Surgery of any area around the bladder.

As with catheters, surgery around the bladder can open the door for opportunistic bacteria to infect the urinary tract, putting those at a much higher risk of a UTI. 

9. Kidney stones

Kidney stones can develop in 1 or both kidneys and most often affect people aged 30 to 60. They’re quite common, with more than 1 in 10 people affected.

Kidney stones are usually found in the kidneys or in the ureter, the tube that connects the kidneys to your bladder. They can be extremely painful and can lead to kidney infections or the kidney not working properly if left untreated.

Moreover, they can increase the risk of UTIs because it creates a blockage in the urinary tract, which makes it more difficult for people with kidney stones to empty their bladder when peeing. 

Common Symptoms of UTIs in Elderly People

1. Urine that appears cloudy or dark.

2. Bloody urine.

3. Strong or foul-smelling urine.

4. Frequent or urgent need to urinate.

5. Pain or burning during urination.

6. Feelings of pressure in the lower abdomen.

7. Low-grade fever.

8. Night sweats, shaking or chills.

Potential Symptoms of UTIs in Elderly People

Older adults may not exhibit any of the hallmark signs of UTI listed above because their immune systems are unable to mount a significant response to the infection. On top of the lack of noticeable symptoms, many seniors do not or cannot express their discomfort to their caregivers.

Since elders’ bodies respond differently to infection, it is important to look for atypical signs and symptoms. A marked change in mental state is one tell-tale symptom of UTIs in the elderly, but it is often mistaken for the early stages of dementia or Alzheimer’s disease.

Thus, it is incredibly important to check whether it is dementia or a UTI that is causing these symptoms since this could mean the difference between independence or home care or admittance into a nursing home. UTIs can cause the following symptoms in elderly people:

1. Confusion or delirium.

2. Agitation.

3. Hallucinations.

4. Other unusual behavioral changes.

5. Poor motor skills or loss of coordination.

6. Dizziness.

7. Falling. 

How Is a UTI Diagnosed?

In older adults who have symptoms of a UTI, a simple urine test — called a urinalysis — can confirm infection. In some cases, the doctor requests a urine culture to identify the type of bacteria causing the infection and help determine the best antibiotic to treat it.

However, it’s important to know that older adults often have bacteria in the urine that don’t cause any symptoms. This condition is called asymptomatic bacteriuria, and it often resolves on its own without treatment without progressing to bladder infections or other common infections.

Doctors now recommend against doing a urine test to check for a UTI, unless patients have typical, bothersome UTI symptoms. This is to avoid the excessive use of antibiotics to treat infection, which can lead to antibiotic resistance.

How Are UTIs Treated in the Elderly?

Antibiotics are the first choice of treatment for UTIs. Mild UTIs often clear up in only a few days with the right antibiotic.

However, depending on the person’s age and health plus the severity of the infection, treatment for a UTI may take several weeks and a longer course of antibiotics. In more severe cases, older adults may need to be hospitalized to receive IV antibiotics.

If you think your loved one might have a urinary tract infection, see a doctor right away to avoid further complications. An urgent care clinic is a viable alternative if you cannot get an appointment with their primary care physician soon enough.

Urinalysis and/or a urine culture are typically required to diagnose a UTI, determine what kind of bacteria are present in the urine and select the most appropriate antibiotic for treatment. If caught early on, a course of antibiotics typically clears the infection in no time.

Keep in mind that older individuals are also prone to a related condition called asymptomatic bacteriuria, which is characterized by the presence of bacteria in the urine but the absence of any signs or symptoms of a urinary tract infection.

The estimated incidence of asymptomatic bacteriuria is 15 percent or greater in women and men between 65 and 80 years of age and continues to climb after age 80 to as high as 40 to 50 percent of long-term care residents.

Research shows that most patients with asymptomatic bacteriuria do not develop symptomatic UTIs, therefore antibiotic treatment is not beneficial. In fact, antibiotic use can result in adverse side effects, such as Clostridium difficile infection, and contribute to the development of resistant bacteria.

A senior’s physician will consider their symptoms (if any) and test results to differentiate between a UTI and asymptomatic bacteriuria and determine whether treatment is necessary.

Tips for Preventing UTIs in the Elderly

The following lifestyle and personal hygiene changes can significantly reduce a senior’s risk of developing a urinary tract infection.

1. Drink plenty of fluids. (Aim for two to four quarts of water each day unless this conflicts with a physician’s orders.)

2. Drink cranberry juice or use cranberry tablets, but NOT if the elder has a personal or family history of kidney stones.

3. Avoid or limit caffeine and alcohol, which irritate the bladder.

4. Do not douche or use other feminine hygiene products.

5. After toileting, always wipe from front to back (for women).

6. If incontinence is not an issue, wear breathable cotton underwear and change them at least once a day.

7. Change soiled incontinence adult diapers promptly and frequently.

8. Keep the genital area clean and dry.

9. Set reminders/timers for seniors who are memory impaired to try to use the bathroom instead of an adult brief.

Moving Forward, Keeping Healthy

UTIs are a bacterial infections that can be a huge problem for senior health. Not only do they cause some very annoying and painful symptoms, but they can also lead to much more serious symptoms.

While UTIs in young people do not cause dementia-like symptoms, the fact that UTIs do often bring about these symptoms in the elderly means that you or your family or loved ones need to take extra care to avoid UTIs or treat UTIs as soon as possible. 

Aging can be a very frightening experience for those who have passed middle age and are now elderly. There is, of course, the fear of death, and the deep sadness that comes from close friends and loved ones dying or being hospitalized.

Moreover, there is the possibility of aging-related illnesses, such as advancing Alzheimer’s disease or Parkinson’s disease. These and many other factors can lead elderly people to refuse help, act irrational, and sometimes even hide new symptoms. 

This type of behavior can be incredibly hard to deal with for an aging parent’s adult children or an elderly person’s caregiver. For adult children, the shift in power dynamics from the recipient of care to the caregiver for one’s aging parents can be rocky terrain to traverse, and watching one’s parents make risky, dangerous, or irrational choices can be very taxing.

If you are reading this article, it is very likely that you simply want to find the best way to care for the people you love or whose care is your responsibility. 

In this article, we seek to give you the information you need so that you can deal with the multifaceted issue of irrationality in the behavior of elderly people and provide the best elder care. Thus, we give you a number of general tips for dealing with irrational elderly people, and then we dive a little deeper into specific scenarios that show these tips in action. 

Dealing with Irrational Elderly People the Right Way

1. Make sure to understand their motivations for their behavior 

Aging is a difficult process for virtually everyone. Many older adults are living with dementia or mental health issues, including anxiety and depression. Learning how to tell an elderly parent they need help through incorporating their feelings can help you communicate with them better.

One important thing to recognize is that elderly people more often than not want to maintain a sense of their autonomy, and it is important to recognize this in their actions. Some questions you can ask yourself when you are trying to understand an elderly person’s actions that may seem irrational are as follows:

• Are they acting this way out of habit?
• Are they worried about losing their independence?
• Are they suffering from depression or anxiety?
• Are they confused or do they have dementia?
• What are some things they may be fearing?

Answering these questions may help you get to the root cause of an elderly person’s actions, and with this knowledge, you can then approach the situation with a better grasp of the situation and a better sense of how to deal with seemingly irrational behavior of the elderly person in question. 

2. Be persistent but gentle 

Patience and persistence go a long way toward making conversations productive. It is important not to go in with the expectation that everything should be resolved in one sitting. You will probably have to bring up your concerns to your aged parents or person in your care numerous times. That’s why being patient is key. 

You want to avoid bombarding the senior you love with too much information in a single conversation since this can needlessly trigger their fear of losing control. And if your loved one has dementia or cognitive impairment, they may be unable to take in too much information at once. But this is also just a good general role.

Even people without cognitive impairments can be overwhelmed by too much information, especially when that information pertains to important facets of their lives. 

3. Choose your battles

People don’t respond well to nagging, real or perceived. In the long run, it might help your case to stop insisting your parents update their phones, join a fitness class or complete other beneficial, but nonessential, tasks for their well-being.

Instead, decide what issues are the most important and focus on them — at least initially. Matters involving your parents’ safety, for instance, should take top priority. But remember, they’re much more likely to take your concerns seriously if you don’t bombard them with several at once, no matter how valid they may be.

Moreover, you should avoid power struggles. Don’t push, nag, or harangue your loved one or person in your care. Giving ultimatums will only get their backs up, and yelling, arguing, slamming doors, and so on could seriously damage the relationship.

Instead, empower the recipient of your care by making them a part of every decision-making process. Validate their emotions and show them that you value their opinions.

The best way to avoid power struggles is to pick the right battles and to make sure that all decisions about an elderly person’s care are made as a group effort so that the elderly person can maintain a sense of autonomy and dignity. 

4. Timing is important 

Bringing up important and life-changing issues when everyone is already stressed or tired is a great way to ensure the discussion will be unproductive and possibly even counterproductive. When dealing with an irrational person, you must choose a time to talk about a serious matter at a time that they are feeling calm and safe.

For example, you wouldn’t want to bring up their medical care in a room full of a lot of people, even if those people are family members. An intimate setting would be far more productive. Just keep in mind that you are dealing with a fragile situation and that your elderly loved one’s mood may be unpredictable, so choosing the right time to talk about serious issues is incredibly important. 

5. Seek outside support for yourself 

If you are placed in a caregiving role for an elderly loved one, you might also be dealing with fears, such as fears of loss, and stress from the pressure of responsibility.

In order to stay calm and sensitive to your elderly loved one to provide them the support that they need, you may often find that you need support yourself. Being serene and soothing may not come easily if you yourself feel frightened, helpless, and frustrated.

If this is the case, it can be a great idea to divert some of your caregiving energy to yourself and get some outside support, be it a meditation group, a counselor, or a support group. These can help you with setting boundaries that are necessary for high-quality caregiving. 

6. Spend more time with the elderly person in your care 

Often, elderly people feel left behind. Sometimes their friends have died or are dealing with serious health issues and they can feel left behind by the world. This feeling of loneliness only serves to compound the many fears that come with aging. 

Sometimes the best thing that you can do for your elderly loved one is to simply spend quality time with them. You can give suggestions for their care needs, but one of the best ways to contribute to that care is to be with them.

This can be a great opportunity for both adult children and their elderly loved ones because its a chance to develop a healthy, trusting, and harmonious relationship that will make having the important conversations a lot easier. 

7. Ask questions

Instead of telling your elderly loved one what to do, try involving them in the discussion as much as possible. One of the best ways to deal with difficult elderly parents is to ask them questions about how they are feeling and what they would like to do.

This really comes down to treating your elderly parents with the care and sensitivity that you might give to a child but with the trust and inclusiveness that is proper when dealing with adults. 

When people get older, they do not simply stop feeling like adults, and so when they are talked at as if they were helpless or unable to make decisions, that can feel very wrong to them. So ask questions. This gives validation and can be a great first step in developing a harmonious and productive relationship. 

8. Focus on the benefits 

Always focus on the benefits of your proposed solution. For instance, if you see assisted living as the answer, emphasize the variety of social and recreational activities that these communities offer.

If you see in-home care as the answer, focus on the advantages of this solution. Elderly people will often see only the downsides of these types of living situations so it is incredibly important to be the champion of the care you believe that they need. 

9. Outline the consequences 

If the elderly person or persons in your care are still bound and determined to stay in their four-bedroom house or to keep driving, calmly let them know about the possible consequences of their actions. Don’t frame things in punitive terms or talk to them like they’re children.

Instead, remind them that their actions extend beyond the family. Remind them that everyone needs to consider the potential effects their actions might have on other people. For example, continuing to drive with specific impairments or health problems might put not only their lives but the lives of other unknown drivers at risk.

Outlining the consequences in this way can be a wake-up call and has the potential to affect real change in their behavior. 

Dealing with Irrational Elderly Parents and Others: Specific Examples

1. Anger, Hostility, Tantrums, and Outbursts 

If you are met with anger,  hostility, or other difficult behavior when you approach your loved one about your concerns, it can feel like a personal attack. However, the more you know about the potential causes for that anger, the more you can not take it personally and get any follow-up care your loved one may need.

The aging process is not easy and can cause frustration in seniors. Having a bit of empathy and putting yourself in their shoes can soften your approach and help you not take any attacks personally. When possible, take a break from your caregiving roles through respite care solutions so you can re-enter your role with a relaxed perspective.

2. Abusive Behavior

Sometimes a parent’s behavior that begins with anger and stubbornness can turn into abusiveness. Abusive behavior occasionally occurs in older adults. Sometimes, this behavior stems from a mental illness that your loved one has lived with for years.

In this case, you may already have some coping skills in your personal mental health toolbox that can help you navigate the situation. Other times, abusive behavior is new. This can indicate a change in mental health or cognition.

You can first address abusive behavior by trying to explain how their behavior makes you feel. You can also leave the situation as long as your loved one is safe before you go.

Finally, if abusive behavior continues, you can consider outside help, such as respite care, senior living communities, or other types of senior care to give you the break you need and deserve and potentially give your loved one the care they might not want but truly need. 

3. Using Inappropriate Language or Making Offensive Comments 

Cognitive decline is often the reason behind seniors making offensive comments or using inappropriate language. However, it can still be jarring for adult children or caregivers to hear, even if they’re aware of the source. 

When seniors begin using new inappropriate language or offensive comments, it is often because they are in pain, frustrated, or reaching a new stage in their cognitive decline. A sudden personality change could also point to an infection.

Ignoring the behavior can often solve it right away. You can also call out the behavior and say you do not like it when they do that. However, if your loved one has dementia, it is important for you to note that they will likely not be able to remember your direction or consequences.

4. Paranoia, Delusions, and Hallucinations 

It is startling to watch your loved one experience delusions or paranoia. Cognitive decline is often the reason why it happens, but you may also find that your loved one is experiencing a medication side effect.

Medications can cause paranoia, hallucinations, memory loss, and delusions. Be sure you speak to your loved one’s physician or pharmacist to talk about these types of side effects. Dementia and infections, such as a UTI, can also cause this type of behavior.

The best course of action in these troubling cases is to work with your loved one’s geriatric medical team and social worker to discover the underlying cause of the delusions or paranoia. Once you are able to discern if it is a dementia side effect, an infection, or a medication issue, you can begin to make the appropriate changes.

Navigating the Behavior of Irrational Elderly People

When dealing with elderly people, whether they are loved ones for who you are a family caregiver or simply people put in your care through institutional means, can be extremely tricky.

You are dealing with adults who have the right to make their own decisions, and at the same time, they may often act in irrational and dangerous ways, and often they can experience various behavioral changes that might leave you confused or frustrated.

It is important to make sure that the elderly people you are dealing with know that you value their opinions and respect their autonomy, while at the same time being persistent in pursuing the best possible health care situation for them.

Of course, when caring for elderly people, one should not forget that they can seek out help and support for themselves. 

Finding free things for seniors and the elderly can help make life a lot easier for those at a tender age, especially if they are living off of a low income.

Luckily, free things for seniors and the elderly abound as long as you know the right place to look. Many of the freebies senior discounts for seniors come from the U.S. Federal Government or state government programs, while others are provided by Non-profits (NGOs) and charities and can range from assistance in legal matters to free money. 

Below we list some of the best resources for finding free stuff for seniors and the elderly.

1. Elderly Assistance Programs 

The elderly and seniors can receive help from a number of community resources or assistance programs that specialize in meeting their needs. Find free government money for seniors, prescription medications, home delivery of food or meals, employment and more. Resources are offered by your state or the federal government,  Area Agency on Aging offices, charities or social service organizations.

The exact type of senior citizens resources available near you will vary by state, county, and agency. Examples of some of the programs that are offered for low-income senior citizens and the elderly include government benefit or grant money programs, Medicare, financial help, home care and grants for paying for medications or other bills. Assistance programs help the elderly, retirees, and older Americans, whether they have medical issues or not.

There are other resources that help the elderly as well as senior citizens. Other assistance is provided from free senior centers, home care programs, employment resources, free pantries as well meal on wheels programs, and much more. With the population of the country continuing to age and more individuals reaching the so-called senior “status”, the demand for assistance, information, and advice continues to increase.

Some of the best general resources are:

1. The Area Agency on Aging (AAA)

“AAAs” are available in most major cities to provide services for seniors. Services at each office will vary so you’ll need to contact your local office to see what they provide.

Typically, AAAs offer free counseling on long-term care, health and other insurance, nutrition, minor home repair, and help with applying for government assistance programs. AAAs are also an excellent source of services for free in your local area that may not be widely advertised, such as public transportation and other city and county services, adult day care, and food banks that provide meals for seniors.

2. Eldercare Locator 

Another way to find free local services specifically for seniors is through the Eldercare Locator website. This program is funded by the U.S. Administration on Aging and can help you find options such as transportation, legal assistance, elder abuse resources, and more. Some services may just be discounted but many can be found in your location that are free. You can also call them at 1-800-677-1116 for assistance.

2. Senior Citizen Food Services 

Congregate meals are offered in all states. Individuals can choose from meal sites including churches, senior centers, religious facilities, area on aging offices, food pantries, soup kitchens or housing facilities. Not only can a senior citizen get a free, nutritious USDA-approved hot meal or lunch or grocery bag of Ensure nutritional supplements, but they can also have the opportunity to socialize with their peers.

Homebound people (seniors or those with health care issues) who can’t make it to a feeding site and who are homebound can look into free home-delivered meals. The home-delivered meal programs are also commonly referred to as Meals on Wheels, however, the name can change by local state.

Volunteers will bring food and meals to homebound seniors, which can help them to remain in their homes for as long as possible. Some of the volunteers will also bring the client a free, special holiday meal at Thanksgiving or Christmas.

Another source of free food is offered to seniors over 60 years of age from the federal government-funded Commodity Supplemental Food Program (CSFP). Healthy meals and groceries are offered in partnership with the United States Department of Agriculture (USDA) and your state.

For seniors struggling to feed their pets, free dog or cat food may be available too. Some Meals on Wheels services now provide this for low-income elderly and the homebound. It is not yet offered nationwide, but an increasing number of providers are implementing this program for those elderly households that have a very low income. 

3. Free Dental Care 

If you are a lower-income senior, Donated Dental Services (DDS) provides free senior dental care. The program is entirely staffed by volunteer dentists and is available in every state. Their website has a listing of facilities by state and their application process.

You may also be able to get dentures for free by contacting your state’s dental association. They will be aware of any free services offered by dental schools and others in your state. You may also be able to find local free denture programs through your local AAA.

4. Healthcare Assistance 

Seniors have options when it comes to health insurance, such as Medicare and government programs that can help people pay their medical bills and offset medical premiums. With many retirees living on a fixed income, paying for health care is very difficult if not impossible. So there is information and resources offered to help the elderly deal with escalating medical costs.

The Senior Health Insurance Assistance Program (SHIP) is a great source of information. The specialists that are part of this program can help seniors understand their health insurance benefits, plans that are available, medical bills and rights. The elderly can learn about grants or vouchers for buying prescription medications as well. This program supports Medicare beneficiaries, including people who are under 65 years old.

One great option that seniors have when it comes to healthcare is Medicare. The federal government Medicare service is a national social insurance program. Millions of households currently receive assistance from this benefit. It operates similarly to a free health insurance plan in that it allows senior citizens to get the comprehensive medical and dental care they need.

It was created and is administered by the U.S. federal government. The program guarantees access to health insurance for seniors and Americans ages 65 and older, many of them who recently retired. Younger people can also benefit from Medicare, and the program can help individuals with disabilities as well as patients with end-stage renal disease.

Low-income older adults can also receive medical services for seniors through local free clinics run by the National Association of Free & Charitable Clinics. If you need help with medication, pharmaceutical companies operate Patience Assistance Programs that provide seniors with free medication. Some of these programs are run by states and can be found on the National Council on Aging website.

5. Free Public Transportation 

Many local municipalities have free public transportation waivers for senior citizens. Your local AAA or government offices can let you know what is available in your community.

Some cities and counties even offer free transportation services specifically for seniors, such as RideATA in Pennsylvania and AGIS in multiple states. Churches and local community organizations may also offer free car services run by volunteers who can take you on shopping trips, doctor appointments, and even entertainment.

6. Free or Reduced-cost Phone and Internet Services

The Lifeline program, funded by the Federal Communications Commission, provides low-cost and free cell phone or landline services for low-income seniors. The program is available through various phone service providers, such as QLink and AT&T, and options will vary.

Some providers include a free phone while others do not so it’s best to shop around. Likewise, many local cable companies offer free internet service for the elderly. Some of these include Comcast, Cox, and AT&T. These services may be discounted or completely free for seniors, so you’ll need to call and research the best options in your service area.

7. Free Home Care

Free home care can be provided to the elderly. This can be an option of going to a nursing home or assisted living facility. The PACE program is for lower-income seniors on Medicare and/or Medicaid, and it pays for some or all of the care they need in their own homes or apartments. It provides the assistance that allows senior citizens or retirees to continue to be independent.

8. Senior Centers

Senior Centers operate in many towns, cities, and counties. Various resources and programs are administered from the locations. For example, they can provide free and low-cost health screenings. Examples may include checks and health care for issues such as vision testing, blood pressure, cholesterol, thyroid, depression, glucose (for diabetes), hearing, stroke, osteoporosis, foot and screenings for several types of cancer.

Additionally, pharmacists often offer their time and services at the centers. They will frequently provide consultations to discuss affordable prescription medications, nutritionists will assist with a personal nutrition plan, and nurses provide individual guidance and discuss specific health concerns. Flu or pneumonia shots are often given during the fall months to keep seniors well. Also, health education seminars and disease prevention are offered throughout the year.

Not only can medical needs be met, but Senior Centers also offer other services. This can include a place for people to stop by to get a meal or pick up an emergency food box or lunch. It is a place to go for social activities and companionship. Also, many centers will hold workshops and provide seminars on issues such as low-cost housing, medical bill programs like Medicare, and budgeting classes.

9. Free Eye Care

Lions Clubs International provides free eyeglasses, exams, and glaucoma screenings for seniors. While specific services will vary depending on your local Lions Club, this is a great option for seniors to check out if they are in need of eye care. 

10.  Free Tax Preparation 

Depending on your eligibility status and need, many agencies provide assistance each tax season. A community center or senior center would be the best place to look for information. Tax Counseling for the Elderly provides free preparation services for seniors. You can find a TCE office near you by calling 800-906-9887 or on the AARP website.

11. Financial Assistance and Bill-Paying Assistance Programs 

These programs are normally sponsored by local charities, the government and/or the AARP Foundation as well as Aging and Adults. Services will often include money management advice to help low-income senior citizens and adults with physical disabilities that have difficulty paying routine bills, budgeting and keeping track of financial matters and credit card bills.

The goal of this resource is to also promote independent living for individuals and senior citizens. It is targeted at those who are at risk of losing their independence due to inability to pay their bills on time and in general manage their financial affairs.

The program uses a combination of credit counselors and volunteers to assist individuals who may not have relatives or friends who are willing to help. There are even government benefit programs for the elderly.

Sadly, many older Americans are the targets of scams or fraud, even when it comes to medical bills, health care, and prescriptions. A free service known as Senior Medicare Patrol (SMP) was created by a group of specialists.

It can help individuals detect billing errors and fraud, even when it comes to Medicare. Most of the counselors operate out of agency on agency offices in towns and cities across the nation. Another great source of financial assistance is the Supplemental Security Income (SSI) program which provides financial assistance for seniors with disabilities. 

Getting Started

This article has contained a lot of information, and it is quite possible that you are not sure where to start. Below we have listed the Department of Aging websites for each state. If you don’t know where to start, these links are a great first step.

• Alabama Department of Senior Services
• Alaska Commission on Aging
• Arizona Division of Aging and Adult Services
• Arkansas Division of Aging and Adult Services
• California Department of Aging
• Colorado Aging and Adult Services
• Connecticut Department on Aging
• District of Columbia Office on Aging
• Delaware Division of Services for Aging and Adults
• Florida Department of Elder Affairs
• Georgia Community Care Services Program
• Hawaii Aging and Disability Programs
• Idaho Commission on Aging
• Illinois Division of Aging
• Indiana Division of Aging
• Iowa Department on Aging
• Kansas Department for Aging and Disability Services
• Kentucky Department of Aging and Independent Living
• Louisiana Aging and Adult Services
• Maine Office of Elderly Services
• Maryland Department of Aging
• Massachusetts Executive Office of Elder Affairs
• Michigan Aging and Adult Services
• Minnesota Office of Aging and Adult Services
• Mississippi Aging and Adult Services
• Missouri Department of Health and Senior Services
• Montana Senior and Long-Term Care Division
• Nebraska Seniors and Aging
• Nevada Aging and Disability Services Home
• New Hampshire State Committee on Aging
• New Jersey Division of Aging Services Home
• New Mexico Aging and Long-Term Services
• New York Office for the Aging
• North Carolina Division of Aging and Adult Services
• North Dakota Department of Human Services
• Ohio Department of Aging
• Oklahoma Aging Services Division
• Oregon Aging and People with Disabilities
• Pennsylvania Department of Aging
• Rhode Island Division of Elderly Affairs
• South Carolina Office on Aging
• South Dakota Department of Social Services
• Tennessee Commission on Aging and Disability
• Texas Department of Aging and Disability Services
• Utah Aging and Adult Services
• Vermont Department of Disabilities, Aging, and Independent Living
• Virginia Department for the Aging
• Washington Aging and Long-Term Support Administration
• West Virginia Bureau of Senior Services
• Wisconsin Aging and Disability Resource Centers
• Wyoming Department of Health Aging Division

Getting the Care You Need

It’s no secret that aging can be difficult. Luckily there are a ton of resources available for seniors and elderly people to get free stuff. The barrier often has to do with a lack of information, and we sincerely hope that this article has helped to bridge that gap. 

It can be very difficult talking to someone who is terminally ill or dying. If it is a loved one who is dying, you may be so full of emotions that you don’t know how to talk to this person who means so much to you and will at some point in the near future no longer be there.

Or maybe the person who is dying is an acquaintance. You may not know the proper way to interact with this person, and you may likely be worried about saying something inappropriate.

While the correct thing to say to someone who is dying will invariably differ depending on the person who is dying and your relationship with them, there are certainly some general guidelines about what to say to a dying person and what to avoid saying.

And if you are at a loss for what to say, we hope that what follows in the rest of this article can help you find the right words. The important thing to remember is that whether you are comfortable speaking about death and dying or not, being there for your loved one can make a world of difference to them as they go through this difficult time. 

Tips for Talking to Someone Who Is Dying

1. Take the initiative and start the conversation 

When someone is dying, they are often fatigued and will hold many conversations with caregivers and loved ones. This does not mean that they want to talk to you any less. What it simply means is that it would be nice to take the burden of beginning a conversation off of their shoulders.

Of course, there will be terminally ill or dying people who are still bubbling with words, and in this case, taking the initiative is not necessary. Still, in many cases, it is a good idea to help get the conversational ball rolling.

The goal is not to dominate where to conversation goes, but to open up the space for the dying person to speak if they desire to speak. Some specific ideas for starting a conversation are listed below:

• Check-in and ask how they’re doing. Ask how their day was. Then ask follow-up questions to show you’re fully listening and give them the chance to discuss their feelings and concerns.
• Reassure your dying loved one that you’re here for them. They might be feeling lonely or scared of what is to come. Reassurance that they aren’t alone is important.
• Ask if there is anything specifically they want to talk about. Ask if there is anything they want you to know before they’re gone.
• Ask how you can help. If they have specific wants or wishes, help make a plan to see they’re carried out and take responsibility. It’s also a good idea to discuss practical arrangements like their funeral wishes or preparing their will.

2. Follow their conversational lead

Everyone approaches death differently, so when you are conversing with someone who is going to die soon, it is good to follow their lead in terms of conversational topics. Some people like to talk about death and will do so bluntly, while others will want to avoid the topic.

It is important that you be prepared to talk about death with someone who wants to talk about it, and if you are not, you should simply let them know that it is too hard for you to talk about. However, if the person you are talking to wants to avoid the topic of death, you will definitely want to avoid making any mention of death.

If your loved one isn’t openly discussing the end-of-life process, you should listen for cues that they might be ready to talk about death. This could mean talking about their symptoms, their emotional state, or not being around in the future. If you think it’s a cue, be compassionate and ask questions allowing them to clarify how they are feeling or what they mean. Listen carefully.

Of course, the conversation may have nothing to do with death. The dying person may simply want to talk about their fondest memories or a particular flower they love. The conversation can truly go anywhere, and going into a conversation with a dying person should not be treated as if it was confined to a few prescribed topics. 

The key is to simply let the conversation flow, letting the dying person take the lead, while you keep your ears open for cues of where the dying person may want the conversation to go, even if they are not ready to say what they want to talk about outright. 

3. Focus on their needs 

When spending time with your dying friend or loved one, be attentive and focus on their unique emotional needs. How can you comfort them? Talking to them should be a part of palliative care. Ask what they need and if there’s anything special you can get them.

It may be as simple as physical affection. A hug or gently holding their hand might mean everything. Or some people appreciate tangible gifts. These can be meaningful such as photographs and mementos from times spent together, or one of their favorite things such as flowers.

Being attentive to their needs will help them feel supported and surrounded by love during the end-of-life process and their stage in end-of-life care.

4. Don’t avoid the topic of death

This point was briefly touched on before, but it is important not to avoid the topic of death if that is what the dying loved one wants to talk about. This can be incredibly difficult for the person talking to the dying loved one, and it may be appropriate to remain silent.

However, it is important not to act afraid of death since the dying person is probably dealing with their own fear of dying and may feel those fears being relieved by talking about the subject. 

Unfortunately, it’s a common misconception that talking about someone’s terminal illness or impending death is negative and will only upset the person. For many, talking honestly about death is actually a relief. 

Being able to talk about death openly helps a dying person to express their emotions and fears. When they feel heard and understood, this can help reduce stress about the dying process and bring people closer together.

Sometimes a person in the process of dying will want to discuss what it has been like for them to go through this. This may feel uncomfortable for some, but it is especially important that your friend or family member gets to voice his or her concerns and questions.

He or she may want to talk about funeral arrangements, organ donation, or making a will. Listen, ask questions respectfully, and make sure they feel heard during this time.

5. Express yourself honestly

You want your conversation or conversations with a dying loved one to be authentic for both parties. It is likely that a dying person will feel free to be fully authentic, and you should take this opportunity to be fully authentic as well. Express your feelings.

This could mean crying or being silent. This is an opportunity to become much closer to your loved one. Of course, you don’t want to overburden the dying loved one, but refraining from oversharing should not be a constraint on being authentic. 

6. Let them know you are there to talk if they wish

Not everyone who is near death will want to talk, and it is important to respect their wishes if this is what they desire. Even if they do not want to talk, it is important to let them know that you are there to talk or listen to them if they would like, while also reassuring them that it is totally okay if they wish to remain silent or be left alone. 

7. Listen, listen, listen 

Death and dying can bring up a lot of anxiety within yourself, so try to just be there with them in the moment and validate their thoughts and emotions, even if your opinions or thoughts are different. Slow down and really listen to what your friend or a family member has to say.

Some people want to share their favorite memories at the end of their lives and may feel comforted when someone stops to listen to a favorite story from their childhood. Others may have worries and fears they want to share. Listen without passing judgment and offer support and validation.

8. Talk about past memories 

Often, a dying person will want to talk about past memories that bring them joy. This can be an especially fruitful topic of conversation if you and the dying person have shared memories together.

Of course, having shared memories together is not necessary. It may be very nice for the dying person to talk about their memories and life experiences. You can learn a lot about the dying person and grow closer to them as you learn about their life and what mattered to them.

9. What to say if the person dying is an acquaintance?

If an acquaintance tells you that they are in the process of dying or entering their final days, or you hear about it from someone else, keep in mind that it’s okay to not know what to do or say. You may simply be a care provider responsible for the hospice patient. Saying something simple or reaching out with a gesture can look like this:

• Baking them something special.
• Offering to be there for them if they want to talk.
• Telling them, “I heard about what’s going on and am here for you.”
• Sending a card, flowers, or food delivery with a note that says you are thinking of them.
• Saying to them, “I am so sorry to hear about what you are going through, please let me know if there’s anything I can do.”

10. What to say if a person is nearing death

You may find yourself in a situation where you are present as a person goes through their last seconds of life. It is not uncommon for people so near death to hallucinate or not be fully cognizant, and for that reason, you may not be sure what to say. 

It is important to remember that there is a good chance that your words will reach them, even if all health care methods and doctors’ best efforts have been exhausted. Tell them that you love them, that you are there for them, and say your final goodbyes. 

What to Avoid Saying to a Person Who is Dying?

1. Discussing your religious thoughts without asking first 

It is important not to push your religious thoughts and beliefs onto someone who is a hospice patient. This can come as unwelcome and unthoughtful since the dying person may hold very different beliefs and find solace in those beliefs.

If you do wish to talk about religious matters, then you should first ask if that is an appropriate thing to talk about. In some cases, a dying person may very much enjoy talking about religion and religious matters. They may even express a desire for spiritual care. This is why it is important to ask. 

2. Cliches and corny phrases 

You certainly want to avoid saying cliches about death and repeating corny phrases you may have seen on television. This can come across as disingenuous and is also unlikely to bring comfort to the dying person.

As we said before, it is important to be authentic and cliches bring a feeling of inauthenticity and emptiness, and therefore, are the wrong thing to say. 

3. Focusing solely on your feelings

When a person is a hospice patient who is near death or has received a terminal diagnosis, it is important to let them talk about their feelings. It would be unkind to take up their time by simply talking about your feelings and making their death about you when it is really about them and what they are going through.

This is not to say that you cannot express your feelings. This only means that you need to allow space for the dying person to express their feelings. 

Moving Forward as They Move On

Dealing with a loved one’s death can be extremely difficult, and the fear and grief of losing a loved one can feel overwhelming. However, your conversations with a dying loved one can be some of the most meaningful that you have ever had with them and can deepen your relationship at this critical time.

The most important thing to remember is that you are there to comfort them, and you should allow them to talk about what they want to talk about, as you listen, and then respond sincerely and with love and empathy.