Bed Sores: Home Treatments & Preventative Measures

Bed sores—also known as pressure ulcers or decubitus ulcers—are wounds that form when the skin and its underlying tissue are compressed between bones and a hard surface for a prolonged period of time. When this happens, blood flow to the area is cut off and the tissue begins to die. 

Sounds terrible, right? There is nothing pleasant about bed sores, but there are steps that can be taken to prevent bed sores from developing in the first place, and if bed sores do occur, there are some at-home treatments that can help heal them.    

Bedsores (pressure ulcers) injuries skin underlying tissue from lying down or sitting prolonged period

What Are Bed Sores? 

Bed sores, also known as pressure ulcers, are a wound- or ulcer-like type of injury that can occur when someone is confined to a bed or wheelchair. 

The injury is caused by the constant pressure of the body against the surface, which cuts off the supply of blood to the area. This can cause the skin and tissue to break down, leading to an open wound. Bed sores can be very painful and difficult to heal, and unfortunately, are especially common in people who are elderly or have a chronic illness.    

The Four Stages of Bed Sores

Like many medical conditions, bed sores are categorized in stages ranging from stage 1 to stage 4. 

Stage 1

A bed sore in stage 1 is not yet an open wound, but the skin will be very red. If you aren’t sure if a bed sore is forming, press gently on the red spot. If the spot fails to lighten up, then it is likely blood is not reaching that area. 

Symptoms of a stage 1 bed sores include itching, pain, or a burning sensation. The red spot itself may feel warmer or cooler, firmer or softer than the area around it. 

Stage 2

In stage 2, the skin breaks open and forms a shallow crater. This could look like a shallow wound or a blister that has yet to pop. You may also notice some swelling or redness around the sore, indicating that this tissue is damaged or dying.

Symptoms of stage 2 bed sores include pain and pus at the site of the ulcer.     

Stage 3

In stage 3, the bed sore deepens and creates a tunnel under the skin. The sore will look like a crater or hole, and you may even be able to see some fat tissue. 

Other symptoms of a stage 3 bed sore include redness, the presence of pus or discolored discharge, and the foul odor of infection.  

Stage 4

Stage 4 is the most serious. By now, the bed sore is a deep crater that goes through muscle and down to the bone, muscle, tendons, and/or ligaments. By the time a bed sore reaches stage 4, serious infection becomes likely. 

Symptoms of a stage 4 bed sore include sharp and consistent pain, pus and other visible signs of infection, and the appearance of hard, dead tissue known as eschar.   

Who Is Most Prone To Developing Bed Sores? 

Bed sores can occur in any individual who is confined to the same place for a prolonged period of time. However, certain individuals are at a higher risk for developing bed sores, including those who are:

  • obese
  • elderly 
  • incontinent
  • suffering from a medical condition that impairs circulation
  • diabetic 
  • comatose  

By understanding which individuals are most at risk for developing bed sores, healthcare providers can take steps to prevent them. For example, a doctor or other caregiver may recommend that patients perform frequent turning and positioning changes, use special support surfaces, and maintain good hygiene.   

How To Prevent Bed Sores

If bedridden or confined to a wheelchair, then it is important to understand that bed sores could develop. Not only are bed sores extremely painful, but they can lead to serious infections. Therefore, it is important to know how to prevent bed sores before they can develop. Here are some tips: 

1. Keep the skin clean and dry 

Bed sores form when blood cannot reach a particular spot, but can be exacerbated by dirt and debris, or excessive moisture. Therefore, it is important to keep the skin of anyone who is confined to one place as clean and as dry as possible. 

Use a damp cloth to wipe the skin down daily, paying special attention to those places like hips, feet, elbows, and anywhere else bone sits close to the skin. Check for redness, pressure points, and new sores, then report anything you see to your healthcare provider. 

2. Move position often 

When lying down, shift position every few hours to avoid sustained pressure on one area of the skin. If the confined person can’t change position on their own, then employ the use of pillows or foam wedges to prop up the body and relieve pressure. 

3. Maintain a healthy diet and drink plenty of fluids 

Keeping the skin healthy and pliable should be a priority during times of confinement. If health allows, maintain a balanced diet with plenty of water and other fluids. 

4. Keep the skin moisturized 

Use petroleum-free lotion regularly—especially on bony areas—to keep the skin pliable and moisturized.

5. Keep bedding clean and dry

To prevent excessive moisture and harmful bacteria, keep any bedding and clothing as clean and dry as possible. Change wet or soiled sheets and clothes right away. 

Preventing bed sores is the best way to avoid the pain and complications associated with them. 

Close up old woman hand, upper limb or arm to the wounded waiting for nurse treatment on wound dressing a bloody and brine of patient.

How To Treat Bed Sores At Home

If you develop bed sores, it is important to reach out to a healthcare provider. The recommended treatment will depend on the stage of the bed sore; ulcers at stage 1 and 2 are most successfully treated at home, while sores at stage 3 and 4 will require more aggressive treatment—antibiotics at least, surgery in the worst cases. 

After reaching out to your doctor or another medical professional, you will likely be told to: 

1. Keep any bed sores clean

If you develop a bed sore, clean it with mild soap and water. Pat dry very gently. If the bed sore has yet to crater, monitor it closely and reach out to your doctor if it worsens or does not heal. 

2. Add support and remove pressure 

Bed sores develop because of pressure, friction, and shear force—that is, when the skin rubs against something repeatedly, like a bed sheet. If bed sores are beginning to develop, then rearrange any pressure points by adding pillows, propping up on a foam wedge, or removing extra sheets and blankets. 

3. Keep the skin moisturized 

Keep skin moisturized by using lotion regularly, especially on bony areas. Not only is moisturized skin less likely to break open, but the act of applying lotion will promote blood flow to the area. For the best results, avoid lotions that contain petroleum or other oils, as these can make the skin more likely to break down. 

4. Apply dressings regularly 

If the bed sore hasn’t yet opened or cratered, apply an antibiotic ointment after cleaning it thoroughly with soap and water. This could prevent infection from getting into the sore and worsening it. 

When To See a Doctor For Bed Sores 

You should reach out to your doctor or another healthcare professional any time you notice a bed sore beginning to develop. If the sore has not yet broken open, your doctor will likely tell you to change a few things and keep an eye on it to make sure it isn’t worsening. 

If the bed sore has opened, then seeing a doctor is essential. Sores in stages 1 and 2 will likely require a prescription antibiotic, while sores at stages 3 and 4 may require more aggressive treatment, such as surgery. 

People Also Ask 

What are pressure ulcers? 

Pressure ulcers—also known as bed sores—are sores that develop on certain parts of the body when a person lies or sits in the same position for long periods of time. The lack of movement causes the skin and underlying tissues to break down, resulting in an open wound.   

Where do bed sores develop?

Though bed sores can develop anywhere on the body, they most commonly develop in places where bone is close to the skin—the hips, elbows, heels, and ankles, for example. Other places bed sores commonly develop include the back, shoulders, and back of the head. 

Who gets bed sores? 

People who are unable to move on their own are at greatest risk of developing bed sores, as they are more likely to experience prolonged periods of pressure on one area of their body. People with diabetes, poor circulation, obesity, and incontinence are also at increased risk, as are older adults who are bedridden or no longer able to move.  

Should bed sores be covered? 

Developing bed sores should be covered with a specific dressing provided by a doctor. The purpose of the dressing is to keep the sore moist and to protect against infection. For larger bed sores, a doctor may recommend covering the wound and dressing with gauze. 

How long does it take to recover from bed sores? 

Bed sores can take weeks or months to heal completely; generally speaking, the later the stage of bed sore, the longer the healing time. For some patients, chronic pain and scarring will continue even after the wound has healed. 

Should you keep a bed sore dry or moist?  

It is important to keep the wound of a bed sore moist, but the skin around it nice and dry. This can be done by covering the sore with a film, gel, or foam dressing, then covering the area with gauze. 

How do you prevent bed sores from getting worse? 

If you have just noticed a bed sore on either yourself or a loved one, it’s important to do what you can to ensure it doesn’t get worse. If the bed sore is still mild (stage 1), change position or add a pillow or foam mat to remove the offending pressure. If the bed sore has reached stage 2, then change position, add a pillow or foam mat, clean the wound with water, and cover it with a moist gauze. 

Conclusion

Bed sores, or pressure ulcers, can be painful and lead to serious infections, so it is important to know how to prevent and treat them. Those who are bedridden or in a wheelchair can prevent bed sores by moving position often, keeping their skin clean and moisturized, and maintaining a healthy diet. If bed sores develop, it is best to seek medical advice. Bed sores in stages 1 and 2 can usually be treated at home with moist dressings and a slight change of habits, though sores in stages 3 and 4 could potentially require antibiotics and/or surgery.  

10 Signs That An Elderly Person Is Nearing The End

As people age, their bodies begin to shut down. This natural process is usually accompanied by certain signs that indicate a person is nearing death. If you have an elderly loved one, it’s important to be aware of these signs so you can provide them with the best possible palliative care during this time. 

In this article, we break down 10 common signs that an elderly person is nearing the end of life, plus offer tips on how caregivers and loved ones can support someone in their final days. 

elderly man crying and mourning the loss of his wife, sitting by her side

10 Signs That An Elderly Person Is Nearing The End

Death is a natural part of life, and as we age, our bodies slowly begin to shut down. For some, this happens over the course of months or even years, but for others it can occur in a matter of weeks or days. 

Although the following is merely a guideline, these are 10 of the most common signs that an older person is nearing death. 

1 to 3 Months Before Death 

Though signs of slowing down are likely to occur well before the final one to three months of life, at this point you are likely to notice a dramatic decrease in activity and energy. 

1. They eat and drink less.

Most older people begin to eat and drink less as death approaches. This loss of appetite can be due to a number of factors, including a lessened ability to swallow. In some cases, people may begin to experience difficulty digesting food or absorbing nutrients. As the body starts to shut down, it becomes less efficient at using the energy from food and as a result, the idea of food and drink becomes less appealing.  

Some people also attribute a psychological component to this decrease in appetite—as death nears, people may simply start to lose interest in food and drink, preferring instead to focus on their inner thoughts and feelings.  

2. They sleep longer and more frequently.

You may notice your older loved one begin to sleep more frequently and for longer periods of time. More time will likely be spent in bed, and naps and drowsiness become common during the day as the person may have trouble staying awake for long periods of time. 

This increase in sleep is the result of the body’s metabolism beginning to fall—just one of the first signs that the body is beginning to shut down. Without a normal supply of food, the person has less energy to fight fatigue.  

As sleeping hours increase, you may also notice that the quality of sleep changes, too. It becomes shallower and more fragmented. Though more research needs to be done, some healthcare professionals believe this change is due to a decrease in the brain’s ability to regulate sleep-wake cycles. 

3. They stop taking part in things they love, and begin to withdraw from friends and family.

People often withdraw from their friends and families as they approach the end of their lives. Though this can be difficult for loved ones to understand, there are a few possible explanations for this behavior. 

First, dying patients may feel like a burden on their loved ones, and withdrawing can feel like a way of sparing them from this sense of responsibility. Secondly, a person may simply want to conserve their energy for the task of dying. And finally, some people may have already fully accepted death to the point of feeling that they are already dead inside. Therefore, withdrawing from loved ones is just a matter of following through on what has already happened in their hearts.   

1 to 2 Weeks Before Death

In the last couple of weeks before death, you will likely notice signs that your loved one’s body is beginning to shut down.     

4. They experience changes in breathing, heart rate, and blood pressure.

As the pulmonary system begins to shut down, the dying person is likely to exhibit fluctuations in their breathing patterns—you may notice that they respirate anywhere from six to 50 times in a single minute. As the heart slows down, the person’s blood pressure will decrease and it might take longer to find a noticeable pulse. 

These pulmonary changes often cause the dying person to appear congested. They may puff their lips as they exhale, cough more frequently, or exhibit a rattling sound—known as the “death rattle”—when they breathe.   

5. They feel more pain. 

The human body is an amazing machine, capable of enduring great hardship. But there comes a time when even the strongest body must give in to the inevitable, and death begins to take hold. For some, this process is quick and relatively painless. But for others, the body shutting down can be a long and painful process. 

Much of dying is still a mystery, but it’s thought that the pain is the result of the heart or kidneys shutting down, the lungs failing and making it harder to breathe, or a build-up of fluid in the stomach that puts pressure on other organs. 

Fortunately, patients who are in the hospital or under hospice care can receive painkillers to take away the pain and promote peace and comfort in the final days.  

6. They experience incontinence. 

Incontinence—the official term for losing control of the bladder and/or bowels—can become increasingly common in the one to two weeks before death. This is because as the body shuts down and energy levels decrease, muscles in the lower body relax to the point that the body’s contents are released. 

This is totally normal, but can be extremely distressing or embarrassing for the dying person. 

7. They appear confused or in a daze. 

In the final week or two, the dying person may become increasingly confused or dazed. This is caused by the body’s shutting down of vital organs—namely, the brain. 

The person may also experience hallucinations or delusions, sometimes “seeing” and “talking” to family, friends, or pets that have already passed on. If the person seems happy about or comforted by these hallucinations, then there is no need to try to convince them that what they are seeing doesn’t exist, as this could just cause undue sadness, frustration, or even panic.  

Closer to death, the confusion may evolve into a coma-like state in which the person is completely unresponsive.   

Old man sleeping in a hospital

Days or Hours Before Death

We all hope that our loved ones’ final hours are peaceful and free from all pain and suffering, though sadly, this isn’t always the case. While everyone’s last hours are different, there are at least three signs you can expect to see. 

8. Their body temperature decreases.  

In the days and hours before death, circulation has slowed dramatically and the dying person’s face, hands, feet, and body may begin to feel cold to the touch. In some cases, the body temperature decreases by a degree or more, though in other cases, the person develops a mild fever. 

If the dying person complains of feeling cold, it is important that a heating pad is not provided. By this point in the process of death, the skin is usually extremely thin and fragile, and could be easily burned.  

9. The skin on their hands, feet, and knees begin to appear bruised. 

As circulation continues to slow, the person’s hands, feet, knees, and hips may begin to appear bruised, purple, or mottled. This is caused by blood pooling in these areas, since it is no longer able to flow effectively. 

If the person has been bedridden for awhile, then pressure from lying in bed for long periods of time can also cause bruising.   

10. Their eyes begin to tear and glaze over. 

Just before death, the dying person’s eyes may become glassy or milky looking—very similar to the way a newborn’s look. This is because the cornea begins to lose its reflex as the body shuts down. 

At the same time, the person’s eyes may stay open or shut for longer periods of time, the result of the muscles in the face and around the eyes continuing to relax. 

Though these 10 signs are common, it is important to remember that everyone journeys towards death differently, and there is no one-size-fits-all answer when it comes to what someone will experience in the months, weeks, days, and hours before their death.  

People Also Ask

What are the signs that death is very near? 

As death approaches, there are certain signs that indicate the end is near. These include a decrease in appetite, a decrease in urination and bowel movements, and a decrease in energy levels. The skin may also become pale and cool to the touch, and the dying person may become increasingly drowsy with periods of unconsciousness. As death nears, the body begins to shut down.  

What is the most common symptom seen at the end of life? 

No death is exactly the same, and symptoms may be more apparent in some than they are in others. But one of the most common symptoms is a change in skin color. As the body starts to shut down and circulation slows, the skin may become pale or yellowish. In some cases, the skin may also take on a bluish tint as oxygen levels drop.  

What are the three stages of death?

Though no two people experience the end of life in the same way, it is said that there are three stages of death: denial, anger, and acceptance. When someone first learns of their impending death, they may go through a phase of denial in which they refuse to believe it is happening. This is followed by the stage of anger, in which the individual becomes enraged at fate or God for their situation. Finally, the person comes to accept their death, realizing that it is inevitable, unpreventable, and a part of life. 

What are the last stages of death in the elderly? 

The last stages of death in the elderly can vary depending on the underlying cause, but there are some common symptoms. For example, many older people become more confused and disoriented as their brain function declines. They may also experience worsening pain as their body begins to shut down. There will likely be no interest in food and water, causing their bodies to become increasingly weak. 

Conclusion

There are many signs that an elderly person is nearing the end of their life that begin to appear months, weeks, days, and even hours before death. These include a decline in physical activity, a decrease in appetite, and a change in sleeping patterns. Additionally, the elderly person may become more withdrawn and start to experience confusion or delirium. As death approaches, the body begins to shut down and changes in appearance, such as bruising or mottling of the skin, may occur. Finally, the elderly person’s eyes may begin to tear and glaze over right before death. While these signs may be difficult to witness, it is important to be aware of them so that you can provide comfort and support to your loved one during their final days. 

Rallying Before Death: Why Some People Suddenly Improve

When a person is nearing the end of their life, it’s not uncommon for them to experience a sudden improvement in their condition. This phenomenon, known as a “rally,” can be confusing and upsetting for caregivers and loved ones who are already grieving. While it’s impossible to say definitively why this happens, there are a few possible explanations. 

In this article, we discuss exactly what it means to rally before death. We also examine a few possible explanations for this sudden surge in energy, and break down the very best ways to support someone who is experiencing the process of death.    

Visitor holding hand of female patient in hospital bed giving support and comfort.

What Does It Mean to Rally Before Death? 

Rallying before death (also known as terminal lucidity, “the last hurrah,” or “the final goodbye”) is a sudden and unexpected improvement in a person’s condition that can occur in the final days or hours before death. It is most commonly seen in older patients dying from a terminal illness, but can occur as part of any expected death. 

Signs That Someone Is Rallying Before Death

The most characteristic sign of a final rally is talking, especially if the person has not been communicative for awhile. During a rally, the person’s speech suddenly becomes very clear. They may reminisce about old times, start making plans for the future, or make requests of or amends with family members or friends. The sudden increase in communication can sometimes be alarming for loved ones—especially in the case of someone dying of dementia, Alzheimer’s, or another brain disorder that has affected their ability to communicate effectively. 

A rallying person may also start asking for specific foods or drinks. These requests are usually very specific, and often are long-time favorites or even dishes from childhood. 

In some cases, the dying person may express fears (or the lack of fear) about dying. This could also be accompanied by desires to make amends, solwikve any lingering conflicts, or ensure the continued care of a loved one, pet, car, or house. 

Seeing pets or people that are not there is another sign of rallying. A dying person might see and begin speaking to past relatives, pets, and friends, or start speaking about them.   

How Long Can Someone Rally Before Dying?

Everyone experiences death differently, and no two rallies are the same. According to Michael Nahm, a German biologist and parapsychologist who specializes in near-death experiences and terminal lucidity, about 42% of people die the same day as their rally, while 84% of people die within one week. 

Witnessing a final rally before death can be confusing and concerning for family and friends. However, it is important to remember that a rally does not mean that the person is getting better. In fact, it is usually a sign that death is imminent. 

Why Do People Rally Before Death? Five Possible Explanations

Descriptions of rallying before death can be found in medical literature dating back to at least the mid-1700s, but there has been very little research done to understand exactly why some people experience sudden surges of energy and clarity before death. Granted, studying such a phenomenon is potentially impossible. 

As Dr. Craig Blinderman, the director of adult palliative medicine at Columbia University Medical Center, told the New York Times, “Aside from the challenges of catching dying people at the moment of springing back, it’d be tough to get the medical ethics board to determine that the research would benefit the patient. This type of study would require constant drawing of blood and monitoring of patients, which runs counter to the quiet fade away that is a signature element of palliative care.”   

Still, medical professionals do have a few theories as to what might cause a final rally.  

1. The Body Releases Adrenaline

For many—if not most—people, the sudden realization that death is imminant can be downright terrifying. One common theory is that this realization triggers the body into releasing a burst of adrenaline in response to the stress. Sometimes described as the body trying one last time to go into survival mode, this surge of hormone can temporarily increase heart rate and blood pressure, providing the dying person with a boost of energy. 

2. The Brain Releases Dopamine and Endorphins

Most people who experience an end-of-life rally are those in hospice care after a long battle with a terminal illness—in other words, those whose dying process is sadly filled with discomfort.

Perhaps for this reason, another common theory is that the brain releases high levels of dopamine and endorphins in an effort to ease pain and suffering. These neurochemicals have been shown to have analgesic effects, and they could help to explain why some people seem oddly peaceful in their final moments. 

Top view of doctors and old patient on life extension medication

3. The End of Extensive Medications

Many end-of-life patients spend weeks, or even months, on various medications and fluids like those used for chemotherapy. These drugs often have strong toxic side effects that can affect the body’s muscle and brain functions in a negative way. 

Some medical professionals believe that stopping these medications before death make the mind clearer and the body more responsive, allowing the patient to briefly appear like their old self. 

4. A Form of Closure 

Some hospice nurses and other healthcare professionals have compared the end-of-life rally to the overwhelming urge to nest that many expectant mothers feel before their baby is born. In other words, the final surge of energy before death could be seen as a way for the body to allow closure and acceptance of death. It allows the patient to tie up loose ends, say a last goodbye to loved ones, and make peace with their impending death. 

5. A Miraculous Gift

Still others prefer to look at the end-of-life rally as a gift from God, or as something more miraculous than scientific. This explanation—which, with current technology, can be neither proven nor falsified—lends credence to the fact that so many rallying patients are focused on forming final connections with those they love. 

What an End-of-Life Rally is Not 

Though watching a loved one rally can feel encouraging, it is important to realize that this phenomenon is not a sudden or miraculous recovery. Many hospice workers recommend that family members speak directly with their loved one’s doctor if they have any questions about what to expect during this process.   

How To Support Someone Who Is Rallying Before Death 

As anyone who has watched someone face a terminal illness knows, the journey toward death can be long and arduous. For loved ones, it can be difficult to know how to best support a dying family member or friend. There are many factors to consider, including the person’s wishes for end-of-life care. Still, there are some best practices that can help loved ones offer support during a final rally before death. 

Listen

Many patients who experience an end-of-life rally have not been able to communicate for awhile, and now want to be heard. Answer any direct questions, but otherwise, just listen. The dying person may say something beautiful—or they could say something confusing or downright upsetting. Try to maintain an open mind as you offer this final gift of an ear. 

Try to Accommodate Requests

No one has full control over their death—a scary realization for many. This could help explain why many patients make very specific requests in their final hours. 

Hospice workers recommend making an effort to honor any final requests a loved one might have. Whether it is grabbing a favorite meal or beverage, getting a particular person on the phone, or even re-telling a favorite story, these small gestures of accommodation can mean a great deal to someone who is facing the end of their life.

Of course, it is not always possible to fulfill every request, but even making an effort to do so can be a valuable way of providing a dying person with some measure of comfort and peace.   

Don’t Give False Hope

Death is an inevitable part of life, and it is natural to want to comfort a dying person. However, offering false hope can be more harmful than helpful. When a person is facing death, they need to be able to come to terms with their own mortality. This process can be made more difficult if they are led to believe they may recover, as it could prevent them from saying goodbye and putting their affairs in order. 

Stay Positive 

As hard or conflicting as it may be to witness someone rally before death, try to stay as positive as possible. Unless the dying person brings it up, there’s no need to rehash old conflicts. Be supportive of any discussion about the past, and try not to correct any recollections. Finally, stay calm and present in the moment so as not to impart any anxiety or stress.   

Remain With Them

Finally, stay with them. Despite any surges of dopamine or adrenaline, impending death can be scary. A loved one by their side, offering a friendly smile, could make their final transition one of peace and comfort. 

People Also Ask

How long does rallying last before death? 

The temporary increase in strength before death, known as rallying, can last for hours or even a full week. In the vast majority of cases, death occurs within one week of the rally, and about half of those occur the same day.  

What is the final surge before death? 

The final surge—most commonly known as “rallying”—is a last burst of energy before death. Researchers and doctors are still unsure as to what causes the final surge, though theories include a sudden release of endorphins, a rush of adrenaline, or simply a reaction to the outpouring of attention from caregivers and loved ones.   

What is the purpose of terminal lucidity? 

Terminal lucidity is another term for “rallying,” and refers to the short period of mental clarity and alertness that sometimes occurs before death. Though it is unknown exactly why terminal lucidity occurs, this temporary phenomenon is typically welcomed by those who love and care for the dying person.   

How does the body know when to die?

In the days and hours before death, a person’s heart begins to slow. As blood circulation becomes less effective, the brain and other organs receive less of the oxygen they need to function properly. At this point, the body begins to shut down. 

Conclusion  

It’s not entirely clear why some people rally before death, but plenty of medical professionals have ideas about possible scientific explanations. Though a sudden surge of energy can incite a slew of emotions in caregivers, friends, and family members, many choose to look at this amazing phenomenon as a chance to say a final goodbye to those they love.  

How To Help Seniors With a Hoarding Problem

If you have a friend or family member who is a senior citizen and struggling with hoarding, you may feel at a loss as to how to help them. While it can be difficult to watch a loved one suffer from this condition, there are things that you can do to ease their burden and help them get the treatment they need.

In this article, we offer tips for friends, family members, and caregivers who want to help an older adult with hoarding, plus discuss reasons seniors hoard and why hoarding is dangerous. 

man hoarder with stuff piles sitting in the room

1. What Is Hoarding?

While most people have a few items that they hold onto for sentimental reasons, hoarding is a different matter entirely. Hoarding is defined as the persistent accumulation of possessions that fill up living spaces, regardless of their value. For many people who hoard, the objects they collect become more important than even the people in their lives.

Hoarding is a complex and often misunderstood disorder that can have a debilitating effect on both the sufferer and their loved ones. While it can be seen as a simple case of being messy or disorganized, hoarding is actually a serious condition that can cause immense emotional and physical distress. In some cases, compulsive hoarding can be linked to mental health issues such as Obsessive Compulsive Disorder (OCD), Alzheimer’s disease, or post-traumatic stress disorder. It can also be a coping mechanism for people who are dealing with anxiety or depression.

One of the most obvious signs of hoarding is an excessive accumulation of possessions, often to the point where entire rooms are filled from floor to ceiling with clutter. Hoarders may suffer from feelings of shame or embarassment about their condition, which can lead to social isolation. In severe cases, hoarders may even put themselves and their families at risk by living in unsafe and unsanitary conditions.

2. Why Do Seniors Hoard?

While it may seem like odd behavior, hoarding is actually quite common among senior citizens. There are a number of reasons why older adults may start to hoard.

A Fear of Getting Older

For many elderly people, their years of accumulation have led to a house full of stuff. As they downsize or move to a smaller home, they may feel reluctant to get rid of things, even if they don’t need them. In some cases, seniors may hoard out of a fear of being unable to replace items if they need them in the future. 

Changes in Mental Health

Additionally, seniors may hoard due to changes in their mental health, including dementia and depression. The act of hoarding can provide a sense of comfort and familiarity in an increasingly confusing world.

In fact, the official, medical term for someone who suffers from compulsive hoarding is Diogenes Syndrome, also known as hoarding disorder. This condition is characterized by a lack of social interaction, poor personal hygiene, and an obsession with acquiring and hoarding objects. While the exact cause of Diognenes Syndrome is unknown, it is believed to be linked to mental illness and/or other cognitive decline.

The Result of a Trauma

In some cases, compulsive hoarding can be the result of a traumatic event, such as abuse, neglect, or even extreme poverty. Studies have shown that hoarders often have a history of trauma, and that their symptoms tend to worsen during times of stress.

Whatever the reason, it is important to be understanding and patient with seniors who hoard.

3. The Dangers Of Hoarding For Seniors

While many people think of hoarding as a quirk or an episode of reality television, it is actually a serious mental disorder that can have disastrous consequences, especially for seniors.

Financial Problems

Financial trouble is a very common danger of hoarding. When a person reaches retirement age, they are often on a fixed income. This can make it difficult to keep up with the cost of living, let alone the cost of extra purchases or repairs on a home that is damaged as the result of hoarding behaviors.

Strained Relationships

For many people, their home is their sanctuary; it’s a place where they can relax and feel comfortable. But for people who suffer from hoarding, their home can be a source of great stress.

The clutter and disarray can make it difficult to move around, and the constant mess can be an emotional drain. Seniors—for whom isolation is already a common issue—may lose the energy to leave their house, but be too embarrassed to allow friends and family members to visit them at home. Those who do visit may feel like they are walking on eggshells around the hoarders, afraid to upset them or trigger a negative reaction.

While hoarding may seem like a personal issue, it can have a profound impact on those closest to the hoarder, too.

Eviction notice Frustrated old man sitting and reading the eviction notice he just received

Eviction

One of the most common problems associated with hoarding is eviction. When a person’s home is filled with so much stuff that it becomes a fire hazard or health risk, their landlord, or even the city in which they live, may have no choice but to evict them and/or condemn the property.

In some cases, the senior may find new places to live, but untreated hoarding habits often lead to them being evicted again and again. In extreme situations, older adults who suffer from compulsive hoarding end up homeless.

Health Risks

As people age, they may become increasingly isolated and unable to take care of their living space—especially if it’s full of stuff. The combination of old age, isolation, and compulsive hoarding can lead to serious home safety dangers, such as trip hazards, fire hazards, and pest infestations. In severe cases, seniors who hoard may even be at risk of starvation if they are unable to access food to the state of their homes.

4. How Can Friends, Family, And Caregivers Help Seniors With Hoarding Problems?

If you know and love someone who is struggling with hoarding, there are a number of ways you can help, as well as some important things to remember.

Do: Learn as much as you can about hoarding disorder

Begin by trying to learn as much as you can about hoarding and its root causes. This will help you to understand why your friend or family member is behaving in this way, and may provide insight about how best to help them.

Do: Listen and show empathy

Seniors who struggle with compulsive hoarding are not likely to use words like “junk” or “garbage” when referring to their possessions, and you should not either. Instead, follow the senior’s lead and use the same descriptors they do—for example, “collection” or “things.” Remaining empathetic will go a long way in building trust.

Do: Focus on safety

Despite their struggles, an older adult with hoarding tendencies is well aware that they shouldn’t be living in a mess. Instead of repeatedly bringing up the obvious, let them know that you are concerned about their safety and offer to help them eliminate major hazards.

Do: Offer to help

Once you have built up some trust, you can offer to help. Deciding what to get rid of and when can feel like a debilitating decision for someone with hoarding disorder, so make sure they know you are willing to work with them at their own pace.

Do: Offer help finding professional support

Recognizing that there is a problem is just the first of many steps on the road to recovery. Encourage your senior friend or family member to seek professional help by offering to connect them with local therapists, treatment programs, and support groups. You can even offer to drive and/or accompany them to appointments as a means of moral support.

Dont: Be judgemental

Compulsive hoarding is often accompanied by feelings of immense guilt and shame. There is no need to add to the embarrassment with judgemental words or body language. 

Don’t: Touch any possessions without permission

Though it may seem obvious to you that something belongs in the trash, it is likely viewed by someone with a hoarding disorder as something important. Remain respectful, and ask permission before touching, moving, or removing any items. This will send the important message that they are in control of the decluttering process.   

5. Resources For Seniors With Hoarding Disorder

Hoarding Cleanup is a nation-wide directory of hoarding cleanup services and related mental health providers specializing in hoarding behavior. The organization also offers online support groups for hoarders and their family members and friends. 

If you or a family member is looking for help getting organized, then consider reaching out to the National Association of Productivity & Organizing Professionals. Their website includes a directory of professional organizers that specialize in hoarding behavior. 

For help understanding Diogenes Syndrome, hoarding disorder, and hoarding behaviors, the National Alliance on Mental Illness (NAMI) is an excellent resource. 

Finally, the International OC Foundation: Hoarding Center provides referrals for resources, education, clinics, therapists, and support groups local to your area.   

People Also Ask

What does it mean to hoard?

Hoarding is a complex and often misunderstood condition that can have a profound impact on an individual’s life. Put simply, hoarding is the excessive accumulation of possessions, to the point where they begin to interfere with everyday activities.

While everyone has some level of attachment to their belongings, for people with a hoarding disorder, these possessions take on a special significance and become extremely difficult to let go of.

What are the signs of hoarding?

People who hoard tend to feel an intense need to possess certain objects, even if those objects are of no real value. They may feel highly anxious about letting go of anything, even things that are damaged or useless.

As a result, their homes become cluttered with piles of stuff, and they may have difficulty using rooms for their intended purpose. Hoarding can cause conflict with family and friends, and it can lead to financial problems and even eviction.

What is the best way to help a hoarder?

If you suspect that a friend or family member may be hoarding, the best thing you can do is to start a conversation; express your concerns and let them know you are there to help. Be aware: many hoarders may be unable to admit that there is a problem. You should also try to educate yourself about Diogenes Syndrome and its potential causes.

This will help you to understand the situation and to be more patient. Finally, don’t try to force them to get rid of their things. This will only make them feel more anxious and could even exacerbate the hoarding behavior. Just take things one step at a time and offer your support. 

Conclusion 

There is nothing easy about watching a beloved friend or family member struggle with hoarding disorder, known also as Diogenes Syndrome.

Though it may seem like a daunting task, there are many things that family and friends can do to help a senior who is hoarding, including listening, helping to improve safety in the home, and encouraging professional help. Sometimes, simply being there for an older adult who hoards can make all the difference in the world. 

Where to Take Seniors & Elderly for a Fun Day Out (10 Ideas)

Spending time with loved ones is important at any age, but as we get older and slow down, it can become more challenging to get out and about.

Many seniors and older adults find themselves cooped up at home, with little interaction outside of a caregiver. Such loneliness and stagnation can lead to boredom, depression, and a decline in overall health. 

However, there are a number of activities that older adults can enjoy! Here are ten easy ideas for a fun day out with your senior or elderly friend or family member.  

Smiling senior couple jogging in the park

Mental and Health Benefits of a Day Out 

Studies suggest that older adults who get out for even a few hours a day have better mental well-being than those who stay home all day.

Not only do seniors who leave the house feel more connected to their community and have a greater sense of purpose, but they are also at less risk of certain mental conditions like depression, Alzheimer’s disease, and cognitive decline. Meanwhile, breathing in fresh air can help to improve mood and reduce stress levels.   

Regularly experiencing a day also benefits a senior’s physical well-being, as staying physically active keeps your body flexible and strengthens your immune system. 

Where to Take the Elderly for a Day Out 

1. Stroll Through an Art Gallery or Museum 

A trip to an art gallery or museum makes for a great day out. Spend a little time walking around and looking at the different exhibits, converse with the docents, or even join a guided tour. When a break is needed, take advantage of the many benches and chairs available throughout the museum, or have a light snack in the museum café. 

A recent study from the University of Pennsylvania found that visiting art museums can reduce feelings of stress and loneliness—both of which plague many older adults—and increase positive emotions by promoting feelings of engagement.         

2. Attend a Book Club Meeting

A book club can provide many benefits for older adults, including meeting new people and discussing ideas in a small group setting. For some, this can be a welcome change of pace from the usual routine. Plus, book clubs offer a chance to socialize and connect with others who share similar interests. 

Participating in a book club keeps the mind active and engaged. Studies have shown that mental stimulation can help delay the onset of dementia, so book clubs can play a role in promoting brain health. 

To find book clubs in your area, begin by checking with your local book store or community center. 

3. Make a Trip to the Botanical Gardens   

The botanical gardens are a great getaway for senior citizens. Seniors can stroll through the gardens at their leisure, taking in the sights and smells of the flowers and plants, without having to worry about things like traffic or loud noise. When they get tired, there are plenty of benches where they can sit and rest with a good view. 

Seniors can also benefit from the educational opportunities that botanical gardens provide. Many gardens offer classes and workshops on topics such as gardening, horticulture, and plant identification. These classes can help to keep seniors active and engaged, while also providing them with a chance to interact with other people. 

4. Visit a State or National Park

For a nice day out with a senior friend or family member, consider taking a road trip to a nearby national or state park. Many parks offer senior-friendly activities like birdwatching, short walks on paved paths, and scenic overlooks.

For those who don’t want to do any strenuous activity, simply driving through the park and taking in the sights can make for an enjoyable day. And don’t forget to look out for the senior passes and other discounts offered by many state and national parks!  

5. Go Shopping at the Farmer’s Market 

Farmer’s markets offer a great way for seniors to get fresh, healthy food. Most markets offer a variety of fruits and vegetables, as well as meats, eggs, and dairy products. Many markets also sell baked goods, honey, and other local specialties. Sometimes, senior citizens can even find discounts at farmer’s markets, making it a budget-friendly option for healthy eating. 

In addition to being a great source of fresh food, farmer’s markets are a great place to socialize. Seniors can chat with farmers and other vendors, and enjoy the festive atmosphere of the market. There are often live music and other entertainment at farmer’s markets, making them a pleasant place to spend a long morning.    

6. Go Out for Ice Cream

For many seniors, going to a cafe or an ice cream parlor is a special treat. It’s a chance to relax, chat, and indulge in a delicious ice cream confection. But beyond the simple pleasure of enjoying something sweet, there are actually several benefits that seniors can enjoy just by visiting a cafe.

First, it’s an opportunity to get out of the house and socialize. This can be especially important for those who live alone or who don’t get out as often as they’d like. Second, going to a cafe can help stimulate the mind and provide a break from the daily routine. 

Even ice cream provides a health benefit! Studies have shown that ice cream is a “good mood food” that can increase feelings of happiness and contentment. It’s also a good source of calcium and vitamin D, both of which are essential to senior health.      

7. Go Sightseeing for a Day

Spend a day playing tourist in your own backyard by taking your senior friend or family member sightseeing for the day! Whether visiting somewhere new, or gaining a new perspective on an old favorite, sightseeing provides a great way for older adults to get out of the house for a change of scenery. 

One option is to join a guided bus tour, like those found on Viator. These tours typically involve stops at various attractions, giving passengers plenty of time to explore at their own pace. And, since most bus trips are guided by a professional driver, passengers can sit back, relax, and socialize while someone else takes care of the navigation.

Another option is to drive or take the bus to a nearby city or town for a self-guided day trip. This can provide an opportunity to explore different shops and restaurants, as well as any historical sites or museums.    

Group of seniors in the park in a picnic in summer having fun

8. Picnic Outdoors or at a Park 

Picnics provide an ideal reason for older adults to spend an afternoon getting some fresh air and exercise, enjoying the company of others, and taking in the beauty of nature. 

Pack up a basket with some sandwiches, sliced fruit, chips, and anything else you and a friend might enjoy, and head to the nearest enjoyable outdoor area. Parks, historic homes, waterfronts, and wineries make excellent picnic locations, though even a porch or patio can make a nice lunch spot!  

9. Take a Cooking Class

A cooking class can be a fun and rewarding activity for even the most accomplished senior chef. Cooking classes typically involve a group of people working together to prepare a meal, thereby providing an opportunity to socialize with other people, enjoy delicious food, and maybe even pick up a new skill or two. 

Additionally, a cooking class—or a photography class, art class, etc—can be a great way to keep older adults feeling active and engaged. Seniors who take classes often find they have more energy and feel more connected to their community.   

10. Visit Friends and Family

As people age, their social circles change due to retirement, moving, and the illnesses and losses of those around them. As a result, they can often feel isolated and alone. 

A wonderful way to help a senior stay connected to those they love is to spend a day helping them to visit friends and family. This usually includes making arrangements and driving, but allows an older adult a healthy and important form of social interaction. 

Tips for Planning a Fun (and Safe!) Outing for a Senior 

There are a few things to keep in mind when planning a fun and safe outing for a senior. First, consider the amount of time and energy the senior has.

An all-day excursion may be too much for someone with limited mobility, so in that case it’s important to choose an activity that can be done in a morning or afternoon. A looser itinerary, with additional time built in for rests and meals, is also likely to be appreciated.  

Second, remember that seniors may need help with certain activities. Be prepared to assist with anything from getting in and out of the car to using the restroom. 

And finally, plan ahead. Older adults are more susceptible to heatstroke and dehydration, so avoid extended exposure to the sun and bring some extra snacks and waters. It is also recommended to bring along any necessary medications or supplies, in case of a later-than-planned return home.     

People Also Ask

What do senior citizens do for fun?

As we age, our social circles often shrink, and it can become more challenging to find things to do that are both enjoyable and stimulating. This is why many senior citizens turn to hobbies to stay active and engaged. From knitting and painting to gardening and hiking, there are endless options. And the best part is that hobbies can be pursued alone or with others, making them the perfect way to socialize and stay connected. 

What activities are recommended for older adults to do outdoors? 

Older adults can enjoy many outdoor activities, such as walking, gardening, and bird watching. Getting outside and enjoying the fresh air can help improve mood and overall wellbeing, so it is important to encourage older adults to get out and about.

What are the pros and cons of taking a senior citizen on a day trip? 

Besides the mental and health benefits of helping a senior citizen get out for the day, giving a primary caregiver a break is also nice. Some other pros of taking an older adult on a day trip include the fact they can often get discounts at many places, they may have lots of knowledge and interesting stories to share, and they are very likely to enjoy the company. Meanwhile, some more significant challenges include walking shorter distances at a slower pace and needing more frequent breaks.   

What are some benefits of taking elderly people to a museum? 

Like other museum-goers, older adults enjoy learning about different cultures, seeing interesting artwork, and appreciating the history and heritage of a place. Additionally, museums can provide a stimulating and enjoyable environment for seniors who may be experiencing boredom or isolation. 

Conclusion  

There are plenty of great places to take seniors and the elderly for a fun day out.

Not only can activities like visiting a museum, taking a cooking class, and shopping a farmer’s market provide some much-needed mental and physical stimulation, but they can also be a good way for loved ones to bond with one another.

Whichever activity you choose, a little preparation and a smile can create lasting memories for all.  

Why Do Elderly People Sleep So Much?

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. 

Old woman in grey hair sleeping peacefully at night time in bed.

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. 

Senior with dementia or Alzheimer's is comforted by caring female doctor

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 in the Elderly: Symptoms and Treatments Explained

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.

A medical worker in gloves holds a card with the words UTI - Urinary Tract Infection. Medical concept.

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

Urinary Incontinence in elderly and changing diaper

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.