When someone close to you dies, your world changes. You are in mourning — feeling grief and sorrow at the loss. You may feel numb, shocked, and fearful. You may feel guilty for being the one who is still alive. You may even feel angry at your loved one for leaving you. All of these feelings are normal. There are no rules about how you should feel. There is no right or wrong way to mourn.

When you grieve, you can feel both physical and emotional pain. People who are grieving often cry easily and can have:

• Trouble sleeping
• Little interest in food
• Problems with concentration
• A hard time making decisions

As time passes, you may still miss your loved one. But for most people, the intense pain will lessen. There will be good and bad days. You may feel guilty or surprised for laughing at a joke or enjoying a visit with a friend. It is important to understand that these can be common feelings.

Finding a support system

There are many ways to grieve and to learn to accept loss. Try not to ignore your grief. Support may be available until you can manage your grief on your own.

While family and compassionate friends can be supportive, they may be grieving, too. Some people find that sharing memories and stories about the person who is gone is one way to help each other. Sometimes, people hesitate to bring up the loss or mention the name of the person who died because they worry this can be hurtful. But many people may find it helpful to talk directly about their loss. You are all coping with the death of someone who was important in your lives.

What is complicated grief?

It is normal to feel sad, numb, or lost for a while after someone close to you dies. But for some people, mourning can go on so long or be so distressing that it becomes unhealthy. This prolonged and intense reaction to loss is known as complicated grief. People with this condition may be unable to comprehend or accept the loss, experience intense sorrow and emotional pain, and have trouble resuming their own life and making plans for the future. Other signs of complicated grief may include having overwhelmingly negative emotions, feeling preoccupied with the person who died or the circumstances of the death, and being unable to find meaning or a purpose in life.

Complicated grief can be a serious condition. Those who have it may need additional help to overcome the loss. If sadness is making it difficult for you to carry on in your day-to-day life, help is available. Reach out to a support group, mental health professional, or loved ones for support. If cost is a factor for you, ask your doctor or other healthcare provider if they know of any local health professionals or programs that offer low-cost or free help.

How grief counseling can help

Some people find that grief counseling makes it easier to work through their sorrow. Regular talk therapy with a grief counselor or therapist can help those who are grieving learn to accept a death.

There are also support groups for grieving people to help each other. These groups can be specialized — people who have lost loved ones to Alzheimer’s disease, for example — or they can be for anyone learning to manage grief. Check with local hospitals and senior centers, nursing homes, religious groups, funeral homes, or your doctor to find support groups in your area. Hospice care professionals can also provide grief counseling, sometimes called bereavement support, to the family of someone who was under their care. You can also ask hospice workers for bereavement support even if hospice was not used before the death.

For older adults who are socially isolated or have limited family nearby, there are resources available. Try one of the suggestions below:

• Online support groups. Many online forums or support groups online are free and can help offer support from the home.
• Online therapy or counseling sessions. If you’re looking for a therapist or counselor to address your grief or loss, many offer online sessions that you can attend from your home.
• Support books. Books can be a great way to understand grief and sorrow, and they can provide tips to help overcome these feelings. Check your local library or ask a librarian for recommendations.
• Community resources. Some communities offer grief and loss counseling or resources. Check with your local community center, senior center, faith community, or hospital to learn about what they offer.

Taking care of yourself while grieving

In the beginning, you may find that taking care of details and keeping busy helps. For a while, family and friends may be around to assist you. But there comes a time when you will need to face the change in your life.

Here are some ideas to keep in mind:

• Take care of yourself. Grief can be hard on your health. Exercise regularly, eat healthy food, and try to get enough sleep. Bad habits, such as drinking too much alcohol or smoking, can put your health at risk.
• Make mealtime plans. Some people who have lost a loved one lose interest in cooking and eating. Sometimes eating at home alone feels too quiet, so it may help to have lunch with friends. Turning on the radio or TV during meals can also help. For information on nutrition and cooking for one, look for books at your local library, bookstore, or online.
• Talk with caring friends. Let family and friends know when you want to talk about your loved one. When possible, accept their offers of help and company.
• Participate in your favorite activities. Doing things you enjoy, such as painting, biking, volunteering, or social club events can help improve overall mood and well-being. Listening to uplifting music may also bring comfort.
• Reach out to your faith community. Many people who are grieving find comfort in spending time with others who share their religious beliefs, praying, or reading religious or spiritual scripture.
• See your doctor. Keep up with visits to your healthcare provider. If it has been a while, schedule a check-up and bring your doctor up to date on pre-existing medical conditions and any new health issues that may be of concern. Let your health care provider know if you are having trouble taking care of everyday activities such as personal hygiene and dressing, or fixing meals.
• Mourning takes time. It’s common to have a roller coaster of emotions for a while.

If you have children, remember that they are grieving, too. It will take time for the whole family to adjust to life without your loved one. You may find that your relationship with your children and their relationships with each other have changed. Open, honest communication is important.

When you feel ready, go through your loved one’s clothes and other personal items. It may be hard to give away these belongings. Instead of parting with everything at once, you might make three piles: one to keep, one to give away, and one “not sure.” Ask your children or others to help. Think about setting aside items such as a special piece of clothing, watch, favorite book, or picture to give to your children or grandchildren as personal reminders of your loved one.

Mourning the loss of a spouse or partner

If you have lost a spouse or partner, you may worry about how you will take care of yourself or your home. Many couples divide up their household tasks. One person may pay bills and handle car repairs. The other may cook meals and mow the lawn. Splitting up jobs often works well until there is only one person who must do it all. Learning to manage new tasks — from chores to household repairs to finances — can take time.

Reaching out to friends and family who are close by to help manage tasks right after your loss can help. If you don’t have loved ones nearby, local organizations may be able to help. The Administration for Community Living (ACL) offers online tools to help connect people with resources in their community. After a while, you may develop a better understanding of how to handle tasks on your own.

Being alone can also increase concerns about safety. It’s a good idea to ensure there are working locks on the doors and windows.

Facing the future without a spouse or partner can be scary, especially for those who have never lived alone. Those who are both widowed and retired may feel very lonely and become depressed. Talk with your doctor about how you are feeling.

Socializing after the death of a loved one

It may be overwhelming to think about going to parties or other social events without your loved one. It can be hard to think about coming home alone. If you were married or had a long-time partner, you may feel anxious about dating. Many people miss the feeling of closeness that marriage or other intimate relationship brings. After time, some may be ready to have a social life again.

Here are some things to remember:

• Go at a comfortable pace. There’s no rush.
• It’s okay to make the first move when it comes to planning things to do.
• Volunteer.
• Try group activities. Invite friends for a potluck dinner or participate in an activity at a local community or senior center.
• Consider lower-stress, informal outings such as walks or movies.
• Find an activity you like. You may have fun and meet people who share your interests.
• You can develop meaningful relationships with friends and family members of all ages.
• Many people find that pets provide comforting companionship.

Getting your legal and financial paperwork in order

When you feel ready, you might consider getting your legal and financial affairs in order. If you were married and your spouse died, you may need to update certain legal documents and other paperwork. For example, you might need to:

• Write a new will and update your advance care planning.
• Look into a durable power of attorney for legal matters and health care in case you are unable to make your own medical decisions in the future.
• Put joint property (such as a house or car) in your name.
• Consider changes you may need to make to your health insurance as well as to your life, car, and homeowner’s insurance.
• Make a list of bills you will need to pay in the next few months, for example, your rent or mortgage; utilities such as electricity, water, and phone and internet services; insurance; and state and federal taxes.

To learn more, please visit https://www.nia.nih.gov/health/grief-and-mourning/coping-grief-and-loss.

Vascular dementia refers to changes to memory, thinking, and behavior resulting from conditions that affect the blood vessels in the brain. Cognition and brain function can be significantly affected by the size, location, and number of vascular changes.

Symptoms of vascular dementia can begin gradually or can occur suddenly, and then progress over time, with possible short periods of improvement. Vascular dementia can occur alone or be a part of a different diagnosis such as Alzheimer’s disease or other forms of dementia. When an individual is diagnosed with vascular dementia, their symptoms can be similar to the symptoms of Alzheimer’s.

What causes vascular dementia?

Vascular dementia is caused by different conditions that interrupt the flow of blood and oxygen supply to the brain and damage blood vessels in the brain.

People with vascular dementia almost always have abnormalities in the brain that can be seen on MRI scans. These abnormalities can include evidence of prior strokes, which are often small and sometimes without noticeable symptoms. Major strokes can also increase the risk for dementia, but not everyone who has had a stroke will develop dementia.

Other abnormalities commonly found in the brains of people with vascular dementia are diseased small blood vessels and changes in “white matter” — the connecting “wires” of the brain that are critical for relaying messages between brain regions.

Researchers are investigating how these changes in the brain — and their underlying causes — are involved in the onset and progression of dementia. Research has shown a strong link between cardiovascular disease, involving the heart and blood vessels, and cerebrovascular disease, involving the brain, and subsequent cognitive impairment and dementia. This area of research is referred to as “vascular contributions to cognitive impairment and dementia,” or VCID. It is helping researchers better understand this connection and whether the methods used to prevent and treat cerebrovascular disease and heart disease could also help prevent dementia. Researchers investigating VCID are exploring diverse conditions that affect blood flow to and within the brain, including infarcts (an area of dead tissue resulting from a lack of blood supply), hemorrhages (bleeding from ruptured or damaged blood vessels), cerebral hypoperfusion (reduced blood flow), and small vessel disease in the brain such as that thought to be associated with white matter hyperintensities (white patches seen on brain MRI scans), and stroke.

What are the symptoms of vascular dementia?

People with vascular dementia may experience:

• Difficulty performing tasks that used to be easy, such as paying bills
• Trouble following instructions or learning new information and routines
• Forgetting current or past events
• Misplacing items
• Getting lost on familiar routes
• Problems with language, such as finding the right word or using the wrong word
• Changes in sleep patterns
• Difficulty reading and writing
• Loss of interest in things or people
• Changes in personality, behavior, and mood, such as depression, agitation, and anger
• Hallucinations or delusions (believing something is real that is not)
• Poor judgment and loss of ability to perceive danger

How is vascular dementia treated?

Because many different disease processes can result in different forms of vascular dementia, there may not be one treatment for all. However, vascular dementia is often managed with medications to prevent strokes and reduce the risk of additional brain damage. Some studies suggest that medications that are used to treat Alzheimer’s might benefit some people with an early form of vascular dementia. Treating modifiable risk factors like high blood pressure, diabetes, high cholesterol, and problems with the rhythm of the heartbeat can help prevent additional stroke. Living a healthy lifestyle is important to help reduce the risk factors of vascular dementia.

To learn more, please visit https://www.nia.nih.gov/health/vascular-dementia/vascular-dementia-causes-symptoms-and-treatments.

If you’re seriously ill and can’t communicate your wishes about medical care, a living will can help ensure you get the care you want. A living will is an important part of advance care planning, which involves discussing and preparing for future health care decisions in the event you can’t make them. These decisions are often put into legal documents called advance directives. A living will is one of the most common types of advance directives. The other common advance directive is called a durable power of attorney for health care, which names a person (called a health care proxy) who can make decisions on your behalf.

What is a living will?

A living will is a legal document that tells doctors how you want to be treated if you cannot make your own decisions about emergency treatment. In a living will, you can say which common medical treatments or care you would want, which ones you would want to avoid, and under which conditions each of your choices applies.

This is different than a will, which provides legal guidance about a person’s estate — their property and financial assets — as well as care for a child or adult dependents, gifts, and end-of-life arrangements such as a funeral or memorial service and burial or cremation.

What kinds of decisions are covered in a living will?

Through a living will, you can share your preferences about the use of emergency treatments to keep you alive. You should also talk with your health care proxy about your choices. Decisions that might come up at this time relate to:

• CPR. This procedure tries to restore your heartbeat if your heart stops or is in a life-threatening abnormal rhythm. It involves repeatedly pushing on the chest with force, while putting air into the lungs. This force can sometimes break a person’s ribs. Electric shocks, known as defibrillation, and medicines might also be used as part of the process. The heart of a young, otherwise healthy person might resume beating normally, but CPR is less likely to work among older adults who have chronic medical conditions or are hospitalized with a serious illness.
• Ventilators. If you are not able to breathe adequately, you may need a ventilator, a machine that uses a tube in the throat to push air into the lungs to help you breathe. Inserting the tube down the throat is called intubation. Intubation can be very uncomfortable, so medicine is often used to keep the person sedated. If you are expected to remain on a ventilator for a long time, a doctor may insert the tube directly into your trachea (a part of the throat) through a hole in the neck. This is called a tracheotomy. For long-term help with breathing, this procedure makes it more comfortable. People who have had a tracheotomy need additional help to speak.
• Pacemakers and ICDs. Some people have pacemakers to help their hearts beat regularly. If you have one and are near death, it may not necessarily keep you alive. Some people have an implantable cardioverter-defibrillator (ICD) that will shock the heart back into regular beats if the rhythm becomes irregular. If you decline other life-sustaining measures, the ICD may be turned off. You should state in your advance directives what you want done if a doctor suggests it is time to turn it off.
• Artificial nutrition and hydration. If you are not able to eat or drink, fluids and nutrients may be delivered into a vein through an IV or through a feeding tube. A feeding tube that is needed for a short time goes through the nose and esophagus into the stomach. If a feeding tube is needed for an extended period, it may be surgically inserted directly into the stomach through the skin of the abdomen. Hand feeding (sometimes called assisted oral feeding) is an alternative to tube feeding. This approach may have fewer risks, especially for people with dementia. Artificial nutrition and hydration can be helpful if you are recovering from an illness. However, studies have shown that artificial nutrition toward the end of life does not meaningfully prolong life.

In your living will, you may also choose to document other preferences that are important to you, such as organ and tissue donation and brain donation.

How do you prepare a living will?

Preparing a living will often involves the following steps:

• Reflect on what matters most at the end of life. Many people begin the process by thinking about their values and wishes. For example, if your heart stops or you have trouble breathing, would you want to undergo lifesaving measures if it meant that, in the future, you could be well enough to spend time with your family? For some people, staying alive as long as medically possible, or long enough to experience an important family event, is the most important goal. Other individuals have a clear idea about when they would no longer want to prolong their lives. Reflecting on what matters most to you can help you decide on the types of care and treatment options you want to include in your living will.
• Talk to a doctor. Talking with a doctor about advance care planning is covered by Medicare as part of your annual wellness visit. If you have private health insurance, check with your insurance provider. Talking with one or more health care providers can help you learn about your current health and the kinds of decisions that are likely to come up. For example, you might ask about the decisions you or your family may face if your high blood pressure leads to a stroke. You can ask a doctor to help you understand and think through your choices before you put them in writing. If it makes you more comfortable, you can also ask your health care proxy to come to your appointment with you.
• Complete your living will form. You can find, download, and print free advance directive forms for your state. You may need to have your form witnessed or notarized, so be sure to read the directions closely. Once you’ve completed your form, store it in a safe place and give copies to your proxy and health care provider.
• Update your living will regularly. Remember: You may feel differently as time goes on. You should update your living will at least once each year and after any major life event, like a divorce or move.

Ready to get started? Learn where to find advance directive forms in your state.

Having a stroke is just as serious as having a heart attack. So, it’s important to know the signs of stroke and act quickly if you suspect you or someone you know is having one. Stroke is the fifth leading cause of death in the United States and is the number one cause of serious adult disability. Stroke risk increases with age, but strokes can — and do — occur at any age. The good news is that most strokes can be prevented, and there are steps you can take that may lower your chance of having a stroke.

Know the signs of stroke

Knowing the symptoms of a stroke and acting quickly could mean the difference between life and disability or death. If you delay getting help, the risk of permanent damage or death increases greatly.

Even if the symptoms don’t last long, they may still be a sign of stroke. Call 911 right away if you or someone you know has any of these symptoms:

• Sudden numbness or weakness in the face, arm, or leg — especially on one side of the body
• Sudden confusion, trouble speaking, or understanding speech
• Sudden problems seeing in one eye or both eyes
• Sudden dizziness, loss of balance or coordination, or trouble walking
• Sudden severe headache with no known cause

Other danger signs that may occur include double vision, drowsiness, and nausea or vomiting. Stroke strikes fast. Responding quickly when you notice any of these symptoms is key.

Do not drive yourself to the hospital and don’t ask someone else to drive you. Call 911 for an ambulance so that medical personnel can begin lifesaving treatment on the way to the emergency room.

What is a stroke?

A stroke happens when there’s a change in how blood flows through the brain. Blood brings oxygen and nutrients to brain cells. If blood can’t flow to a part of the brain, cells that do not receive enough oxygen suffer and eventually die. If brain cells are without oxygen for only a short time, they can sometimes repair themselves. However, once brain cells die, they can’t be repaired. While there is growing evidence that, in some cases, new brain cells help to replace those lost, this takes time and occurs much more slowly in older adults. As a result, someone who has had a stroke may have trouble speaking, thinking, or walking.

There are two major types of strokes:

• Ischemic stroke: This is the most common stroke and happens when a blood clot or the narrowing of a blood vessel (artery) reduces blood flow to the brain. This keeps blood from flowing into other parts of the brain and stops oxygen and nutrients from reaching brain cells. Ischemic strokes are commonly caused by:
  • Thrombosis: a clot that forms in a blood vessel of the brain or neck
  • Embolism: a clot that moves from another part of the body, such as from the heart to the neck or brain
  • Stenosis: when a blood vessel in the brain narrows, typically due to fatty deposits lining the walls of the artery
• Hemorrhagic stroke: This is the second major kind of stroke. It’s marked by a burst blood vessel that causes blood to leak into or around the brain. This break reduces delivery of oxygen and nutrients to brain cells and exposes the brain tissue to toxic substances that may cause the cells to die. The bleeding also increases pressure inside the skull that can compress brain tissue and cause damage.

Sometimes the symptoms of a stroke last for a short time (minutes to hours) and then go away. This is called a transient ischemic attack (TIA), a mini-stroke, or a warning stroke. TIA is also a medical emergency. You must call 911 and get medical help right away. If a TIA is not treated quickly, it could be followed by a major stroke within hours or days.

The earlier someone with a stroke arrives at the hospital, the more likely they are to receive effective treatment. Don’t delay if you or someone you know experiences any symptoms.

Lower your risk of stroke

Some risk factors for stroke, such as age, race and ethnicity, and family history, can’t be controlled. But there are steps you can take to help lower your risk, including:

• Control high blood pressure. Regularly check your blood pressure. If it is high, follow a doctor’s advice on how to lower it. Treating high blood pressure lowers the risk of both stroke and heart disease.
• Don’t smoke. Smoking increases your risk for stroke. It’s never too late to quit.
• Control your cholesterol. High blood cholesterol levels can lead to plaque buildup in your arteries. In time, this can block blood flow and lead to a stroke. If you have high cholesterol, work with a doctor to lower it.
• Control your diabetes. Untreated diabetes can damage blood vessels and lead to narrowed arteries and stroke. Follow a doctor’s suggestions for keeping diabetes under control.
• Eat healthy foods. Eat foods that are low in cholesterol and saturated fats. Include a variety of fruits and vegetables every day.
• Exercise regularly. Try to make physical activity a part of your everyday life. Do things you like; for example, take a brisk walk, ride a bicycle, or go swimming. Talk with your health care provider if you haven’t been exercising and you want to start an exercise program or increase your physical activity.
• Manage blood thinners. Too much blood thinning medication, such as aspirin or anticoagulants, can lead to bleeding. If you take these medications, a doctor can help to ensure your dosage is correct.

If you’ve had a stroke or heart attack in the past, you’re at a higher risk for another stroke. Talk with your doctor about ways to reduce your risk.

Diagnosing and treating stroke

Get to the hospital right away to be evaluated and receive treatment because ALL strokes benefit from immediate medical treatment.

A doctor will diagnose a stroke based on symptoms, medical history, a physical exam, and medical tests such as a CT scan. A CT scan is a test that lets doctors see detailed images of the brain that can show bleeding or other abnormalities.

Treatment depends on the type of stroke and may include medications, surgery, other procedures, and rehabilitation.

• Ischemic stroke treatments: Drug therapy is the most common treatment for strokes caused by a blood clot. The two most common drug therapies for stroke are:
  • Antithrombotics, which prevent the formation of new blood clots that can become stuck in an artery of the brain and cause strokes. This group of drugs includes antiplatelet and anticoagulant drugs, also called blood thinners. They help stop cells and other factors in the blood from sticking together and forming blood clots.
  • Thrombolytics, whichtreat the stroke by dissolving the blood clot that is blocking blood flow to the brain. The most commonly used drug for thrombolytic therapy is called tissue-plasminogen activator (t-PA), but other drugs can do the same thing. Starting treatment with t-PA within three hours after an ischemic stroke is important for recovery. Getting to a hospital right away allows time for a CT scan of the brain, which helps the doctor decide whether the clot-busting medicine is the right treatment choice.
• Hemorrhagic stroke treatments: Treatment for hemorrhagic stroke involves finding the source of the bleeding and controlling it. Hemorrhagic strokes get worse with thrombolytic medications, so it is essential to determine the type of stroke before starting emergency treatment. Hemorrhagic strokes require surgery or other procedures to stop the bleeding and relieve any pressure on the brain caused by the excess fluid.

Surgery and vascular procedures are also often used to prevent stroke, reduce the risk of having another stroke, or repair damage to the arteries or malformations in and around the brain. These include:

• Angioplasty: The insertion and inflation of a small balloon within a blocked artery to press plaque or a blood clot against the artery wall to improve blood flow.
• Stenting: The placement of a small metal tunnel, or stent, in the clogged artery. The stent helps to keep the artery open and decrease the chance of it narrowing again.
• Carotid endarterectomy: A surgical procedure in which a doctor removes fatty deposits blocking one of the two carotid arteries, the main suppliers of blood for the brain.
• Endovascular thrombectomy: The removal of a large clot using a special device that can suction out or grab a clot and pull it out.

What happens after a stroke?

A stroke can cause a variety of health problems. How a stroke affects a person depends on which part of the brain is damaged. Someone who has had a stroke might be paralyzed or have weakness, usually on one side of the body. He or she might have trouble speaking or using words. There could be swallowing problems, pain, or numbness.

Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory. Fatigue after a stroke is common. Someone who has had a stroke might feel depressed or find it hard to control emotions. This is more than general sadness: It’s a serious mood disorder that may need treatment. If depression is a concern, talk to a doctor as soon as possible. Call or text the 24-hour 988 Suicide & Crisis Lifeline at 988 or 800-273-TALK (800-273-8255). For TTY, use your preferred relay service or dial 711 then 988.

Rehabilitation from stroke

There are many different ways to help people get better after a stroke. Many treatments start in the hospital and continue at home. By supporting the brain’s ability to rewire some of the circuits lost after a stroke — a process called neuroplasticity — rehabilitation therapy may lead to some improved function over months or years.

• Physical therapy: Helps a person relearn simple motor activities such as walking, sitting, standing, lying down, and the process of switching from one type of movement to another.
• Occupational therapy: Helps a person relearn everyday activities, such as eating, drinking, and swallowing; bathing and dressing; cooking; reading and writing; and using the toilet. Using exercise and training activities, occupational therapists focus on helping a person become independent or semi-independent.
• Speech therapy: Helps a person relearn language and speaking skills or learn other forms of communication. With time and patience, a stroke survivor may be able to regain some, and sometimes all, language and speaking abilities.

Each person’s stroke recovery journey is unique. Rehabilitation results and recovery time depend on many factors, including severity of the brain damage, age, and the management of other physical health conditions. For example, during rehabilitation, steps should be taken to prevent the development of new medical problems, including pneumonia, urinary tract infections, injury due to a fall, or a clot formation in large veins.

Overall, the sooner stroke rehabilitation therapy begins, the better the chances are for a person to regain function. Supportive family, friends, and social networks can help the person recovering from stroke cope with their emotions and also help coordinate therapy, which can extend over a long period of time.

Research to reduce stroke risk and improve rehabilitation

Scientists are working to develop better treatments and strategies to prevent, detect, and improve stroke rehabilitation outcomes. Both people who have experienced a stroke and those who haven’t may be eligible to participate in research.

Talk with a doctor if you’re interested in joining a stroke research study or visit www.clinicaltrials.gov to find a study near you or online.

Osteoporosis weakens bones to the point that they can break easily. It is called a “silent disease” because people who develop it may not notice any changes until a bone breaks — usually a bone in the hip, spine, or wrist.

Bones are made of living tissue. To keep them strong, a healthy human body breaks down old bone and replaces it with new bone. Osteoporosis develops when more bone is broken down than replaced.

The inside of a bone looks something like a honeycomb. When someone has osteoporosis, the bone, which forms the “walls” of the honeycomb, get smaller, and the spaces between the bone grow larger. The outer shell of the bone also gets thinner. All of this makes a bone weaker.

In serious cases of osteoporosis, a simple motion such as a cough or minor bump can result in a broken bone, also called a fracture. People with osteoporosis also have a harder time recovering from broken bones, which can sometimes cause pain that does not go away. Broken hip and spine bones are especially serious, as these injuries can cause older adults to lose their mobility and independence.

Who is at risk for osteoporosis?

While people of all races and ethnic groups can develop osteoporosis, certain groups are more likely to develop the disease. Osteoporosis affects about one in five women over age 50, but only one in 20 men. Among women, those of White and Asian descent are more likely to develop osteoporosis. Other risk factors for osteoporosis include:

• A family history of broken bones or osteoporosis
• History of a broken bone after age 50
• Previous surgery to remove the ovaries before menstruation periods stopped naturally
• Poor dietary habits, including insufficient amounts of calcium and/or vitamin D or protein
• Physical inactivity or prolonged periods of bedrest
• Smoking cigarettes
• Heavy use of alcohol
• Long-term use of certain medications, such as corticosteroids, proton pump inhibitors, and antiepileptic medications
• Altered levels of hormones, such as too much thyroid hormone, too little estrogen in women, or too little testosterone in men.
• Low body mass index or underweight

The risk of developing osteoporosis increases as people grow older. At the time of menopause, women may lose bone mass quickly for several years. After that, the loss slows down but continues. In men, the loss of bone mass is slower. By age 65 or 70, men and women lose bone mass at the same rate.

How is osteoporosis diagnosed?

Osteoporosis rarely has any symptoms. In fact, some people may not notice any changes until a minor bump or fall causes a bone to break. Don’t wait for a potential accident to determine if you have osteoporosis.

If you are a woman over age 65, the U.S. Preventive Services Task Force recommends that you get tested for osteoporosis. Women younger than 65 who are at greater risk should also get tested. The task force does not recommend regular screening for men. Men lose bone density more slowly than women but should still be aware of the possibility of developing osteoporosis. Older men who break a bone easily or who are at risk for osteoporosis should talk with their doctor about testing and treatment.

Health care providers can measure how strong bones are with a bone density scan. This test compares a person’s bone density to the bones of an average healthy young adult. The test result, known as a T-score, indicates whether a person has osteoporosis or osteopenia, which is low bone density that’s not as severe as osteoporosis. Your doctor may also use other screening tools, including questionnaires, physical exams, and ultrasounds, to predict your risk of having low bone density or breaking a bone.

How is osteoporosis treated?

Treating osteoporosis means slowing or stopping the bone loss to prevent breaks. If your test results show that you have osteoporosis or bone density below a certain level and you have other risk factors for fractures, your doctor may recommend lifestyle changes and medications to lower your chances of breaking a bone.

The same healthy lifestyle choices that help prevent osteoporosis can be used to treat it. These include exercising regularly and eating a healthy diet. However, lifestyle changes may not be enough if you have lost a lot of bone density. There are also several medications to consider. Some can slow your bone loss and others can help rebuild bone.

Medications that slow down bone loss include bisphosphonates, calcitonin, RANKL blockers, estrogen, and drugs that change how estrogen acts in the body.

Medications that help rebuild bone include a synthetic version of the parathyroid hormone and drugs that inhibit a protein called sclerostin.

Talk with your doctor to see if there is a medication that can help you manage your osteoporosis.

In addition to managing your osteoporosis, it’s important to avoid activities that may cause a fracture. Such activities include movements that involve twisting your spine, like swinging a golf club, or bending forward from the waist, like sit ups and toe touches.

You can also help reduce the risk of breaking a bone by preventing falls. For individuals with weakened bones, falling is more likely to cause a fracture. Additionally, broken bones in people with osteoporosis may not heal properly and could cause persistent pain, leading to a loss of mobility and independence.

How can I keep my bones strong as I age?

There are things you can do at any age to prevent weakened bones. Here are some tips:

• Eat foods that support bone health. Get enough calcium, vitamin D, and protein each day. Low-fat dairy; leafy green vegetables; fish; and fortified juices, milk, and grains are good sources of calcium. If your vitamin D level is low, talk with your doctor about taking a supplement.
• Get active. Choose weight-bearing exercise, such as strength training, walking, hiking, jogging, climbing stairs, tennis, and dancing. This type of physical activity can help build and strengthen your bones.
• Don’t smoke. Smoking increases your risk of weakened bones. If you do smoke, here are tips for how to quit smoking.
• Limit alcohol consumption. Too much alcohol can harm your bones. Drink in moderation or not at all. Learn more about alcohol and aging.

To learn more, please visit https://www.nia.nih.gov/health/osteoporosis/osteoporosis.

As you age, it is normal to notice changes in your vision. A few common changes for older adults include:

• Losing the ability to see up close
• Having trouble distinguishing colors, such as blue from black
• Needing more time to adjust to changing levels of light

These problems are often easily corrected. Glasses, contact lenses, and improved lighting may help and enable you to maintain your lifestyle and independence.

Your risk for some eye diseases and conditions increases as you grow older, and some eye changes are more serious. Keep your eyes as healthy as possible by getting regular eye exams so any problems can be spotted early.

What can you do to protect your vision?

Have your eyes checked regularly by an eye care professional — either an ophthalmologist or optometrist. Finding and treating any problems early can help protect your vision and prevent vision loss. Make a list of your questions and concerns to share with the doctor. Tell them which medications you are taking. Some can affect your eyes.

Normal changes in the aging eye usually do not harm your vision. However, sometimes they can be signs of a more serious problem. For example, your eyes may leak tears. This can happen with light sensitivity, wind, or temperature changes. Sunglasses and eye drops may help. Sometimes, leaking tears may be a symptom of dry eye or sign of an infection or blocked tear duct. Your eye care professional can treat these problems.

Many people don’t notice any signs or symptoms in the early stages of eye diseases. A dilated eye exam performed by an eye care professional is the only way to find some common eye diseases while they’re easier to treat — and before they cause vision loss. Everyone over age 50 should have a dilated eye exam every year or as recommended by your eye care professional, even if you have good vision and don’t wear contacts or glasses. After age 60, you should get a dilated eye exam every year or two. Most people with diabetes or high blood pressure need to get a dilated exam at least once a year.

During this exam, the eye care professional will put drops in your eyes to widen (dilate) your pupils so that he or she can better see inside each eye. Your vision may be blurry after the exam, and your eyes may be more sensitive to light. This only lasts a few hours. Make plans for someone else to drive you home.

If you wear glasses or contact lenses, get your prescription checked, too. Even small changes in sight can increase your risk for falls and injuries. It’s important to use the proper prescription glasses or contact lenses.

See your primary health care provider regularly to check for diseases like diabetes and high blood pressure. These diseases can cause eye problems if not controlled or treated.

Eye diseases and conditions

The following eye problems can lead to vision loss and blindness in older adults. They may have few or no early symptoms. Regular eye exams are your best protection. If your eye care professional finds a problem early, often there are things you can do to protect your vision.

• Age-related macular degeneration (AMD) can harm the sharp, central vision needed to see objects clearly and to do common things like driving and reading. Your eye care professional will ask about your family history and look for signs of AMD during a dilated eye exam. Treatments are available, and special dietary supplements can help lower your chance of it getting worse.
• Diabetic retinopathy may occur if you have diabetes. It develops slowly, often with no early warning signs. If you have diabetes, be sure to have a dilated eye exam at least once a year. Keeping your blood sugar, blood pressure, and cholesterol under control can prevent diabetic retinopathy or slow its progress in early stages. Laser surgery in later stages can sometimes prevent it from getting worse.
• Cataracts are cloudy areas in the eye’s lens causing blurred or hazy vision. Some cataracts stay small and don’t change your eyesight much. Others become large and reduce vision. Cataract surgery can restore good vision and is a safe and common treatment. If you have a cataract, your eye care professional will watch for changes over time to see if you would benefit from surgery.
• Glaucoma is usually caused by too much fluid pressure inside the eye. If not treated, it can lead to vision loss and blindness. People with glaucoma often have no early symptoms or pain. You can help protect yourself by having dilated eye exams yearly. Glaucoma can be treated with prescription eye drops, lasers, or surgery.
• Dry eye occurs when tear glands don’t work well. You may feel stinging or burning, a sandy feeling as if something is in the eye, or other discomfort. Dry eye is common as people get older, especially for women. Your eye care professional may tell you to use a home humidifier or air purifier, special eye drops (artificial tears), or ointments to treat dry eye. For more severe cases, treatment options might include prescription medication, tear duct plugs, or surgery.

What is low vision?

Low vision means you cannot fix your eyesight with glasses, contact lenses, medication, or surgery. Low vision affects some people as they age. You may have low vision if you:

• Can’t see well enough to do everyday tasks like reading or cooking
• Have difficulty recognizing the faces of your friends or family
• Have trouble reading street signs
• Find that lights don’t seem as bright

If you have any of these problems, ask your eye care professional to test you for low vision.

Vision rehabilitation programs and special aids, such as a magnifying device, can help you adapt to vision loss and make the most of your remaining sight. There are also programs, such as the National Library Service, that link people who have low vision or visual disabilities to resources at no cost.

Remember to ask your eye doctor if it is safe for you to drive with your vision. If you have to stop driving, organizations in your area may be able to arrange rides for you, or public transportation may be available.

Other tips that may help:

• Brighten the lighting in your room.
• Write with bold, black felt-tip markers.
• Use paper with bold lines to help you write in a straight line.
• Put colored tape on the edge of any stairs in your home to help you see them and prevent you from falling.
• Install dark-colored light switches and electrical outlets so that you can see them easily against light-colored walls.
• Use motion lights that turn on when you enter a room. These may help you avoid accidents caused by poor lighting.
• Use clocks with large numbers and phones with large screens; put large-print labels on the microwave and stove.

To learn more, please visit https://www.nia.nih.gov/health/vision-and-vision-loss/aging-and-your-eyes.

Over time, people with Alzheimer’s disease will become less able to manage things around the home. For example, they may forget to turn off the oven or faucet, or even how to use the phone in an emergency. People with Alzheimer’s also may not see, smell, touch, hear, or taste things as they used to.

Caregivers can do many things to make the person’s home a safer place. The tips on this page cover a wide range of safety concerns that may arise — some may not apply to your current circumstances. It is important, however, to keep thinking about home safety as the person’s behavior and abilities change.

Creating a Safer Home for a Person with Alzheimer’s

Go through the house room by room to identify potential problems and safety issues. First, correct any immediate dangers, such as loose stair railings and poor lighting, and then work on other ways to ensure the person will be as safe as possible at home.

To prevent falls, mark the edges of steps with brightly colored tape so the person can see the steps as they go up or down stairs.

• Use brightly colored signs or simple pictures to label the bathroom, bedroom, and kitchen.
• Limit the size and number of mirrors in your home and be specific about where you put them. Mirror images may confuse a person with Alzheimer’s.
• Make the walls a lighter color than the floor to create contrast. Avoid busy patterns.
• Install safety latches on storage cabinets and drawers designated for breakable or dangerous items.
• Set the water heater to 120°F to avoid scalding tap water.
• Label hot-water faucets red and cold-water faucets blue and/or write the words “hot” and “cold” near them.
• Pad any sharp corners on your furniture or replace or remove furniture with sharp corners.
• Place decals at eye level on sliding glass doors, picture windows, or furniture with large glass panels to identify the glass pane.
• Consider a “NO SOLICITING” sign for the front gate or door.
• Use smoke detectors and natural gas detectors and check their functioning and batteries frequently. People with Alzheimer’s may not be able to smell smoke or an unlit gas stove.
• Install nightlights and/or automatic light sensors.
• List emergency phone numbers (such as ambulance, poison control, and doctors) and the person’s address near all phones.

Store potentially dangerous items in a locked area or remove them from the home. These items can include:

• Prescription and over-the-counter medicines
• Alcohol
• Cleaning and household products, including paint thinner, matches, rubbing alcohol, and laundry detergent pods
• Poisonous plants
• Guns and other weapons, scissors, knives, power tools, and machinery
• Gasoline cans and other flammable items

Learn basic first aid in case the person gets sick or injured. Learn the Heimlich maneuver and CPR, and when to use each. Check with your local hospital or American Red Cross chapter about health and safety classes.

Kitchen Safety

• Put signs near the oven, toaster, iron, and other things that get hot. The sign could say, “Stop!” or “Don’t Touch — Very Hot!” Be sure the sign is not so close that it could catch fire.
• Check foods in the refrigerator often. Throw out any that have gone bad.
• Add safety knobs and an automatic shut-off switch on the stove.
• Consider disconnecting the garbage disposal.
• Insert a drain trap in the kitchen sink to catch anything that may otherwise become lost or clog the plumbing.
• Remove artificial fruits and vegetables or food-shaped kitchen magnets, which may seem edible to the person with Alzheimer’s.

Bedroom Safety

• Use a room monitoring device (like those used for infants) to alert you to any sounds indicating a fall or other need for help during the night.
• Remove portable space heaters. If you use portable fans, be sure that objects cannot be placed in the blades.
• Be cautious if using electric mattress pads, electric blankets, electric sheets, and heating pads, all of which can cause burns and fires. Keep controls out of reach of the person with Alzheimer’s.
• Install bed rails and other transfer or mobility aids.

Bathroom Safety

• Remove small electrical appliances from the bathroom and cover electrical outlets.
• Put away or lock up items such as toothpaste, lotions, shampoos, soap, and perfume. They may look and smell like food to a person with Alzheimer’s.
• Install grab bars in the tub/shower. A grab bar in contrasting color to the wall is easier to see.
• Use a raised toilet seat with handrails or install grab bars beside the toilet.
• Place nonskid adhesive strips, decals, or mats in the tub and shower. If the bathroom is uncarpeted, consider placing these strips next to the tub, toilet, and sink.
• Use a foam rubber faucet cover in the tub, plastic shower stool, and hand-held shower head.

Find more information here: Alzheimer’s Caregiving: Bathing, Dressing, and Grooming.

To learn more, please visit https://www.nia.nih.gov/health/safety/alzheimers-caregiving-home-safety-tips.

Hearing loss is a common problem caused by loud noise, aging, disease, and genetic variations. About one-third of older adults have hearing loss, and the chance of developing hearing loss increases with age. People with hearing loss may find it hard to have conversations with friends and family. They may also have trouble understanding a doctor’s advice, responding to warnings, and hearing doorbells and alarms.

Some people may not want to admit they have trouble hearing. Hearing problems that are ignored or untreated can get worse. If you have a hearing problem, see your doctor. Hearing aids, special training, certain medications, and surgery are some of the treatments that can help.

Signs of hearing loss

Some people have a hearing problem and don’t realize it. You should see your doctor if you:

• Have trouble understanding what people are saying over the telephone
• Find it hard to follow conversations when two or more people are talking
• Often ask people to repeat what they are saying
• Need to turn up the TV volume so loud that others complain
• Have a problem understanding speech because of background noise
• Think that others seem to mumble
• Can’t understand what’s being said when children and people with higher pitched voices speak to you

Types of hearing loss

Hearing loss comes in many forms. It can range from a mild loss, in which a person misses certain high-pitched sounds, to a total loss of hearing.

Sudden hearing loss

Sudden deafness, also known as sudden sensorineural hearing loss, is an unexplained rapid loss of hearing. It can happen to a person all at once or over a period of a few days. It should be considered a medical emergency. If you or someone you know experiences sudden hearing loss, visit a doctor immediately.

Age-related hearing loss

Age-related hearing loss, also called presbycusis, comes on gradually as a person grows older. It seems to run in families and may occur because of changes in the inner ear and auditory nerve, which relays signals from the ear to the brain. Presbycusis may make it hard for a person to tolerate loud sounds or to understand what others are saying.

Age-related hearing loss usually occurs in both ears, affecting them equally. Because the loss is gradual, people with presbycusis may not realize they have lost some of their ability to hear.

Tinnitus

Tinnitus is also common in older people. It is typically described as ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It can come and go. It can be heard in one or both ears, and it may be loud or soft. Tinnitus is sometimes the first sign of hearing loss in older adults. It can accompany any type of hearing loss.

Tinnitus is a symptom, not a disease. Something as simple as a piece of earwax blocking the ear canal can cause tinnitus. It can also be a sign of other health conditions, such as high blood pressure or allergies. Tinnitus can also occur as a side effect of certain medications.

Causes of hearing loss

Loud noise is one of the most common causes of hearing loss. Noise from lawn mowers, snow blowers, or loud music can damage the inner ear and result in permanent hearing loss. Loud noise also contributes to tinnitus. You can prevent most noise-related hearing loss by turning down the sound on your devices, moving away from loud noise, or using earplugs or other ear protection.

Earwax or fluid buildup can also cause hearing loss by blocking sounds that are carried from the eardrum to the inner ear. If wax blockage is a problem, your doctor may suggest mild treatments to soften earwax.

A ruptured eardrum can also cause hearing loss. The eardrum can be damaged by infection, pressure, or putting objects in the ear, including cotton-tipped swabs. See your doctor if you have ear pain or fluid draining from an ear.

Health conditions common in older people, such as diabetes or high blood pressure, can contribute to hearing loss. Ear infections caused by viruses and bacteria (also known as otitis media), a heart condition, stroke, brain injury, or a tumor may also affect your hearing.

Hearing loss can also result from taking certain medications that can damage the inner ear, sometimes permanently. These medications may be used to treat serious infections, cancer, or heart disease. They also include some antibiotics, and even aspirin at some dosages. If you notice a problem while taking a medication, check with your doctor.

Genetic variations can cause hearing loss as well. Not all inherited forms of hearing loss are evident at birth. Some forms can show up later in life. For example, otosclerosis, which is thought to be a hereditary disease, involves the abnormal growth of bone that prevents structures within the ear from working properly.

Health effects of hearing loss

Hearing loss can affect cognitive health. Studies have shown that older adults with hearing loss have a greater risk of developing dementia than older adults with normal hearing. Cognitive abilities (including memory and concentration) decline faster in older adults with hearing loss than in older adults with normal hearing. A recent analysis of several studies found that people who used hearing restorative devices (such as hearing aids and cochlear implants) had a lower risk of long-term cognitive decline compared to people with uncorrected hearing loss.

Older people who can’t hear well may become depressed or withdrawn from others because they feel frustrated or embarrassed about not understanding what is being said. Sometimes, older people are mistakenly thought to be confused, unresponsive, or uncooperative because they don’t hear well. These circumstances can lead to social isolation and loneliness.

Hearing loss, even small amounts, is also linked to an increased risk for falls. It also can affect public as well as personal safety, such as the ability to drive safely, when warning sounds are harder to hear.

How to cope with hearing loss

If you notice signs of hearing loss, talk with your doctor. If you have trouble hearing, you should:

• Let your family and friends know you have a hearing problem.
• Ask people to face you and to speak louder and more clearly. Ask them to repeat themselves or reword what they’re saying.
• Pay attention to what is being said and to facial expressions or gestures.
• Let the person talking know if you do not understand what was said.
• Find a good location to listen. Place yourself between the speaker and sources of noise or look for quieter places to talk.

The most important thing you can do if you think you have a hearing problem is to seek professional advice. Your family doctor may be able to diagnose and treat your hearing problem. Or your doctor may refer you to other experts, like an otolaryngologist (ear, nose, and throat doctor) or an audiologist (health professional who can identify and measure hearing loss).

Devices to help with hearing loss

Many types of assistive devices are available to help people with hearing loss. These devices can amplify sounds, provide alerts, and help you communicate with others. For example, alert systems work with doorbells, smoke detectors, and alarm clocks to send visual signals or vibrations. Devices that use keyboards, touch screens, or text-to-speech technology can help you give and receive information more effectively. Learn more about the wide range of assistive devices available for people with hearing loss from the National Institute on Deafness and Other Communication Disorders.

Hearing aids are electronic, battery-run assistive devices that make some sounds louder. There are two main ways to get a hearing aid: by prescription or over the counter.

• An audiologist or hearing aid specialist can prescribe hearing aids for people with significant or complicated hearing loss. Prescription hearing aids require a medical exam, and then the health care professional will fit and adjust the device.
• Hearing aids have recently become available without a prescription. Over-the-counter hearing aids, which are sold in stores and online, may help people with mild to moderate hearing loss.

Before buying a hearing aid, find out if your health insurance will cover part of the cost.

A cochlear implant is a different type of assistive device that can help people who are profoundly deaf or hard of hearing. Whereas hearing aids make sound louder so damaged ears can hear it, cochlear implants create electric signals that the brain recognizes as sound. The implant requires surgical placement and hearing therapy.

If you are experiencing hearing loss, talk with your doctor about assistive devices that may be available to help.

How to talk with someone who has hearing loss

Here are some tips you can use when talking with someone who has a hearing problem:

• In a group, make a point to include people with hearing loss in the conversation.
• Find a quiet place to talk to help reduce background noise, especially in restaurants and at social gatherings.
• Stand in good lighting and use facial expressions or gestures to give clues.
• Face the person and speak clearly. Maintain eye contact.
• Speak a little louder than normal, but don’t shout.
• Try to speak naturally and at a reasonable speed.
• Do not hide your mouth, eat, or chew gum while speaking.
• Repeat yourself if necessary, using different words.
• Try to make sure only one person talks at a time.
• Be patient. People with hearing loss may also be frustrated by their condition. Stay positive and relaxed.
• Ask how you can help.

To learn more, please visit https://www.nia.nih.gov/health/hearing-and-hearing-loss/hearing-loss-common-problem-older-adults.

Each year, millions of people suffer from seasonal influenza, which is often called the flu. Flu is a respiratory illness caused by viruses that infect the nose, throat, and sometimes the lungs.

Flu is a mild illness for some people. But for others, including older adults and those with chronic (long-lasting) health conditions, the flu can be very serious and even life-threatening. Getting a flu vaccine every year can help prevent the flu. The vaccine is safe, effective, and available for little to no cost to you.

How serious is the flu?

Most people who get the flu feel better after a few days to two weeks. However, the flu can make you seriously ill. Some people develop other health issues, called complications, because of the flu. Complications can be mild, such as a sinus or ear infection, or more serious, like pneumonia.

Anyone can get sick from the flu, but some people are more likely to have complications. You are more at risk for flu and its complications if you:

• Are age 65 or older
• Have certain medical conditions such as asthma, diabetes, or chronic kidney disease
• Have heart disease or have had a stroke
• Live in a nursing home or other long-term care facility

Pregnant people and children younger than five years old are also more likely to get very sick from the flu. Flu vaccination is especially important for people in these higher-risk groups. Learn more about people at increased risk for flu and its complications.

Why is the flu more dangerous for older adults?

The flu is more dangerous for older adults for a few reasons. One reason is that the immune system — which helps your body fight infections — weakens as you age. For example, because your body is busy fighting off the flu, you might pick up a secondary infection such as pneumonia. A second reason is that older adults are also more likely to have other health conditions, like diabetes, that increase their risk for complications from the flu.

The good news is the flu vaccine reduces your risk of getting the flu and of getting seriously ill if you do get sick with the flu. Flu vaccination is especially helpful for people with chronic health conditions. For example, it has been linked to lower rates of heart problems (cardiac events) among people with heart disease and fewer hospitalizations among people who have chronic lung disease or diabetes. Learn more about the benefits of flu vaccination.

How does the flu spread?

The flu is contagious, which means it spreads from person to person. It mostly spreads through droplets in the air when people with flu cough, sneeze, or talk. It can spread from up to six feet away. Although it isn’t as common, the flu can also spread from surfaces — for example, if you touch something the virus is on and then touch your nose, mouth, or eyes.

It’s possible to spread the flu before you feel sick and when you have symptoms. Typically, people with the flu can spread it a day before, and up to a week after feeling sick. Young children and people with weakened immune systems may be able to spread the flu for even longer. If you or someone you know is sick with the flu, take steps to help prevent spreading the disease

Is it the flu, a cold, or COVID-19?

The common cold, flu, and COVID-19 are respiratory illnesses caused by different viruses. They can all cause similar symptoms. If you have symptoms, a health care provider can determine the cause of your illness and help you take steps to feel better.

A cold is often milder than the flu. The flu and COVID-19 have similar symptoms, but COVID-19 spreads more easily and symptoms tend to be more severe. It’s also more common to have a change in your sense of smell or taste with COVID-19.

People with the flu can have fever, chills, dry cough, general aches and pains, and a headache. They feel very tired. Sore throat, sneezing, stuffy nose, or stomach problems are less common. What some people call “stomach flu” is not influenza. Learn more about the differences between the flu and a cold and flu and COVID-19.

How can you prevent the flu?

The most effective way to prevent the flu is to get a flu vaccine every year. Everyone 6 months and older should get a flu vaccine. It makes it less likely that you will get the flu. It also reduces your chances of being hospitalized or dying if you do get sick with the flu.

In addition to getting your flu vaccine, you can help stop the spread of flu by:

• Washing your hands
• Covering your mouth when you cough or sneeze
• Avoiding touching your eyes, nose, or mouth
• Staying home when you are sick
• Avoiding close contact with people who are sick
• Cleaning and disinfecting frequently touched surfaces at home, work, or school

Who should get a flu vaccine and which one should you choose?

You can get the flu at any time of year, but it’s most common in the fall and winter. It usually starts to spread in October and peaks between December and February. That’s why this time is called the flu season.

It takes at least two weeks for your flu vaccine to start working, so try to get vaccinated by the end of October. However, getting vaccinated after October can still help protect you from the flu. Because older adults may lose protection from a flu vaccine more quickly, try to avoid getting vaccinated too early (before September).

There are flu vaccines designed specifically for older adults. The CDC recommends that people age 65 and older receive a higher-dose flu vaccine or an adjuvanted flu vaccine (one with an additional ingredient called an adjuvant that helps create a stronger immune response). These vaccines are potentially more effective than the standard flu vaccine for people in this age group. Talk with a health care provider or pharmacist about which vaccine is best for you.

Where can you get a flu vaccine?

You can get your flu vaccine at a doctor’s office or from your local health department. Many grocery stores, drug stores, and pharmacies also offer flu vaccines. Visit Vaccines.gov to find a location near you.

Why do you need a flu vaccine every year?

You need a flu vaccine every year for two reasons. First, flu viruses change and the flu vaccine is updated each year to target the flu viruses that are anticipated to spread that year. Second, the protection you get from a flu vaccine lessens with time, especially in older adults. Getting your flu vaccine every fall gives you the best protection from that year’s flu viruses.

What are the side effects of flu vaccines?

The flu vaccine is safe and cannot give you the flu. Most people have no problems after getting a flu vaccine.

When side effects occur, they are generally mild and go away on their own. The most common side effects are soreness, redness, or swelling at the site where you got the shot. Some people also get a headache, fever, nausea, or muscle aches. These side effects start shortly after getting the vaccine and can last up to two days. They typically do not get in the way of daily activities.

If you have allergies, talk with a health care provider about your options for flu vaccines. Even people with mild egg allergies can safely get most flu vaccines. Egg-free flu vaccines are also available. You should not get vaccinated if you have had a severe allergic reaction to the flu vaccine in the past.

How much does getting a flu vaccine cost?

Most people can get a flu vaccine for little to no out-of-pocket cost. Medicare and most private health insurance plans will cover the cost of your flu vaccine. However, some insurance plans require that you receive your vaccine at a specific location. Check with your insurance company. If you do not have health insurance, contact your local or state health department.

What can you do if you get the flu?

If you get the flu, there are steps you can take to feel better. Act fast! First, talk with a health care provider. The flu and COVID-19 have similar symptoms, so you may need to get tested for an accurate diagnosis. This will also help determine which medications might make you feel better.

There are prescription drugs, called antivirals, that are used to treat people with the flu. If you take them within 48 hours after flu symptoms begin, these drugs can make you feel better more quickly. Antivirals can also help reduce your risk of complications from flu. Antibiotics do not help you recover from the flu. However, they are sometimes prescribed to treat a secondary infection if it is caused by bacteria. Bacteria are a different type of germ than viruses.

If you are sick, rest and drink plenty of fluids like juice and water, but not alcohol. Over-the-counter medicines, such as acetaminophen or ibuprofen, can bring down your fever and might help with the aches and pains.

It is important not to smoke if you are sick with the flu. It is a respiratory illness that can infect your lungs as well as your nasal passages. These same areas are also affected by smoking.

Monitor your symptoms and talk with a health care provider if you start feeling worse. For example, contact your provider right away if you:

• Have shortness of breath or difficulty breathing
• Feel weak, dizzy, or confused
• Develop ongoing pain or pressure in the chest or abdomen
• Have a fever or cough that goes away and then comes back, which may be a sign of a secondary infection
• Experience worsening of other chronic health problems, such as asthma or heart disease
• Develop any other symptoms that worry you

To learn more, please visit https://www.nia.nih.gov/health/flu/flu-and-older-adults.

It is not always clear whether an aging parent or relative needs help. Sometimes a person will recognize that they need help and request it, or an emergency or sudden illness will make it clear. Others may not want to cause worry or admit they’re struggling.

If you become aware of the signs that a loved one needs help, you will be better prepared to provide support for their safety and well-being.

How to tell if someone needs extra support

The best way to know what someone needs is to ask them directly. But a phone call, email, or text message is not always the best way to tell whether an older person needs help. These signs may indicate that someone needs extra support:

Changes at home. When you spend time at the person’s home, you might notice possible trouble spots. Some examples include:

• Can the person prepare meals on a stove safely?
• Are they bathing regularly and wearing appropriate clothing for the weather?
• Is the home relatively clean and free of clutter?
• Do they have the medications they need, and are they taking them regularly?

Mental health concerns. Changes in a person’s mood could indicate a need for help. Sometimes depression in older people is confused with normal aging. An older person with depression might brighten up for a phone call or short visit, but it’s harder to hide serious mood problems during an extended visit. Seek immediate help if the person says they feel hopeless or have no reason to live, or if you’re worried they may harm themselves. Call or text the 24-hour 988 Suicide & Crisis Lifeline at 988 or call 800-273-TALK (800-273-8255). For TTY, use your preferred relay service or dial 711 then 988.

Other health concerns. Signs related to the person’s general health that can raise concerns include:

• Significant weight gain or weight loss
• Poor hygiene
• Confusion
• Falls
• Loneliness or social isolation
• Trouble walking or getting around

Memory issues. Occasional forgetfulness is a normal part of aging. But more significant memory problems, changes in thinking ability or personality, or poor decision-making could indicate a serious condition that requires medical attention.

Recognizing changes if you live far away

If you don’t live close to an older family member or see them often, it may be difficult to notice if the person needs help.

With the person’s permission, you could contact people who see them regularly – neighbors, friends, doctors, or local relatives, for example – and ask them to call you with any concerns. You might also ask if you can check in periodically.

What to do when a loved one needs help

When you notice signs that your aging parent or relative needs help, it is important to know what steps to take next. Some issues have a simple fix, like needing a new glasses prescription. But other times, you may need to provide more support.

Your first step may be to talk to the older person about your concerns. Mention your worry without sounding critical, such as, “Mom, it looks like you don’t have much food in the house. Are you having trouble getting to the store?”

Then try to fulfill the person’s wishes to the extent possible. For example, if they want to keep cooking at home, you could ask, “Would you like me to arrange to have groceries delivered on a regular basis?” Try to include practical help with your suggestions and give specific examples of what can be done.

If you’re concerned about the person’s physical or mental health, suggest a visit to a health care provider. You might offer to make the appointment, give them a ride, or go with them to see the doctor.

You don’t have to do everything yourself. In many communities, a variety of services are available to help older people. Depending on the person’s needs, you might hire a home health aide to visit on a regular basis, arrange transportation so the person can run errands, or speak with a geriatric care manager to help coordinate care. You can also find ways to share caregiving responsibilities with other family members, neighbors, or friends.

Helping an aging parent or other relative plan for the future

The best time to plan is before the older person needs extensive help. Planning for the possibility of long-term care gives you and your family time to learn about services available in your community and what they cost. It also allows the older person to make important decisions while they are still able.

There may be a time when your older relative can no longer live independently at home. Learn as much as you can about housing options, which may include moving to a residential facility (such as a nursing home or assisted living) or living with a family member. These choices may depend on the person’s health, ability to perform activities of daily living, financial resources, and personal preferences. Talk about the pros and cons of each option before making a decision.

You may also need to help the older person prepare for decisions about their future medical care — a process called advance care planning. It’s important to know what they would want if they became seriously ill or unable to communicate their wishes. Having conversations about the person’s preferences and making a plan makes it more likely that they will get the care they want.

To learn more, please visit https://www.nia.nih.gov/health/caregiving/does-older-adult-your-life-need-help.