Older adults need about the same amount of sleep as all adults—7 to 9 hours each night. But, older people tend to go to sleep earlier and get up earlier than they did when they were younger.

There are many reasons why older people may not get enough sleep at night. Feeling sick or being in pain can make it hard to sleep. Some medicines can keep you awake. No matter the reason, if you don’t get a good night’s sleep, the next day you may:

• Be irritable
• Have memory problems or be forgetful
• Feel depressed
• Have more falls or accidents

Get a Good Night’s Sleep

Being older doesn’t mean you have to be tired all the time. You can do many things to help you get a good night’s sleep. Here are some ideas:

• Follow a regular sleep schedule. Go to sleep and get up at the same time each day, even on weekends or when you are traveling.
• Avoid napping in the late afternoon or evening, if you can. Naps may keep you awake at night.
• Develop a bedtime routine. Take time to relax before bedtime each night. Some people read a book, listen to soothing music, or soak in a warm bath.
• Try not to watch television or use your computer, cell phone, or tablet in the bedroom. The light from these devices may make it difficult for you to fall asleep. And alarming or unsettling shows or movies, like horror movies, may keep you awake.
• Keep your bedroom at a comfortable temperature, not too hot or too cold, and as quiet as possible.
• Use low lighting in the evenings and as you prepare for bed.
• Exercise at regular times each day but not within 3 hours of your bedtime.
• Avoid eating large meals close to bedtime—they can keep you awake.
• Stay away from caffeine late in the day. Caffeine (found in coffee, tea, soda, and chocolate) can keep you awake.
• Remember—alcohol won’t help you sleep. Even small amounts make it harder to stay asleep.

Insomnia Is Common in Older Adults

Insomnia is the most common sleep problem in adults age 60 and older. People with this condition have trouble falling asleep and staying asleep. Insomnia can last for days, months, and even years. Having trouble sleeping can mean you:

• Take a long time to fall asleep
• Wake up many times in the night
• Wake up early and are unable to get back to sleep
• Wake up tired
• Feel very sleepy during the day

Often, being unable to sleep becomes a habit. Some people worry about not sleeping even before they get into bed. This may make it harder to fall asleep and stay asleep.

Some older adults who have trouble sleeping may use over-the-counter sleep aids. Others may use prescription medicines to help them sleep. These medicines may help when used for a short time. But remember, medicines aren’t a cure for insomnia.

Developing healthy habits at bedtime may help you get a good night’s sleep.

Sleep Apnea

People with sleep apnea have short pauses in breathing while they are asleep. These pauses may happen many times during the night. If not treated, sleep apnea can lead to other problems, such as high blood pressure, stroke, or memory loss.

You can have sleep apnea and not even know it. Feeling sleepy during the day and being told you are snoring loudly at night could be signs that you have sleep apnea.

If you think you have sleep apnea, see a doctor who can treat this sleep problem. You may need to learn to sleep in a position that keeps your airways open. Treatment using a continuous positive airway pressure (CPAP) device almost always helps people with sleep apnea. A dental device or surgery may also help.

Movement Disorders and Sleep

Restless legs syndrome, periodic limb movement disorder, and rapid eye movement sleep behavior disorder are common in older adults. These movement disorders can rob you of needed sleep.

People with restless legs syndrome, or RLS, feel like there is tingling, crawling, or pins and needles in one or both legs. This feeling is worse at night. See your doctor for more information about medicines to treat RLS.

Periodic limb movement disorder, or PLMD, causes people to jerk and kick their legs every 20 to 40 seconds during sleep. Medication, warm baths, exercise, and relaxation exercises can help.

Rapid eye movement, or REM, sleep behavior disorder is another condition that may make it harder to get a good night’s sleep. During normal REM sleep, your muscles cannot move, so your body stays still. But, if you have REM sleep behavior disorder, your muscles can move and your sleep is disrupted.

Alzheimer’s Disease and Sleep—A Special Problem

Alzheimer’s disease often changes a person’s sleeping habits. Some people with Alzheimer’s disease sleep too much; others don’t sleep enough. Some people wake up many times during the night; others wander or yell at night.

The person with Alzheimer’s disease isn’t the only one who loses sleep. Caregivers may have sleepless nights, leaving them tired for the challenges they face.

If you’re caring for someone with Alzheimer’s disease, take these steps to make him or her safer and help you sleep better at night:

• Make sure the floor is clear of objects.
• Lock up any medicines.
• Attach grab bars in the bathroom.
• Place a gate across the stairs.

Safe Sleep for Older Adults

Try to set up a safe and restful place to sleep. Make sure you have smoke alarms on each floor of your home. Before going to bed, lock all windows and doors that lead outside. Other ideas for a safe night’s sleep are:

• Keep a telephone with emergency phone numbers by your bed.
• Have a lamp within reach that is easy to turn on.
• Put a glass of water next to the bed in case you wake up thirsty.
• Don’t smoke, especially in bed.
• Remove area rugs so you won’t trip if you get out of bed during the night.

Tips to Help You Fall Asleep

You may have heard about some tricks to help you fall asleep. You don’t really have to count sheep—you could try counting slowly to 100. Some people find that playing mental games makes them sleepy. For example, tell yourself it is 5 minutes before you have to get up, and you’re just trying to get a little bit more sleep.

Some people find that relaxing their bodies puts them to sleep. One way to do this is to imagine your toes are completely relaxed, then your feet, and then your ankles are completely relaxed. Work your way up the rest of your body, section by section. You may drift off to sleep before getting to the top of your head.

Use your bedroom only for sleeping. After turning off the light, give yourself about 20 minutes to fall asleep. If you’re still awake and not drowsy, get out of bed. When you feel sleepy, go back to bed.

If you feel tired and unable to do your activities for more than 2 or 3 weeks, you may have a sleep problem. Talk with your doctor about changes you can make to get a better night’s sleep.

To learn more, please visit https://www.nia.nih.gov/health/sleep/good-nights-sleep#sleep-and-aging.

Carter Nursing and Rehabilitation, in partnership with Reliant Rehabilitation, is thrilled to celebrate resident Loretta Hall’s inspiring Success Story!

After an illness and hospitalization left her unable to care for herself at home, Loretta joined our community. With determination and the support of her dedicated Care and Therapy Teams, Loretta worked tirelessly toward her goal of regaining independence. Her hard work paid off, and Loretta was able to return home independently—right back to her beloved dog, Cheezy, who she missed so much. We are so proud of Loretta’s journey and honored to have been a part of her recovery!

The common cold, flu, and COVID-19 all have similar symptoms. Knowing the signs of a cold, the flu, and COVID-19 can help keep you and your loved ones safe.

These are common signs, but your symptoms may be more or less severe, or you may only have a few. If you feel sick, stay home and call your doctor to discuss how you’re feeling and whether you need to get tested. Older adults are more likely to become seriously ill from the flu and COVID-19. Getting vaccinated is the best way to prevent some of these diseases.

• Common symptoms of a cold include sore throat, runny or stuffy nose, sneezing, and cough.
• Common symptoms of the flu include fever and/or chills, headache, muscle pain or body aches, feeling tired or weak, sore throat, runny or stuffy nose, sneezing, cough, shortness of breath or difficulty breathing, vomiting, and diarrhea.
• Common symptoms of COVID-19 include fever and/or chills, headache, muscle pain or body aches, feeling tired or weak, sore throat, runny or stuffy nose, sneezing, cough, shortness of breath or difficulty breathing, vomiting and diarrhea, and change in or loss of taste or smell.

To learn more, please visit https://www.nia.nih.gov/health/covid-19/it-cold-flu-or-covid-19

Providing care for an older adult can be overwhelming, especially at the beginning. On this page, you will find answers to frequently asked questions about caregiving.

Click on each of the expandable sections below to see the answer to each question and links to other resources.

I’m new to caregiving. Where do I start?

If you have never been a caregiver before, it may feel daunting at first. There might be tasks to organize, new medical terms to learn, and schedules to coordinate. Start by thinking about:

• Your loved one’s needs
• Family members and friends who can help you with caregiving tasks
• Services and community resources, such as home health care or adult day care centers
• Options for paying for care

If you don’t live nearby, you can learn about ways to provide support and assistance as a long-distance caregiver.

How can I find a caregiver support group?

Caregiver support groups (online or in-person) are a great way to connect with people who understand what you’re going through.

Your doctor or faith community may be able to help you find the right support group. You can also reach out to your local senior center, state office on aging or social services office, or local Area Agency on Aging for information about support groups. The Family Caregiver Alliance and the Caregiver Action Network offer online and in-person settings for caregivers to connect with one another.

Caring for an older adult can be both rewarding and challenging. Learn about more ways you can take care of yourself as a caregiver.

How do I help an older adult plan for the future?

You may need to help your loved one plan for the future by preparing important documents and storing them in a safe place. Learn how to get their affairs in order, which includes locating and organizing legal, financial, and personal records.

Depending on your loved one’s medical needs, you may need to help them prepare advance directives, which are legal documents that provide instructions for medical care if a person cannot communicate their own wishes. Get tips and worksheets to help you discuss advance care planning with your loved one.

How do I choose a long-term care facility?

When an older person needs more help than family and friends can provide, it may be time to consider moving to a residential (live-in) facility, such as assisted living or a nursing home. Choosing a place to live for long-term care is a big decision. It can be hard to know where to start.

Before you choose a long-term care facility for your loved one, consider their needs and wants. Talk to friends and family in your area and call and visit different facilities. Ask questions during your visit and ask for information about costs and payment options.

I’m overwhelmed and exhausted. How can I get a break from caregiving?

Taking care of a family member is hard work. But taking care of yourself is important, too. All caregivers need a break from time to time. Don’t wait until you’re completely overwhelmed to seek help from family, friends, or professional services.

Accepting help from others isn’t always easy. You may worry about being a burden, or you may feel uncomfortable admitting that you can’t do it all yourself. Get tips for how to ask family members or friends for help.

Respite care may also be an option. Respite care provides short-term relief for primary caregivers, giving them time to rest, travel, or spend time with other family and friends. The care may last anywhere from a few hours to several weeks at a time. Respite care can take place at home, in a health care facility, or at an adult day care center.

How do I make an older person’s home safer?

There are a variety of ways to make an older adult’s surroundings safer and easier to manage. 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.

Download this Home Safety Checklist for room-by-room suggestions to help you identify and remove hazards around the house.

Are you worried that making changes might be expensive? You may be able to get help paying for repairs and safety updates to an older adult’s home. Check with your state housing finance agency, social services department, community development groups, or the federal government for financial aid programs and discounts. You can also contact the Eldercare Locator for help finding resources.

To learn more, please visit https://www.nia.nih.gov/health/caregiving/frequently-asked-questions-about-caregiving.

Hospice care focuses on the care, comfort, and quality of life of a person with a serious illness that is approaching the end of life. It often includes emotional and spiritual support for both the patient and their loved ones. Still, deciding whether and when to start hospice can be a difficult decision, and it may cause people to feel confused or overwhelmed. Explore answers to frequently asked questions below about hospice care and its potential benefits.

Hospice care is a service for people with serious illnesses who choose not to get (or continue) treatment to cure or control their illness. People may choose to enroll in hospice care if the treatment is unlikely to be effective or if continuing it has become too burdensome. Hospice aims to provide comfort and peace to help improve quality of life for the person nearing death. It also helps family members cope with their loved one’s illness and can also provide support to the family after the person dies, including help with grieving, sometimes called bereavement care. Medicare reimburses for hospice services when a physician determines that a patient has a life-expectancy of 6 months or less.

Many people with a serious illness use hospice care. A serious illness may be defined as a disease or condition with a high risk of death or one that negatively affects a person’s quality of life or ability to perform daily tasks. It may cause symptoms or have treatments that affect daily life and lead to caregiver stress. Examples of serious illnesses include dementia, cancer, heart failure, and chronic obstructive lung disease.

Anyone with a serious illness who doctors think has a short time to live — generally 6 months or less —usually qualifies for hospice care. For Medicare to pay for hospice care, patients must stop medical treatment intended to cure or control their illness.

Despite the benefits of using hospice care, many people wait to receive hospice care until the final weeks or days of life. It’s important to talk with your doctor about your illness and how your disease is progressing. Starting hospice early may be able to provide months of meaningful care and quality time with loved ones.

Hospice care can provide a range of different services depending on your symptoms and end of life care wishes. These services include, but are not limited to, emotional and spiritual support for the person and their family, relief of symptoms and pain, help with advance care planning, therapy services, like physical or occupational therapy, and much more.

Hospice can be provided in many settings — a private home, nursing home, assisted living facility, or in a hospital. Many people choose to receive hospice care at home so their friends and family can visit as they wish. Other considerations may include one’s home environment vs. another setting, cost, and stability of the person’s condition. Choosing where to receive hospice care is a personal decision, but it may be helpful to talk with family members, your caregiver, or your doctor about the level of care you need and if it can be provided at home. The costs for receiving hospice care at different locations may differ.

Most Medicaid, Medicare, and private insurance providers will cover some of the services provided by hospice. Older adults enrolled in Medicare can receive hospice care if their healthcare provider thinks they have 6 months or less to live. In most cases, they will need to sign a statement choosing hospice care instead of other Medicare-covered treatments for their illness.

Most people with advanced dementia cannot communicate clearly, which means they may not be able to share their concerns with their caregivers. Caregivers may find it difficult to provide adequate care at the end of life because of this and other concerns. Hospice care can help with this situation. Hospice — whether used at home or in a medical facility — can provide caregivers and the person with dementia the support they may need near the end of life. Studies show that family members of people with dementia who received hospice report better quality of care and having more of their needs met at the end of life.

Studies have shown that when a person enrolls in hospice care they are more likely to have increased family satisfaction and better symptom and pain management. They are also less likely to undergo tests or be given medication they don’t need or want.

To learn more, please visit https://www.nia.nih.gov/health/hospice-and-palliative-care/frequently-asked-questions-about-hospice-care.

Dear Residents and Care Team Members,

As we recognize Veterans Day, I want to take a moment to honor and express our deepest gratitude to all of you who have served in the armed forces. Your dedication, bravery, and sacrifices have not only protected our freedoms but have also set an inspiring example for us all.

To our resident veterans, your stories of courage and resilience are a testament to the strength and spirit that define our community. We are privileged to have you with us, and we cherish the wisdom and experiences you share.

To our care team members who are veterans, your commitment to service continues to shine through in the compassionate care you provide every day. Your military service has instilled in you a sense of duty and excellence that greatly enriches our team and the lives of those we serve.

On behalf of the entire organization, thank you for your service. We honor you today and every day.

With heartfelt appreciation,

Paul Pruitt, Chief Executive Officer

A number of flu vaccines will be available this season. These include:

• injectable flu vaccines, or flu shots. These include:
  • Flu shots that are made with inactivated influenza viruses.
  • One flu shot that is made without influenza viruses.
• A live attenuated influenza vaccine, which is given by nasal spray.

People who can get the flu shot

Everyone 6 months and older should get a flu vaccine every season with rare exceptions. Vaccination is particularly important for people who are at higher risk of serious complications from influenza.

Flu vaccination has important benefits. It can reduce flu illnesses, visits to doctor’s offices, and missed work and school due to flu, as well as make symptoms less severe and reduce flu-related hospitalizations and deaths in people who get vaccinated but still get sick.

Recommended vaccines depend on a person’s age and other characteristics

• There are standard-dose inactivated flu vaccines that are approved for people as young as 6 months of age.
• Some vaccines are only approved for adults. For example, the recombinant flu vaccine is approved for people 18 years and older, and the adjuvanted and high-dose inactivated vaccines are approved for people 65 years and older.
• For people younger than 65 years, CDC does not recommend any one flu vaccine over another.
• For adults 65 years and older, there are 3 flu vaccines that are preferentially recommended. These are Fluzone High-Dose inactivated flu vaccine, Flublok recombinant flu vaccine, and Fluad adjuvanted inactivated flu vaccine. If none of the 3 flu vaccines preferentially recommended for people 65 years and older is available at the time of administration, people in this age group can get any other age-appropriate flu vaccine instead.
• For many people who are 2 years through 49 years of age, the nasal spray flu vaccine is an option. The nasal spray vaccine is not recommended for some groups, such as people who are pregnant and people with some medical conditions.
• In general, each person should get an age-appropriate flu vaccine (that is, one that is approved for their age). However, solid organ transplant recipients who are 18 through 64 years of age and who are receiving immunosuppressive medication regimens may receive high-dose inactivated flu vaccine or adjuvanted inactivated flu vaccine (which are currently approved for people ages 65 years and older). These vaccines are not preferred over other age-appropriate flu vaccines but are acceptable options for this population.
• High-dose inactivated flu vaccine, recombinant flu vaccine, and adjuvanted inactivated flu vaccine are preferred for people 65 years of age and older. There are no other preferential recommendations for specific flu vaccines for specific groups of people.

There are many vaccine options

• Pregnant people and people with certain chronic health conditions should get a flu shot.
• People with egg allergy may get any vaccine (egg-based or non-egg-based) that is otherwise appropriate for their age and health status. Beginning with the 2023-2024 season, additional safety measures are no longer recommended for flu vaccination of people with an egg allergy beyond those recommended for receipt of any vaccine, regardless of the severity of previous reaction to egg.

The most important thing is for all people 6 months and older to get a flu vaccine every year.

When to get vaccinated against flu

For most people who need only one dose of influenza vaccine for the season, September and October are generally good times to be vaccinated against influenza. Ideally, everyone should be vaccinated by the end of October. Additional considerations concerning the timing of vaccination for certain groups of people include:

• Most adults, especially those 65 years and older, and pregnant people in the first or second trimester should generally not get vaccinated early (in July or August) because protection may decrease over time. However, early vaccination can be considered for any person who is unable to return at a later time to be vaccinated.
• Some children need two doses of influenza vaccine. For those children, it is recommended that the first dose be given as soon as vaccine is available because the second dose needs to be given at least four weeks after the first. Vaccination during July and August also can be considered for children who need only one dose.
• Vaccination during July and August also can be considered for people who are in the third trimester of pregnancy during those months, because this can help protect their infants for the first few months after birth (when they are too young to be vaccinated).

People who SHOULD NOT get a flu shot

• Children younger than 6 months of age are too young to get a flu shot.
• People with severe, life-threatening allergies to any ingredient in a flu vaccine (other than egg proteins) should not get that vaccine. This might include gelatin, antibiotics, or other ingredients.
• People who have had a severe allergic reaction to a dose of influenza vaccine should not get that flu vaccine again and might not be able to receive other influenza vaccines. If you have had a severe allergic reaction to an influenza vaccine in the past, it is important to talk with your health care provider to help determine whether vaccination is appropriate for you.

People who should talk to their health care provider before getting a flu shot

Different influenza vaccines are approved for use in people in different age groups. In addition, some vaccines are not recommended for certain groups of people. Factors that can determine a person’s suitability for vaccination, or vaccination with a particular vaccine, include a person’s age, health (current and past) and any allergies to influenza vaccine or its components.

• Children younger than 6 months of age are too young to get a flu shot.
• People with severe, life-threatening allergies to any ingredient in a flu vaccine (other than egg proteins) should not get that vaccine. This might include gelatin, antibiotics, or other ingredients.
• People who have had a severe allergic reaction to a dose of influenza vaccine should not get that flu vaccine again and might not be able to receive other influenza vaccines. If you have had a severe allergic reaction to an influenza vaccine in the past, it is important to talk with your health care provider to help determine whether vaccination is appropriate for you.

Prioritized for flu vaccination during a vaccine shortage

When vaccine supply is limited, vaccination efforts should focus on delivering vaccination to the following people (no hierarchy is implied by order of listing):

• Children aged 6 months through 4 years (59 months);
• People aged 50 years and older
• People with chronic pulmonary (including asthma) or cardiovascular (except isolated hypertension), renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus);
• People who are immunosuppressed due to any cause, including immunosuppression caused by medications or by human immunodeficiency virus (HIV) infection;
• People who are or will be pregnant during the influenza season and people up to 2 weeks postpartum (after delivery);
• People who are aged 6 months through 18 years who are receiving aspirin or salicylate-containing medications and who might be at risk for experiencing Reye syndrome after influenza virus infection;
• People who are residents of nursing homes and other long-term care facilities;
• American Indian or Alaska Native persons;
• People with extreme obesity (body-mass index [BMI] is 40 or greater);
• Health care personnel;
• Household contacts and caregivers of children under 5 years and adults 50 years and older; and
• Household contacts and caregivers of people with medical conditions that put them at increased risk for severe illness from influenza.

To learn more, please visit https://www.cdc.gov/flu/vaccines/vaccinations.html.

Older adults may be even more vulnerable to fraud and scams than previously thought, according to an NIA-funded study that mimicked a real-world government imposter scam. The results suggest that a sizable minority of older adults, including those without cognitive impairment, are vulnerable to fraud and scams. The study results were published in JAMA Network Open.

Previous research on the vulnerability of older adults to financial fraud and scams has largely relied on self-reported data. To assess a more real-world response, researchers from the Rush Alzheimer’s Disease Center in Chicago, in collaboration with the Financial Industry Regulatory Authority Investor Education Foundation, conducted an experiment that mimicked imposter scams. The participants — 644 older adults (on average, age 85) in the Rush Memory and Aging Project — were contacted by a fictitious government agency about unusual activity on their Social Security and Medicare accounts that required verification.

Researchers classified how the older adults responded to the scam into three groups: no engagement (did not answer the phone or call in), engagement (answered or called in but raised skepticism and did not provide personal information), and conversion (answered or called in without skepticism or provided personal information). Most of the participants did not engage (68.5%). However, when they answered or called in, more of the participants engaged without skepticism (16.4%) than with skepticism (15.1%), and 12% of the participants even provided personal information.

The researchers also compared key characteristics across the engagement groups and found differences in cognition, financial literacy, and scam awareness. Older adults who engaged but raised skepticism scored the highest of all three groups on cognitive and financial literacy tests. This group also had the fewest number of people with dementia.

Those in the conversion group had the lowest scam awareness. When participants with dementia were excluded from analysis, cognition and financial literacy differences were no longer statistically significant, but those in the conversion group still scored lowest in scam awareness.

The generalizability of these findings to the general aging population may be limited, as participants were majority White, women, and highly educated. Because of the high levels of education among participants and the use of less intensive tactics than actual scammers, there is likely even more conversion among older adults in real-world scenarios. Increasing scam awareness and further exploring factors associated with vulnerability are important steps to decrease the risk of fraud victimization for this population.

To learn more, please visit https://www.nia.nih.gov/news/high-vulnerability-government-impersonation-scams-among-older-adults

Carter Nursing and Rehabilitation, in partnership with Reliant Rehabilitation, is excited to celebrate Judy Porter’s Success Story!

After an illness left her debilitated and dependent on assistance for daily care, Mrs. Porter came to Carter Nursing and Rehabilitation determined to regain her independence. With her unwavering determination and the dedicated support of our dedicated rehabilitation and Care Team, Judy achieved her goal of returning home. Congratulations to Judy and her Care Team on their success!