Health Conditions
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In this section we list some common health conditions of old age. We also cross-reference to our sections on how to reduce the risk of getting the problem, how to reduce the risk of infection spread, and the methods used to assess for the problem.
We list common health conditions below alphabetically. To look up any other conditions, see the NHS website Health A-Z of conditions.
Common cold, Flu and Covid
See our section on how to reduce the risk of flu and covid spreading.
An annual flu vaccination is strongly advised for old folks, and in the UK is offered to them automatically by the NHS.
Constipation or Wind
Constipation and wind are more common in old folks, associated with general reduction in the muscles that work things through the digestive system, and with lack of mobility. For treatments and foods to avoid see our section on constipation and wind.
Coughing from drinking or eating
As dementia progresses, people can have difficulty in coordinating swallowing, resulting in coughing to clear the tickle from the back of the throat. If it becomes more than a rare event then it should be referred to your GP, before it develops further and becomes a risk of aspiration pneumonia. For more information see our section on coughing from drinking or eating.
For a rare coughing event, smooth yoghurt is better than a drink for 'washing down' food that isn't being cleared by coughing and is causing a tickle, but be careful not to give it while coughing is continuous and may result in it being gasped down the wrong way.
Dehydration
Dehydration (not having enough to drink) can become a serious problem as the sense of thirst becomes less sensitive with age and with dementia. It can also be caused by illness with diarrhoea or vomiting. See our section on how to identify whether someone is dehydrated.
It's worth noting that dehydration can cause impaired brain function making the symptoms of dementia worse, in addition to causing other problems.
Dementia
We cover the effects of dementia, physically and on behaviour, and how to reduce your own risk of getting dementia in our section 'about dementia'.
For information on the tests used to assess cognitive impairment in dementia see our section on cognitive assessment.
Also see our section on dementia medicines.
Depression
Diagnosis of depression, especially for someone with dementia, requires a clinical specialist. There's otherwise too great a scope for misassessment based on the effects of other medical conditions including the symptoms of dementia, or on unassessed pain.
You may come across the Cornell Scale for Depression in Dementia (CSDD) - but there's evidence this isn't a valid or useful tool when used by non-specialist staff.
For more information see our section on depression assessment.
Diabetes
For the check-ups someone with diabetes will have see our section on diabetes tests and assessments. It's particularly important for carers to check feet and extremities periodically, to look for any signs of problems that have gone unnoticed by the person because of loss of feeling, or which they haven't been able to communicate, before the problems develop into skin ulcers and worse.
Also see our section on diabetes medicines.
Diarrhoea or Vomiting
In addition to looking for the cause of diarrhoea or vomiting (e.g. norovirus), there are two further things to consider.
Risk of dehydration
There's a risk of dehydration as a result of diarrhoea or vomiting. In severe cases the person may potentially need not just extra drink but oral rehydration sachets dissolved in the drink, to help keep the correct balance of sugar, salts and minerals the body needs. For old folks (who are likely to have medical issues and may be on several medications) these should only be used according to the instructions of your doctor or a qualified pharmacist. It's to be expected that your doctor would be involved in these circumstances anyway.
Risk of infection spread
Care should be taken when cleaning up vomit or diarrhoea. Other people should avoid eating in the area where this has recently occurred and likewise as far as reasonable avoid spending time in the area. To reduce the risk of spreading airborne particles when flushing the toilet, it's best to put the lid down before flushing and wait a minute after flushing before lifting it again (but don't forget to lift it!).
Eyesight
It's recommended that eyesight is tested annually, including to reduce the risk of falls, and from the point of view of checking eye health.
There are specialist tests for people with dementia who can't recognise letters or can't communicate what they see.
In the UK tests are free on the NHS for over 60s, and home visits can be arranged.
See our section on eye tests.
Falls
Falls are a very serious issue, and even falls that don't cause injury should be referred to your GP. The GP may check whether there are any medical issues that need addressing, and may refer you to an occupational therapist (ot) or a physiotherapist.
Even when there hasn't been a fall there are many things you can do to reduce the risk of a fall.
Hearing
Poor hearing can reduce communication ability, increase a sense of isolation, cause confusion, and prevent enjoyment of music and so on.
If you think your loved one may have hearing loss then consult your GP, who'll be able to check for issues such as earwax buildup and will refer you to a specialist for a test if appropriate. In the UK this is free on the NHS.
Incontinence
Incontinence is involuntary peeing, and should be referred to your GP. A continence nurse or adviser may be involved in the longer-term management of the condition.
It's important that the condition is managed properly, not just from the point of view of embarrassment but also because wetness contributes to pressure sores and urinary tract infections.
Cause
Consideration should be given to whether the problem is something other than not sensing that they need to pee. For example, is there a problem remembering where the toilet is (in which case use a sign on the door and arrows to it), or does poor mobility make getting there in time difficult? In these cases try taking the person to the bathroom at appropriate intervals (and at their regular time for bowel movement). Also consider whether there's difficulty opening a zip, in which case try velcro fasteners or pull down clothes (making sure those don't cause more confusion). Consider getting a commode (in the UK you can be provided with one as loan equipment by social services or the NHS).
Incontinence can't be managed by reducing drink intake, and indeed just the opposite may be the case since more concentrated pee can irritate the bladder and increase incontinence. In any case, reducing drink would also result in dehydration, which is a serious problem.
Not a reason for an internal catheter
Note that incontinence is not managed by an internal urinary catheter - these are for when the bladder's pathway out is obstructed and urine would otherwise be retained. They are intrusive devices, and increase the risk of urinary tract infections, and are not appropriate as an attempt to reduce the frequency of personal care required.
As a medical professional is required in order to fit one this should prevent a poor care home suggesting one inappropriately.
Solution
You'll be advised on the most appropriate type of solution, such as absorbent incontinence pads that fit inside normal underwear, or pull-up underwear that incorporates the pad (which is likely to be more suitable for someone with dementia). These come in different absorbency capacities. Urine collection devices may be used for men. In the UK these items can be prescribed on the NHS, although owing to their high ongoing cost make sure you put forward a good case for pull-ups if required owing to dementia, and for high absorbency. These products are also available to buy online (but use a reputable supplier) and at many supermarkets.
Further information is available on the NHS website Health A-Z for incontinence.
Mobility
See our section on mobility.
Norovirus ('winter vomiting bug'), gastroenteritis
See our section on how to reduce the risk of norovirus infection spreading. It's important to note that unlike flu and coronavirus, norovirus is not killed by alcohol gel - hands should be washed with soap and water.
Also see our information about potential dehydration if there's severe vomiting or diarrhoea.
Pain
See our section on the assessment of whether someone has pain.
See our section about pain relief medicines.
Pressure sores
Pressure sores arise when blood circulation to the area is reduced, usually as a result of lack of movement so that the person's own weight presses on the area for a prolonged period. We naturally adjust our position periodically to avoid it, but with age the need to move may not be felt as greatly, or reduced mobility may prevent it. Pressure sores can be extremely painful, and whilst there may be a visible redness, there may be nothing at all to see. They can potentially develop into ulcers, with broken skin and damaged tissue underneath.
See our section on preventing pressure sores.
Sleeping
See our section on sleeping.
Stroke
See our section on the FAST test for whether someone is having a stroke and needs emergency help.
See our section on how to reduce the risk of getting a stroke.
A stroke is a caused by part of the brain not getting the oxygen it needs, either because a blood vessel is blocked by a clot (an 'ischaemic' stroke) or because a blood vessel is leaking, causing less blood to get through (a 'haemorrhagic' stroke). A 'mini-stroke' (or 'transient ischaemic attack' or TIA) occurs when the blockage clears by itself, but is an indication that another clot may strike and is therefore an emergency situation even when the symptoms have disappeared.
(If you're wondering what the difference is between a stroke and a heart attack, the latter is caused by a clot of blood to the heart, and results in chest pain (which can be mild), sudden breathlessness and feeling weak and/or lightheaded.)
Which brain functions are affected by a stroke will depend on where in the brain it occurred. The brain has a remarkable ability to recover functions over time, including by 'rewiring' itself, and the chances of this are increased by early rehabilitation with the help of physiotherapists, occupational therapists and others. They'll also be able to identify any aids that will be useful.
Much more information about strokes is available on the Stroke Association website, for example under what is stroke - diagnosis to discharge. Also see the British Heart Foundation website, for 'stroke'.
Urinary retention
Urinary retention is when the bladder's pathway out is obstructed and urine is kept in. This has to be managed by an internal urinary catheter that keeps the pathway open, and allows urine to flow into a collection bag.
Urinary catheters increase the risk of urinary tract infections (see below), so watch out for symptoms of this, including a sudden increase in confusion.
Urinary Tract Infection (UTI)
Amongst other symptoms, UTIs can cause greater confusion than usual, in a noticeably rapid change. They occur when bacteria, usually from faeces (poo), get into the urinary tract (where you pee from), and are often treated with antibiotics (though a lab test may be required to determine which antibiotic is appropriate). They're ten times more common in women than in men, and are more likely with a urinary catheter or incontinence.
See our section on the urine test for whether someone may have a UTI.
See our section on how to reduce the risk of getting UTIs.