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Wellness and Chronic Illness

As a caregiver, you may find yourself in the position of having to help deal with medical issues such as chronic illness, medication management, and talking with doctors and other health care providers [1]. In this education module, we review the importance of healthy wellness habits, common chronic illnesses, and some of the resources available to caregivers. 

Topic Quick Links – Click on a topic below to go to that area of the page.

Wellness is the Goal – at all ages

Wellness is a life-long goal. Creating a healthy balance for you and your care recipient includes much more than just being physically fit. 

Healthy Nutrition Practices and Wellness Habits

You can support healthy nutrition practices by…

Check out the latest USDA dietary guidelines here:  https://www.dietaryguidelines.gov/ [18]

You can support wellness habits for yourself and for your care recipient…

Age and Illness

Being an older adult does not mean being ill! Aging does not cause disease nor does disease cause aging. Dizziness, confusion, forgetfulness and incontinence are not normal aging, but usually signs of a disease process. Even if someone has a disease, symptoms may be corrected or relieved

Some age-related conditions are normal and some are caused by disease processes:


Osteoporosis is a disease process causing bones to become more fragile and likely to break. The disease often progresses painlessly and the first symptoms may be a broken bone, height loss, or curvature of the spine. Any bone can be affected, but the hip and spine are frequent sites. The National Osteoporosis Foundation’s website [20] is a good resource for information on this disease.

Common risk factors for osteoporosis:
    • Greater risk with aging, which
    • Tends to cause bones to weaken and lose density

    • Four times more common in women than men
    • One in three women and one in 12 men over the age of 50

Family History and Personal History of Fractures as an Adult:
    • Women whose mothers have a history of vertebral fractures seem to have reduced bone mass
    • Personal history of a fracture as an adult

    • Caucasian and Asian women are more likely to develop osteoporosis
    • African American and Hispanic women at significant risk

Bone structure and body weight:
    • Small-boned and thin women (under 127 pounds)

    • Cigarette smoking, alcohol abuse, consuming an inadequate amount of calcium or getting little or no weight-bearing exercise
    • Medications
    • Chronic Diseases (discuss with doctors)

A Bone Mineral Density scan [21] is a safe and painless test for osteoporosis. It’s recommended for women age 65 and old and for younger women who have significant risk factors. The test is often reimbursable by Medicare or other insurance.

You can take some steps to prevent or reduce the impact of osteoporosis including having a healthy diet and getting regular weight-bearing exercise such as walking.

Discuss any possible treatments such as hormone replacement therapy or use of some of the newer drugs designed to reduce bone loss and increase bone density carefully with your doctor to be sure you fully understand risks and possible side effects of the treatment.


Arthritis is an inflammatory disease of the joints characterized by stiffness and difficulty moving joints through their full range of motion along with swelling or redness in affected areas. The website of the Arthritis Foundation is a good resource for information. Visit arthritis.org [22].

Did you know…there are over 100 different types of arthritis, including: 

Risk factors for arthritis include hormonal changes, age, gender, heredity, obesity, joint injuries and infection.

Often the symptoms of arthritis can be relieved by basic self-care practices. Treatment options include:

You should contact a doctor in these situations:

There are a wide range of assistive devices that can be helpful in living with arthritis. There also are a number of websites that provide helpful information for dealing with arthritis. Check out our blog on this topic: Tools & Gadgets (Assistive Devices) For Independent Living [23]

Hypertension (Blood Pressure above 140/90)

Elevated blood pressure may not produce obvious symptoms so can be easily missed without regular blood pressure checks. If untreated, it is related to the development of arteriosclerosis and may cause stroke, heart attack, congestive heart failure and/or kidney failure. Treatment approaches include medication, low-salt diet, exercise, stress management and weight management.

It is important to recognize signs and symptoms of a stroke since prompt treatment can make a difference in level of recovery from the stroke.

Common signs and symptoms:

Rehabilitation can include:

Lifestyle changes – post stroke:


Stroke survivors, although able to think as well as before the stroke, may experience an interference in the use or understanding of language. The individual may not get the right words out or correctly process words coming in. This condition is called aphasia. Here are some things you can do to help a person deal with aphasia:

Heart Attack  

The risk of dying from a heart attack is higher for women than men. As with men, women’s most common heart attack symptom is chest pain or discomfort. Women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.

Common signs and symptoms:

If you believe someone is having a heart attack, don’t delay – prompt treatment can help reduce the severity of the heart attack! Call 9-1-1.

Consider performing CPR if the individual stops breathing but do not attempt CPR if you are not trained [24] as internal injuries or rib and sternum fractures are common and can cause even more harm! Visit the American Heart Association to learn more about CPR. [25] 


Angina is mild to severe chest pain which may radiate to the neck or shoulders, lasting less than three minutes. It is caused by some obstruction in a major blood vessel of the heart (arteriosclerosis). Angina can be brought on by exertion, cold, eating a heavy meal or excitement. Management strategies for angina include losing weight, stopping smoking and managing stress. A nitroglycerin tablet is placed under the tongue and allowed to dissolve to treat an angina attack. This response normally works in ½ to 3 minutes.


Diabetes is caused when the body is unable to make use of sugars and starches. Glucose accumulates in the blood and may appear in the urine. According to data from the American Diabetes Association in 2018, Diabetes is expected to increase as much as 165% over the next 50 years, especially among those age 75 and older. 

Signs and symptoms of diabetes include:

Infection, surgery, or emotional/mental stress may worsen symptoms. Diabetes requires a lifelong focus on diet, lifestyle, and medical monitoring. People with diabetes should consider wearing a bracelet or necklace to alert responders to the condition.

Current treatment strategies for diabetes are evolving but may include:


Dementia is not a specific illness but a syndrome or group of symptoms which causes memory problems affecting everyday life. Dementia has a gradual onset and get progressively worse. The burden of Alzheimer’s disease and related dementias in 2014 was 5 million people, which is 1.6 percent of the U.S. population in 2014—319 million people. This burden is projected to grow to 13.9 million, nearly 3.3 percent of the population in 2060–417 million people.

An estimated 5% of people over age 65 and 20% of those over 85 have some form of dementia. Alzheimer’s disease accounts for 60% of all cases of dementia with 15-20% caused by strokes (cerebrovascular dementia) and 15-20% resulting from other neuro-psychological disorders, i.e. Parkinson’s disease and Huntington’s disease.

Alzheimer’s Disease

Alzheimer’s disease is an illness of the brain that causes nerve cells in the brain to die. It results in disrupted memory, thinking and functioning. While everyone who has Alzheimer’s disease has dementia, not everyone who has dementia has Alzheimer’s disease. The only definite diagnosis for Alzheimer’s disease is finding plaques and tangles in the brain during autopsy. There is a somewhat greater risk for people with a family history of the disease. Race or ethnicity does not seem to be a factor. To learn more, visit The Alzheimer’s Association’s website. [26]

Diagnosis of dementia or Alzheimer’s is based on a range of tests:

Here are the ten warning signs of Alzheimer’s disease:

  1. Memory loss 
  2. Difficulty performing familiar tasks
  3. Problems with language
  4. Disorientation to time and place
  5. Poor or decreased judgment
  6. Problems with abstract thinking
  7. Misplacing things
  8. Changes in mood or behavior
  9. Changes in personality
  10. Loss of initiative

There are three main stages of Alzheimer’s disease:

Mild – 

Moderate –

Severe –

Multi-Infarct Dementia

Multi-infarct dementia results from repeated strokes that destroy small areas of the brain. It can lead to dementia, Alzheimer’s disease, other strokes, migraine-like headaches and disturbances of coordination and speech. Symptoms depend on the area of the brain that is affected. Individuals may improve for short periods of time but then decline again.

With multi-infarct dementia, damage is noticeable as a series of small steps:

Multi-infarct dementia generally begins between the ages of 60 and 75 and affects men more often than women. Early treatment and blood pressure management may prevent further progression.


Depression is often misdiagnosed in older adults as dementia but is very different in that it is highly treatable. As many as 65% of older adults may experience depression. Depression is a pattern of several symptoms that occur most of the time and nearly every day for several weeks.

Symptoms may include:

Older adults may not realize or even may deny that they are depressed and often do not seek treatment. There are many possible causes of depression.

Common causes for depression in older adults:

Get help!

It is important to not assume depression is normal as people grow older, but to seek treatment. Talk to their physician about changes in how the person is feeling as well as changes in usual behavior and routines. If appropriate, ask about a referral to a mental health professional who understands older adults. Medications commonly prescribed by physicians include Serotonin Uptake Inhibitors (SSRIs): Zoloft, Paxil and other anti-depressants. Remember to ask about possible side effects. 

Most importantly: seek treatment promptly. 


Delirium is a disorder that causes confusion, disorientation, and memory loss. It differs from dementia in that it occurs suddenly. The key difference between dementia and delirium is that delirium is caused by an acute condition and is usually reversible.

Symptoms of delirium occur rapidly not over time as with dementia, and may include:

Risk increases for those who have dementia, are dehydrated, and/or are taking drugs that affect the nervous system.

Parkinson’s Disease

Parkinson’s disease is caused by degeneration or damage of nerve cells located at the top of the brain stem. Nearly one million are living with Parkinson’s disease (PD) and approximately 60,000 Americans are diagnosed with PD each year. Incidence of Parkinson’s disease increases with age, but an estimated four percent of people with PD are diagnosed before age 50.
Men are 1.5 times more likely to have Parkinson’s disease than women. There is no cure but symptoms can be treated with medication. Surgery may reduce tremors and rigidity. To learn more, visit the Parkinson’s Foundation website [27]

Here are the signs and symptoms of Parkinson’s disease:

Resources for Caregivers

Use resources such as Area Agency on Aging [28] (AAA). Types of assistance provided by AAAs:

Assistance available through AAAs for persons age 60 and older may include:

Be sure to check out our Resource Directory [29], FAQ [30], and Educational Events Calendar [31] for more great information! Permission is granted to duplicate any and all parts of this page to use in education programs supporting family members caring for elders.

While experts recommend educating yourself about the health issues of loved ones to reduce the stress of caregiving the information on this website is intended to be general in nature, and should not be considered medical advice. Contact your loved one’s doctor for help with diagnosing or treating a medical problem.

Reviewed March 2022

We hope this information is helpful to you in the important work you do as a family caregiver.
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