Information for Caregivers

Social connectedness

Social connectedness is the degree to which people feel they belong and are supported and valued in their relationships with others. A lack of social contacts (or social isolation), feelings of loneliness, or feeling disconnected from others are common experiences for older adults and can lead to negative effects on their physical health and emotional wellbeing.12 People who have close, supportive relationships tend to have:2

• Longer lives
• Less stress
• Better overall physical and emotional health
• Fewer feelings of loneliness
• Greater quality of life

What does social connectedness look like?

• Meaningful relationships with others345
• Consistent, positive interactions with others345
• Supportive relationships where you feel valued and cared for5
• Emotional support during difficult times and physical support, like running errands or a ride to an appointment5

What can you do to help your loved one improve their social connectedness?

• Do things with them that they already enjoy doing, such as taking a walk or knitting
• Help them visit community areas such as parks, places of worship, and senior centers
• Help them participate in new activities and hobbies with others, such as:
  • Cooking and baking
  • Gardening
  • Group sports, like golf and pickleball
  • Outdoor adventures, like hiking and kayaking
  • Crafts, like knitting and woodworking
  • Group exercise, like water aerobics and dancing
  • Arts, like painting and ceramics
  • Book clubs
  • Card or board games
  • Faith-based activities
• Encourage them to maintain regular in-person interactions with friends and family and connect with them by phone or video calls

Keep them moving.

• Engage them in activities like walking, household chores, and errands to the store
• Modify activities as needed based on their current physical ability

Social connection resources for caregivers

• How Does Social Connectedness Affect Health?
• Social Connectedness Resources
• Connect2Tools to Overcome Social Isolation
• Reducing Loneliness & Social-Isolation Among Older Adults [7 pages]
• Loneliness | Explore Your Emotions
• Suicide Risk and Protective Factors

Preventing a fall

Falls in people age 65 and older are common and can lead to serious injury, reduced mobility and quality of life, or death.67 Fall injuries can be severe—including hip fractures and traumatic brain injury, or TBI.8 Falls can result in a permanent disability, prolonged hospitalizations, and nursing home admission.6

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Adults 65 and over are at an increased risk of falling. Older adults more likely to fall are females, those 85 and older, and American Indian and Alaska Natives.

*Percent of older adults who reported a fall in the preceding 12 months

Behavioral Risk Factors Surveillance System

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What can you do to prevent your loved ones from falling?

Speak up.

• Talk openly with your loved ones and their healthcare provider(s) about fall risks and prevention.

Keep them moving.

• Check with your loved one's healthcare provider to see if it's safe for them to participate in strength and balance exercises, such as Tai Chi.

Have their eyes and feet checked.

• Have your loved one's eyes checked by an eye doctor at least once a year and replace eyeglasses as needed.
• Have a healthcare provider check their feet once a year and discuss proper footwear.

Make their home safer.

• Help your loved one get rid of trip hazards, like throw rugs, and keep floors clutter free.
• Brighten their home with extra lighting or brighter light bulbs.
• Install grab bars in the bathroom(s)—next to the toilet and inside and outside of their bathtub or shower.
• Install handrails on both sides of staircases.

Fall prevention resources for caregivers

• Family Caregivers: Protect Your Loved Ones from Falling (English | Spanish) [2 pages]
• Older Adult Falls: A Growing Burden [4 pages]
• Medications Linked to Falls [1 page]
• Check for Safety (English | Spanish) [2 pages]
• STEADI Fall Prevention Videos
• Measuring Orthostatic Blood Pressure (English | Spanish) [1-2 pages]
• MyMobility Plan (English | Spanish | Tribal) [8 pages]
• Fall Risk Screening Tool: Falls Free CheckUp

Motor vehicle safety

As Americans live longer, there are more older adults (age 65 and older) driving longer. There were more than 50 million licensed older adult drivers in 2022.9

Driving helps keep older adults mobile and independent, but their risk of injury in a motor vehicle crash increases as they get older. More than 200,000 older adults were treated in emergency departments for crash injuries in 2021.10 This means more than 550 sustain an injury every day in motor vehicle crashes.10

What can you do to help your loved ones prevent motor vehicle crashes?

Wear seat belts.

• Encourage your loved one to always wear their seat belt as a driver and as a passenger. Seat belt use is one of the most effective ways to save lives and reduce injuries in crashes.

Drive safe.

• Encourage your loved one to only drive when conditions are safest.
• Conditions, such as poor weather, like rain or snow, and driving at night, increase the likelihood of crash injuries and deaths.

Use transportation options.

• Encourage your loved one to use a ride share service, public transportation, or offer to drive them yourself. The risk of motor vehicle crashes resulting in injuries or death increase with age.

Motor vehicle safety resources for caregivers

• MyMobility Plan (English | Spanish | Tribal) [8 pages]
• Are Your Medicines Increasing Your Risk of a Fall or Car Crash?
• Driving Safely While Aging Gracefully
• Rides in Sight

Traumatic brain injury

Traumatic brain injury, or TBI, is caused by a bump, blow, or jolt to the head, or a penetrating injury such as when an object enters the skull and harms the brain that affects how the brain works. Falls and motor vehicle crashes are two leading causes of TBI-related hospitalizations and deaths among older adults.11

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A TBI may lead to short- or long-term problems with how a person feels, thinks, acts, or sleeps. Older adults who get a TBI may face health problems that last a few days or the rest of their lives, depending on the severity of the injury.

Older adults are more likely to have a hospital stay and die from a TBI compared to other age groups.11 TBIs may also be missed or misdiagnosed because symptoms of TBI overlap with other medical conditions that are common among older adults, such as when older adults have multiple injuries.

Older adults should be checked by a healthcare provider for signs and symptoms of a TBI if they have fallen or were in a car crash.

Danger signs in adults

In rare cases, a stroke can occur as a blood clot in a vessel or a burst vessel that bleeds, limiting blood supply to the brain and affecting brain function.12 Call 9-1-1 or take the older adult in your care to an emergency department right away if they:

• Have a headache that gets worse and does not go away
• Experience weakness, numbness, decreased coordination, convulsions, or seizures
• Vomit repeatedly
• Have slurred speech or unusual behavior
• Have one pupil (the black part in the middle of the eye) larger than the other
• Cannot recognize people or places, get confused, restless, or agitated
• Lose consciousness, look very drowsy, or cannot wake up

What can you do to prevent a TBI in your loved ones?

Practice fall prevention.

• Follow the how you can prevent a fall

Increase motor vehicle safety.

• Follow the increasing motor vehicle safety

What are the signs and symptoms of TBI?

Signs and symptoms of a TBI can range from mild (such as concussion), moderate, or severe.13 Signs and symptoms of concussion or other mild TBI may be subtle. They can show up right after the injury or can take days to appear or be noticed.14 It may be easy to miss a concussion or other mild TBI because sometimes the injured person looks fine but acts or feels differently. A person with a moderate or severe TBI may need to stay in the hospital or receive ongoing care to help with their recovery.1516

After a mild TBI or concussion, they may:14

• Not recognize or admit that they are having problems
• Not understand how the symptoms they are experiencing affect their daily activities

A moderate or severe TBI may result in an extended period of unconsciousness, also called a coma, or amnesia, which means forgetting things that happened before the TBI or having trouble remembering things after the TBI.13 The effects of a TBI are different for each person and may change during recovery.13 A moderate or severe TBI may affect all aspects of their life and they may struggle with:

• Social connectedness, employment, and physical and mental health1117
• Carrying out their daily activities1516

Learn the signs and symptoms of TBI and watch for them in the older adult in your care. Seek medical attention right away if you see any of the danger signs listed above.

What should you do if you think the older adult in your care has a TBI?

Take them to get checked by their healthcare provider. Be sure to tell their healthcare provider about current medical conditions and medicines they are taking. This should include prescription and over-the-counter medicines. Blood thinners (such as anticoagulants like warfarin (Coumadin), rivaroxaban (Xarelto), and apixaban (Eliquis) and antiplatelet medications like clopidogrel (Plavix), ticagrelor (Brilinta), and acetylsalicylic acid (Aspirin)) increase the risk for bleeding in the brain after a TBI.18

Questions to ask the doctor

• When can they return to normal activities?
• Are there activities that should be avoided, such as exercise?
• When can they return to driving, if the injured person drives a car?
• What medicines should they take (or stop taking)?
• Are any other medicines allowed, such as acetaminophen (Tylenol)?
• Is alcohol allowed? If so, how much?
• What other problems, if any, should I look for?
• Is there special treatment or therapy needed, like physical therapy?
• When should we schedule a follow-up appointment?

How long is the recovery process?

How well a person recovers from a moderate or severe TBI depends on many factors such as:

• Health before the injury
• Type and severity of the TBI
• Access to healthcare and specialized TBI care
• Family and other social support13

Older adults in good health tend to have a better and faster recovery than those who are not as healthy, have medical conditions, or problems associated with aging. But remember, healing takes time. Taking time to rest right after the injury is very important, as it helps their brain heal. Ask their healthcare provider for instructions on how and when they can safely return to their normal activities and for recovery tips based on their symptoms.

TBI prevention resources for caregivers

• Mild TBI and Concussion Symptoms
• Getting Better After a Mild TBI or Concussion