Beyond Sleep: Overlooked Causes of Fatigue in Older Adults

Overlooked causes of fatigue in seniors Though my grandfather passed away over a decade ago, I still think of him often. We used to watch films together late at night in his living room; he was always a night owl. As he grew older, fatigued kicked in, and he’d often sleep through the whole day, waking up at about 5pm only to be back asleep by midnight. I know he found the constant fatigue really frustrating, and possibly even felt a little embarrassed about sleeping so much. Fortunately, investigating the underlying causes of the problem—especially those that may be lesser known—can offer new insight, clarity, and hope for aging adults suffering from fatigue.

Symptoms and Signs of Fatigue in Older Adults

Constantly feeling tired and low on energy can create harmful side effects for your aging loved one: as a result of dealing with ongoing fatigue, many older adults experience depression, mood swings, and anger. Fatigue in older adults can be inherently tricky to understand—some people assume fatigue is just a natural part of growing old, but many times there is a specific cause that is being overlooked. Exploring what might be behind your loved one’s fatigue is essential to help them feel better. Signs of fatigue can include:

  • Complaints of tiredness
  • Sleeping too many hours overnight
  • Napping throughout the day
  • Mood swings
  • Angry outbursts
  • Depression
  • A lack of motivation

The Common Causes of Fatigue

If your loved one seems angry, depressed, or irritable for no reason, it could be coming from fatigue. You may notice them sleeping more than ever, while never feeling fully rested. In addition to hormonal changes and imbalances that can accompany the aging process, there are a variety of common causes of fatigue in older adults that caregivers can be on the lookout for.

Cancer, for example, can cause fatigue for many reasons, including difficult treatments, weight loss, and damage to the body. In fact, countless medications, in general, list fatigue as a side effect. If your loved one is taking meds that cause fatigue, they might be able to switch to a different drug. And, of course, any type of sleep disorder—such as sleep apnea—can cause fatigue. Your loved one can get tested at a sleep clinic to find out whether they suffer from something like this.

Lesser-Known Causes of Fatigue

At the same time, there are many overlooked and lesser-known causes of fatigue in older adults. Physical health issues like anemia, dehydration, hypercalcemia, thyroid, as well as mental and emotional stresses, might be playing a role in your loved one’s fatigue. Exploring these lesser-known causes might bring you closer to finding a solution.

  • Hypercalcemia disorders: When older adults have high blood calcium, it can cause mood swings, fatigue, and exhaustion. High blood calcium levels are usually caused by a problem with the parathyroid glands. This can be easily tested for and treated. Less common causes include a high intake of Vitamin D and certain medications.
  • Chronic Fatigue Syndrome: CFS is still difficult for doctors to diagnose, largely because of the lack of information on this mysterious illness. While there’s no official lab test for it, your loved one might have it if they have unexplained fatigue for at least 4 months, in addition to some other telltale signs.
  • Depression and emotional stress: Fatigue can also hit older adults going through a difficult event in their life, such as a death or family stress. Whether your loved one is dealing with the loss of a spouse, experiencing the grieving process, or struggling with family conflict, emotional stress can have a big impact on their level of fatigue. In any of these cases, holistic approaches such as therapy and mindfulness practices can be really helpful.
  • Anemia: Caused by a lack of red blood cells in the body, anemia can render your loved one drained and tired 24/7. Anemia might be fueled by a lack of iron in your loved one’s diet, a B12 vitamin deficiency, or a chronic disease that stops red blood cells from being produced. The illness can generally be tested for and treated with dietary changes, vitamins, and meds.
  • Thyroid problems: If your loved one has been experiencing weight gain and hair loss in addition to ongoing fatigue, their thyroid could be to blame. A geriatric assessment or quick trip to the clinic will be able to test and treat any thyroid issues.
  • Long-term pain: Unfortunately for long-term pain sufferers, fatigue is one of the side effects. It can be incredibly tiring to be in chronic pain. Therapy, support groups, and pain management tools can help your loved one with this difficult problem.
  • Dehydration: This is a classic cause of fatigue that frequently also results in anger and mood swings. Some older adults can experience a reduced thirst response, kidney problems, or medication that affects how much water they retain. As a general rule, encourage your loved one to drink even when they’re not thirsty and eat water-rich foods like fruit and soups. Keeping a water bottle near the bed and next to them throughout the day can also help.

Holistic Approaches to Reducing Fatigue

When your aging loved one’s fatigue has a relatively straightforward treatment (as in, say, anemia), medical treatments are often available to help solve the problem. But fatigue is frequently at least somewhat influenced by your loved one’s psychological state and overall well-being. In these cases, there are a number of holistic approaches that can prove helpful.

  • Cognitive Behavioral Therapy (CBT)
    CBT is a type of talk therapy that uses a structured system that encourages rational thinking, and can be done in a one-on-one setting or group environment. It typically involves a person writing down their thoughts, working through them, and repeating the process. Therapy that uses CBT (or similar techniques) can help your loved one to work through any mental and emotional issues that are either being caused by the fatigue or are causing it in the first place. For fatigue sufferers that are also dealing with anxiety, anger, or depression, this therapeutic remedy may be the ideal fit.
  • Regular exercise
    Likewise, exercise is often recommended for older adults struggling with fatigue. Regular exercise has been shown to have similar effects to talk therapy in terms of reducing stress, anxiety, and depression. Whether it’s walking, swimming, or doing gentle martial arts like Tai Chi, exercising can be a healthy, non-pharmacological way to treat the symptoms of fatigue.
  • Mindfulness practices
    Holistic approaches such as mindfulness practice, meditation, and yoga can also help older adults suffering from fatigue. Regardless of what the underlying cause is, creating a daily routine based around mindfulness and living in the moment can raise your loved one’s spirits and improve their outlook. Making healthy choices like drinking lots of water, eating regular meals, and going to bed at a regular time each day is equally impactful when it comes to reducing fatigue (as well as its effects).

It’s never too late to help your aging loved one combat tiredness—and all of its uncomfortable symptoms—by uncovering the root cause, seeking medical help, and implementing some of these holistic approaches. When your aging loved one feels more rested, they’ll be able to enjoy life that much more.

If you’re unsure how to best support your aging loved one, Institute on Aging can help with our array of compassion-based services, programs, and resources. Get in touch with us today to learn more.


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