Attention Deficit Disorder in the Elderly

Yep, you read that right.

You’re probably thinking

“Attention Deficit Disorder in the elderly? I thought only children were diagnosed with that”

You are right in your thinking.

Until recently, Attention Deficit Disorder (ADD) was widely thought to be a disease that only presented itself in early childhood, but ADD in the elderly is becoming an increasingly common occurrence.

As caretakers, learning how to deal with the symptoms of ADD is a major step in improving the lives of those who have it.

Diagnosing Attention Deficit Disorder in the Elderly

Before you can learn about diagnosing ADD in the elderly and how to deal with its symptoms, we must first describe what ADD is and discuss some of its symptoms.

What is ADD?

ADD is a brain disorder that is primarily marked by continuous patterns of hyperactivity, impulsiveness, and inattention. It also affects the person’s function and development.

A person with ADD might present with one or more of the following symptoms:

•  – They are continuously overlooking details or making careless mistakes
•  – They are seemingly inattentive when being spoken to
•  – It is easy for them to lose focus or get sidetracked
•  – They have consistent problems with keeping organized
•  – They are always misplacing or losing things
•  – They get easily distracted by things that are irrelevant to their primary task
•  – They are seemingly absent-minded or forgetful
•  – They have an inability to sit still for long periods of time

Diagnosing ADD

Before someone can be diagnosed with ADD, two things must happen.

First, the patient must be thoroughly evaluated by a psychologist or psychiatrist who specializes in ADD.

Second, that psychologist or psychiatrist must determine that the patient’s symptoms are that of ADD or merely symptoms of another medical condition.

And herein lies the biggest problem with diagnosing ADD in the elderly.

It is not an easy task because many of the previously mentioned symptoms overlap with various other disorders commonly found in older people.

Symptoms such as forgetting easily, having problems staying focused, losing things, and getting distracted easily can also be present in dementia, Alzheimer’s, strokes, and traumatic brain injuries.

The other problem with diagnosing ADD in the elderly is that a lot of the tests, scales, and measures used were originally designed for children. One example is The Diagnostic and Statistical Manual of Mental Disorders (DSM). Because it was intended to be used to diagnose children, there are some limitations when you are using it to diagnose an adult. You can find some of these limitations described below:

• – The hyperactive symptoms accompanying ADD may not be developmentally appropriate for adults.
• – If adults had symptoms as children, it would be hard for them to recall them and no siblings or parents may be available to give the information.
• – Measuring people’s impairments is more difficult when observing adults because their lives are more complicated than that of children.

While tests, scales, measures, interviews, and observations can efficiently collect the information necessary to reach an ADD diagnosis, you should use none of them exclusively.

Dementia & Alzheimer’s vs. ADD: How to Tell the Difference

So how do you tell the difference between dementia, Alzheimer’s and ADD? The two disorders may have some similar symptoms, but the easiest way to differentiate between the two is through the mechanics of both disorders.

Forgetting easily, for example, is a common symptom of both dementia and ADD. The memory problems that come with dementia have more to do with recognition memory. People who have it have trouble recalling or recognizing things.

On the other hand, the memory problems that come with ADD have to do with short-term memory.

It becomes overloaded with information and cannot filter out unnecessary information.

This overload causes a very small amount of the information to make it to long-term memory.

Dementia and Alzheimer’s are both disorders that cause mild cognitive impairment (MCI). The symptoms of patients with MCI gradually continue to get worse, while the symptoms of patients with ADD do not typically get worse.

With these differences, the best way for you to distinguish between the two to come to the right diagnosis is to conduct lengthy observations of the patient.

These observations will tell you whether the symptoms are getting worse or staying the same. Of course, you should also consider the patient’s medical and family history before making an official diagnosis.

ADD Treatment Options in the Elderly

Treating ADD in the elderly is not an easy task because factors such as health and age must be considered.

The most conventional treatments for ADD are stimulant medications and non-stimulant medications.

However, the problem with using these drugs to treat ADD in the elderly is that they can cause high blood pressure, tachycardia, or other cardiac problems.

These side-effects can cause serious problems for those who already have hypertension or other heart problems.

That is why you must take great care when you are determining which treatment to give to an older adult with ADD. As stated before, you must take his or her entire medical background into consideration when determining the best treatment.

Health and age aren’t the only things that make treating ADD in the elderly difficult, however.

Another thing is that many seniors have other disorders for which they are already taking medication. These medications might not mix well with the ADD medication, which could make it dangerous for them to take it.

However, just because medications may not be the right course of treatment for some elderly patients with ADD does not mean that there is not a treatment that is right for them.

In the case that a patient can’t take the medications, there are other approved treatments you should know about. We discuss some of them in more detail below.

Psychosocial Therapy

In psychosocial therapy, patients are encouraged to address the specific problem or problems that they face.

This treatment often includes psycho-education, which teaches patients several key things, such as:

•  – How ADD affects their lives
•  – How to recognize the symptoms of ADD
•  – How to handle the disorder

Cognitive-Behavioral Therapy

This type of therapy’s primary purpose is to encourage the patient to self-mediate to develop self-control. You can prescribe them to individual therapy or group therapy.

In this instance, group therapy works well because the patient gets a chance to meet others like him/her who have gone through similar problems.

Family Counseling

Family counseling is ideal for those patients who have spouses or other family members.

The primary goal of family counseling is to help the patient and his/her family learn that everyone has a role in dealing with the disorder. When you help family members understand how to address the disease, you assist them in figuring out how to rebuild broken relationships.

Understanding how ADD affects those who have it is just as important to them as it is to you.

Many of these alternative treatments are only effective if you, the patient, and the patient’s family all understand that many of the behaviors the patient displays are not his or her fault.

Dealing with ADD Symptoms

Understanding the effects of ADD on an elderly patient is only part of the treatment process.

While counseling, therapy, and medications may work, there is still the process of dealing with the symptoms. You can help the elderly manage their ADD symptoms in some of the same ways that they are managed for kids. Below, we have given you some suggestions. 

Follow a Daily Routine

Make sure they follow the same schedule every day, from sun-up to sun-down. Following the same schedule every day will give their day structure and will help prevent them from becoming overwhelmed.

Keep Everything Organized

Making sure that there is a place for everything will help prevent them from losing or misplacing things. All you have to do is encourage them to place an item in the same spot every time they put it down.

Limit The Number of Choices They Have

People with ADD often become overwhelmed by their surroundings because their brains are incapable of filtering out the unimportant things. When you limit the number of options that they have to choose from to only a couple, you are helping prevent them from becoming overwhelmed.

Simplify Long Instructions

People with ADD cannot focus on one thing for extended periods of time because of all the stimulus coming into their brains. When you break down longer instructions into shorter steps, it will help limit stress. For longer tasks, you should allow periodic breaks, which will also contribute to alleviating stress.

Keep Up A Healthy Lifestyle

Getting exercise, eating well, and getting adequate sleep are important lifestyle habits for anyone to get into. But when you encourage someone with ADD to do all of these, it can help prevent his or her ADD symptoms from getting worse.

What’s It All Mean?

Diagnosing ADD in the elderly is not an easy task because there are a lot of factors involved. Once the diagnosis is made, however, dealing with the disorder is not that difficult. Understanding ADD and how it affects the patient is the first step to coping with the disease.