Stress is an inevitable part of day-to-day life; however, managing it effectively is important for good health. To coincide with National Stress Awareness Day, we’ve written an article on stress management techniques for older adults.

Stress in Older Adults:

Stress in later life can be due to multiple factors such as: financial worries, bereavement, health problems, caring for others, loss of independence, social isolation and a decline in cognitive and functional abilities (1). Individuals respond differently to stressors—some continue to lead a fulfilling life despite what life throws at them, whilst others succumb to stress and may find themselves encountering health issues and mental health problems (2, 3). Elderly people are most vulnerable to stress compared with other age groups due to stressors relating to declining health and dwindling social relationships (4).

Symptoms of Stress:

Stress can affect people in different ways. People may experience physical symptoms or changes in their emotions and behaviours.

Physical symptoms may include (2, 3):

• Nausea
• Headaches
• Rapid breathing
• Increased susceptibility to infections
• Raised blood pressure
• Gastrointestinal conditions, e.g. IBS

Emotional changes may include (3):

• Feeling angry, fearful, sad or frustrated
• Developing mental health problems such as depression
• Low mood or apathy
• Being tearful

Behavioural changes may include (3):

• Poor sleep (4)
• Changes in appetite and eating habits (5)
• Increased reliance on drugs, alcohol or tobacco (6)
• Altered relationships with friends and family

How Does Stress Affect the Body?

There are two different types of stress; acute and chronic stress. Acute stress (also known as short-term stress) results from specific events or situations such as an argument or car breakdown. Your body releases stress hormones, which triggers the “fight or flight response”. You might find your heart and breathing rate increases—this is normal, and is designed to protect the body in an emergency situation where a quick response is required (7). Once the situation is resolved, the stress usually disappears. 

In contrast, chronic stress occurs in response to long-term exposure to stressors (e.g. during chronic illness or following the death of a loved one). If our stress response is constantly activated, our bodies remain in the “fight or flight” mode. Overexposure to stress hormones disrupts the body’s normal processes, making us more prone to infections and other health problems such as cardiovascular disease and mental health problems (8). The good news is that stress management can help to lower these stress hormones and has been associated with better physical and mental health in older adults.

Stress Management in Older Adults:

The following suggestions are effective and evidence-based ways to manage stress in older people.

Try Mindfulness

Mindfulness is a simple form of meditation. It allows thoughts and sensations to focus on the present moment, rather than focusing on the past or future. Practicing mindfulness stimulates the parasympathetic nervous system which helps induce a relaxation response. It can prevent us from becoming overwhelmed and is known to be a powerful tool for stress management in middle-aged and older adults (9). Listening to relaxing music, observing nature whilst out walking and colouring are examples of mindful activities.

Talk To Someone

Talking therapies such as counselling, psychology and Cognitive Behavioural Therapy (CBT) offer a safe, confidential and neutral space for people to explore thoughts, feelings and behaviours through clinically proven strategies and techniques. CBT has been shown to reduce worries and anxiety, and has been shown to be effective in mood disorders (e.g. depression) in the elderly (10). Older people wishing to access free talking therapies in England can self-refer themselves to local services using this link here.

Meditate

Meditation is a technique where an individual observes thoughts and feelings without judgement. It’s a mental exercise that provides clarity, enhances self-awareness and relieves stress and anxiety. It can be particularly effective for people with limited physical ability (11), and in those with Alzheimer’s and their caregivers (12). Research on the impact of meditation on the ageing brain is scarce, however, it’s thought to have a positive effect on cognition, especially on attention and memory (13). For beginners, listening to a guided meditation via YouTube, audio tapes or apps (such as Headspace or Calm) could be helpful. There’s more information for older people on mediation here.

Practice Breathing Exercises

Also known as “diaphragmatic breathing” or “belly breathing,” breathing exercises are a great way of dealing with stressful situations. It can be done alone, with a physio, or as part of a yoga or tai chi session. The most basic type of diaphragmatic breathing is done by inhaling through the nose (noticing the belly rising) and exhaling out through the mouth. When performed correctly, breathing exercises have been shown to help lower cortisol (a stress hormone) levels (14).

Engage in Physical Activity

Engaging in regular physical exercise has been shown to lower fatigue and cortisol levels in Japanese community-dwelling older adults (60+) (15). Encourage older people to find a form of physical exercise which they enjoy such as walking, water aerobics or golf. The UK government recommends that older adults participate in 150 minutes of moderate exercise per week—this equates to around 30 minutes of exercise five days per week.

Get a Pet Companion

Having a pet as a companion can help those experiencing mental health problems (16). It also helps to alleviate feelings of loneliness, increases social engagement and provides a source of consolation to older people during bereavements (17). Interestingly, a small study in 70 residents living in dementia units found that having an aquarium in the communal dining area increased daily food intake by 25% and resulted in a small average weight gain of 2.2 pounds during the 10-week study (18).

If the practical and emotional burden of having a pet is too much, you could encourage friends and family to bring their pets to visit elderly relatives. Older people may worry about what will happen to their pets should they to move into residential care or become unwell. The Cinnamon Trust provides dog walkers and short-term foster parents when elderly pet owners are unwell, whilst some nursing and care homes allow residents to bring their own pets or have communal pets. You can locate pet-friendly care homes here, and if you’d like to arrange pet therapy for an organisation, check out Pets As Therapy, which provides a visiting service in hospitals, hospices, nursing and care homes.

Join a Community Choir

The saying that singing is good for the soul certainly sings some truth! A case-control study of over 100 older adult singers found that participating in a community choir led to higher ratings of physical quality of life, overall quality of life and satisfaction with health compared to those who did not actively engage in hobbies (19). Other studies have shown that singing helps to lower cortisol levels, improves mood and has beneficial effects on immunity (20).