ADHD in Older Adults: 5 Powerful Reasons to Raise Awareness This October
Undiagnosed ADHD in older adults - October is ADHD Awareness Month
ADHD in older adults is often overlooked. October is ADHD Awareness Month, a time when we typically focus on children and young adults navigating school or work. However, there is a large, often-missed population where recognising Attention-Deficit/Hyperactivity Disorder is crucial to providing truly person-centred care: our care home residents.
For generations born before the 1980s, ADHD was rarely recognised as a condition that persisted into adulthood, and diagnosis in childhood was uncommon. As a result, research suggests that up to 90% of older adults who have ADHD symptoms were never formally diagnosed as children. Globally, it is estimated that 3-4% of older adults live with persistent, symptomatic ADHD, most of whom remain undiagnosed. 4% doesn’t sound like a high number but it equates to approximately 31 million cases of undiagnosed ADHD in older adults.
This is not a historical footnote; it is a critical blind spot in contemporary elder care.
Why Symptoms Get Missed in Older Age
In older adults, ADHD often doesn't look like the stereotypical hyperactive child. Gross hyperactivity decreases, but core symptoms manifest in ways that are easily mistaken for normal aging, anxiety, or even mild cognitive impairment (MCI).
Care staff should look beyond the obvious for these common symptoms of ADHD in care home residents:
- Pervasive Inattention: Not simply forgetting (which is common), but a lifelong pattern of poor listening, difficulty focusing during conversations, or struggling to follow multi-step instructions (e.g., getting dressed, carrying out a complex therapy routine).
- Chronic Disorganisation: Frequent misplacing of personal items (keys, glasses, hearing aids, remote controls), leading to daily frustration, agitation, and time wasted searching.
- Restlessness and Impulsivity: Fidgeting (bouncing legs, tapping hands), an inability to settle during quiet activities, impulsively interrupting staff or other residents, or exhibiting sudden, unexplained mood swings or frustration.
- Comorbidity: Undiagnosed ADHD often coexists with anxiety and depression, which can worsen behavioural symptoms and severely impact quality of life.
Adjustments for Person-Centred Care
Recognising ADHD symptoms as a neurodevelopmental trait rather than a wilful failure or simply "old age", allows staff to shift from managing "challenging behaviour" to providing supportive, person-centred care for ADHD.
Small, targeted adjustments can make a profound difference:
- Simplify Instructions: Use short, simple, and direct language. Break tasks down into one or two steps and use visual aids or written checklists instead of verbal reminders.
- Provide Outlets for Energy: Allow and encourage purposeful, safe movement (e.g., walking the corridor, gentle gardening) or provide acceptable fidget tools (stress balls, textured materials) during stationary activities like mealtimes or group sessions.
- Create Organisational Structure: Assign a specific, highly visible place for essential items (a designated hook for handbags, a bright basket for remotes). Structure the resident's day with predictable, visual schedules to reduce anxiety caused by poor time management.
- Reduce Sensory Overload: Sensitivity to noise and visual distraction can be high for people with ADHD. Offer a quiet area for activities and minimise unnecessary background noise during high-concentration tasks such as mealtimes or one-on-one activities.
By adopting curiosity and liaising with families to identify lifelong patterns of these traits, we can uncover this hidden diagnosis. When we understand the neurological root of a resident’s challenges, we can stop asking "What’s wrong with them?" and start asking the most important question in care: "What do they need from us?"
Supporting Residents with ADHD in Later Life
At Fisher Care, we recognise that ADHD in older adults can often go unnoticed. Our care teams are trained to identify subtle signs and provide the structure, reassurance, and understanding that residents need to thrive. Recognising neurodiversity in later life allows us to offer truly person-centred care for everyone who calls our homes their home
Read more about neurodiversity and how to spot the common traits that often go unnoticed ADHD provision in care
