Here are 12 common “nasty” or difficult habits that can emerge in old age, why they happen, and how to address them compassionately.
1. Poor Hygiene (The Most Common Issue)
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What it looks like: Refusing to bathe, shower, or change clothes regularly. Wearing the same stained outfit for days or weeks. Strong body odor or breath.
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Why it happens: It’s rarely simple laziness. Causes can include physical difficulty (fear of falling in the shower), memory loss (forgetting when they last bathed or how to do it), or depression. As we age, our sense of smell also diminishes, so they may genuinely not notice.
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The Compassionate Approach: Focus on safety and comfort, not smell. “Mom, I’m worried about you slipping in the tub. I got you a shower chair and some nice new soap—let’s make it easier and safer.” Sometimes, a simple wipe-down with a warm washcloth can be a non-threatening start.
2. Hoarding and Extreme Messiness
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What it looks like: Keeping stacks of old newspapers, rotten food, broken items, or trash. The home becomes cluttered to the point of being unsanitary or unsafe.
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Why it happens: Often linked to dementia, which impairs judgment and decision-making. It can also be a response to loss—a way of holding onto the past or filling a void.
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The Compassionate Approach: Never throw things away without permission; it can cause profound distress. Work with them, one small area at a time. Say, “Let’s look through these old magazines together and see which ones we want to keep in a special folder.” If it’s a severe safety hazard, involve an elder care professional or geriatric care manager.
3. Inappropriate Social Comments
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What it looks like: Making blunt, rude, or shockingly personal comments in public or private. “You’ve gained weight!” or “When are you going to get married?” or asking a stranger about their health.
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Why it happens: The brain’s filter (the frontal lobe) is one of the first things affected by aging and dementia. They lose the ability to inhibit thoughts before speaking.
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The Compassionate Approach: Don’t scold them. In the moment, gently redirect or apologize to others: “I’m sorry, Mom’s not feeling quite herself today.” Afterwards, focus on the environment—are they overstimulated or tired?
4. Poor Table Manners
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What it looks like: Eating with hands, making loud smacking or slurping noises, talking with a full mouth, reaching across the table, or hoarding food on their plate.
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Why it happens: This can be due to dental issues (making chewing quiet difficult), dementia (forgetting social rules), or simply a decline in fine motor skills.
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The Compassionate Approach: Offer solutions, not corrections. If they’re eating with their hands, try serving finger foods. If they’re struggling with utensils, look into adaptive ones with larger grips. Ensure they’ve seen a dentist recently.
5. Personal Space Invasion and Inappropriate Touching
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What it looks like: Standing too close, touching faces or hair, patting bottoms, or other forms of physical contact that make others uncomfortable.
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Why it happens: Can be a sign of dementia, where social boundaries dissolve. It can also be a search for comfort and human connection, expressed in an inappropriate way.
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The Compassionate Approach: Gently and physically create space. Take their hand and step back, saying kindly, “Let’s give each other a little room.” If the behavior is sexualized or persistent, it’s crucial to speak with a doctor, as it can be a side effect of certain medications or a symptom of a specific type of dementia.
6. Repetitive Storytelling and Questions
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What it looks like: Telling the same story from 50 years ago four times in one hour, or asking “What time is dinner?” every five minutes.
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Why it happens: This is a hallmark of short-term memory loss. The story from the past is vivid and real; the question they just asked is gone from their memory instantly. It’s not an attempt to annoy you.
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The Compassionate Approach: Patience is key. Don’t say, “You already told me that!” Instead, listen as if it’s the first time, or gently redirect: “That’s a great story. It reminds me of…” For repetitive questions, use visual aids (a large clock, a written schedule) to provide the answer without you having to repeat it.
7. Emotional Volatility and Anger
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What it looks like: Sudden, unprovoked outbursts of anger, paranoia, or extreme sadness. Accusing family members of stealing or plotting against them.
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Why it happens: Often a direct result of changes in the brain. Paranoia and aggression are common in dementia. It can also stem from the immense frustration of losing independence and control.
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The Compassionate Approach: Never argue with paranoia. If they accuse you of stealing, don’t try to prove your innocence. Instead, validate the feeling: “It sounds like you’re really worried about your wallet. Let’s look for it together.” Remove yourself from the situation if you feel unsafe, and always discuss these changes with their doctor.
8. Incontinence and “Accidents”
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What it looks like: Urine smell on clothes or furniture, or visible soiling. Making excuses to avoid going out.
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Why it happens: Physical changes, medication side effects, or simply not being able to get to the bathroom quickly enough. This is a medical issue, not a character flaw.
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The Compassionate Approach: This is one of the hardest things for an elderly person to accept. Approach it purely as a health and logistics problem. “I’ve noticed you’re having a hard time making it to the bathroom. Let’s talk to the doctor about it—there are so many things that can help these days, like different exercises or products that can give you peace of mind.” Frame it as a way to help them stay active and social.
9. Driving Unsafely
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What it looks like: New dents in the car, getting lost on familiar routes, confusion at intersections, or driving too slowly or too fast.
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Why it happens: Loss of vision, slower reaction times, and cognitive decline make driving dangerous.
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The Compassionate Approach: This is about safety, not punishment. Have a direct but loving conversation, focusing on your fear for them and others. “Dad, I love you, and I’m really worried about your safety when you drive. It’s not about your age, it’s about how much traffic has changed.” Offer alternatives: “I’d love to drive you to your poker game every week—it’ll be our special time.” If they refuse, you may need to involve their doctor, who can order a driving evaluation.
10. Unwillingness to Accept Help
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What it looks like: Refusing a walker, declining Meals on Wheels, or resisting a caregiver. Insisting they can do everything themselves, even when it’s clear they can’t.
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Why it happens: Accepting help feels like admitting defeat and losing the last shred of independence. It’s terrifying.
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The Compassionate Approach: Frame help as a tool for independence, not a replacement for it. “This walker isn’t to slow you down—it’s to make sure you’re safe and strong enough to keep going to your garden club.” Give them choices: “Would you rather have help with cleaning or with cooking?” A sense of control is vital.
11. Negative or Bitter Attitude
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What it looks like: Constantly complaining, criticizing everyone and everything, and never having a kind word to say.
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Why it happens: Chronic pain, unaddressed grief from a lifetime of losses, and the frustration of a shrinking world can manifest as bitterness.
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The Compassionate Approach: Acknowledge the pain behind the words. “It sounds like you’re having a really tough day.” Sometimes, simply being heard can soften the edges. Encourage small pleasures and connection, but protect your own mental health by limiting your exposure if it becomes too draining.
12. Extreme Frugality or Miserly Behavior
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What it looks like: Reusing tea bags a dozen times, hoarding scraps of foil, turning off the heat in winter, or refusing to spend money on necessary items like new shoes or healthy food, even when they have plenty of savings.
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Why it happens: Can be a lifelong habit intensified by age, or a symptom of dementia (like Frontotemporal dementia) or anxiety about outliving their money.
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The Compassionate Approach: Don’t try to force them to spend. Work around it. Buy the new slippers and frame them as “an early gift.” Pay for the home repairs yourself if you can. If the behavior is new and extreme, it’s worth mentioning to their doctor as it can be an early sign of cognitive issues.
The most important thing to remember is that these behaviors are almost always symptoms of underlying challenges—physical, cognitive, or emotional. Addressing them with shame or anger will only build a wall. Addressing them with empathy, practical solutions, and professional help can preserve the relationship and ensure their safety and dignity.